Patient handout

Community-Acquired Pneumonia

PRODUCTION

1. Your condition

This handout is for community-acquired pneumonia. Your care team identified this based on: cough + fever ± dyspnea ± pleuritic chest pain (2025 ats cap §diagnosis).

Other reasons your team may use this plan: new infiltrate on cxr / consolidation on lung ultrasound — imaging confirmation required (2025 ats cap §imaging); tachypnea + tachycardia + temperature derangement → screen cap-sepsis (sepsis-3; ssc 2026); leukocytosis with bandemia ± elevated procalcitonin/crp — supports but does not establish bacterial cap (self chest 2016 pmid 27107491).

2. Your medications

Take these medications exactly as prescribed. Do not stop or change a dose without talking to your provider.

Medication	Starting dose	How	When	What it does
amoxicillin	1 g PO TID	PO	q8h × 5 days (3-5 d acceptable if afebrile ≥48 h and stable per 2025 ATS)	2025 ATS / 2019 ATS-IDSA — first-line outpatient when no comorbidity; high dose covers drug-resistant S. pneumoniae (DRSP). RxCUI 723 RxNav-verified IN 2026-05-16
doxycycline	100 mg PO BID	PO	q12h × 5 days	Atypical + S. pneumoniae coverage; preferred first-line alternative — macrolide-resistance hedge. Avoid in pregnancy. RxCUI 3640 RxNav-verified IN 2026-05-16
azithromycin	500 mg PO ×1 then 250 mg PO daily	PO	daily × 5 days total	Use ONLY where local pneumococcal macrolide resistance <25% (2025 ATS / 2019 ATS-IDSA). QTc check. RxCUI 18631 RxNav-verified IN 2026-05-16

Plan: 2025 ATS empirical + targeted antibiotic ladder (outpatient → ward → ICU/severe)

3. When to call your provider

Contact your care team if any of the following happen:

oxygen level (SpO₂) <92% on room air → ED (2025 ATS CAP)
CURB-65 ≥2 / PSI ≥III → ED (Lim Thorax 2003 PMID 12728155)
Failure of oral therapy at 48-72 h → ED (2025 ATS CAP)
Hemoptysis or pleuritic pain with hemodynamic instability → ED (2025 ATS CAP)

4. When to seek emergency care

Call 911 or go to the nearest emergency room right away if you have:

CURB-65 ≥3 (any of confusion, urea >7 mmol/L ≈ BUN >19 mg/dL, RR ≥30, SBP <90 / DBP ≤60, age ≥65 — total ≥3) — predicted 30-d mortality ~22% (3 ~17%, 4-5 ~41-57%)
IDSA severe CAP: ≥1 MAJOR (septic shock needing vasopressors OR respiratory failure needing mechanical ventilation) OR ≥3 MINOR (RR ≥30, P/F ≤250, multilobar infiltrates, AMS, BUN ≥20 mg/dL, WBC <4×10⁹/L, plt <100×10⁹/L, T <36°C, hypotension needing aggressive fluids)(life-threatening)
CAP meeting Sepsis-3 with vasopressor-dependent hypotension / lactate ≥4 — CAP+sepsis co-existence(life-threatening)
Prior MRSA respiratory isolation, necrotising/cavitary pneumonia, post-influenza secondary pneumonia with gram-positive cocci, recent IV antibiotics + hospitalisation — with locally validated MRSA prevalence
Structural lung disease (bronchiectasis, severe COPD), recent IV antibiotics in 90 d + hospitalisation, prior Pseudomonas respiratory isolation
Parapneumonic effusion >1 cm on decubitus / CT OR loculation OR pleural pH <7.20 OR positive pleural Gram/culture
Significant immunocompromise (transplant, neutropenia, HIV/low CD4, biologics, high-dose chronic steroid) with pneumonia

5. Follow-up

Confirm total duration (stop when ≥5 d AND afebrile ≥48 h AND ≤1 instability sign; 3-5 d low-risk); pneumococcal (PCV20 or PCV15+PPSV23) + influenza + COVID vaccination; smoking cessation; follow-up CXR at ~6 weeks if smoker / age ≥50 (occult malignancy); return precautions; routine repeat imaging NOT required if clinically resolved (2025 ATS CAP; ACIP 2025)

6. Sources

Guideline: 2025/26 ATS "Diagnosis and Management of Community-acquired Pneumonia: An Official ATS Clinical Practice Guideline" (Jones BE, Ramirez JA, Oren E, Soni NJ, et al.; Am J Respir Crit Care Med 2026;212(1):24-44; PMID 40679934; DOI 10.1164/rccm.202507-1692ST; ATS-approved, NOT IDSA-endorsed; updates 4 questions: lung-US, viral-positive empirics, <5-day duration, corticosteroids by severity) + foundational 2019 ATS/IDSA CAP Guideline (Metlay JP, AJRCCM 2019;200(7):e45-e67; PMID 31573350) + CAPE COD severe-CAP hydrocortisone + Surviving Sepsis Campaign 2026