Recommended treatment options for patients with severe community-acquired pneumonia (C4)
| No risk factors for P. aeruginosa |
| Nonantipseudomonal cephalosporin III + macrolide or |
| Nonantipseudomonal cephalosporin III + (moxifloxacin or |
| Levofloxacin) |
| Risk factors for P. aeruginosa |
| (Anti-pseudomonal cephalosporin or |
| Acylureidopenicillin/β-lactamase inhibitor or |
| Carbapenem) + ciprofloxacin# |
P. aeruginosa: Pseudomonas aeruginosa. #: evidence in favour of combination therapy for P. aeruginosa remains inconclusive. Aminoglycoside therapy is associated with increased toxicity and monotherapy often leads to the development of resistance against that antibiotic. Therefore, combination therapy with a β-lactam plus a fluoroquinolone is advocated.