Pick Your Poison: Legionella Pneumonia
A Legionella urine antigen returns positive in a patient on empiric ceftriaxone (CRO) and azithromycin for community-acquired pneumonia. How should antibiotics be adjusted?
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Best Answer
Stop ceftriaxone, continue azithromycin
Explanation: Legionella is a common causative pathogen of community-acquired pneumonia (CAP) and is covered by recommended empiric antibiotics such as azithromycin, levofloxacin, and doxycycline. Guidelines prefer azithromycin or levofloxacin over doxycycline. Preference of azithromycin over levofloxacin can preserve Pseudomonas spp activity and provide a favorable safety profile.