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The American Thoracic Society and Infectious Diseases Society of America's (ATS/IDSA) most recent guideline on treating hospitalized patients with community-acquired pneumonia (CAP) recommends combination therapy with a β-lactam plus a macrolide or monotherapy with a respiratory fluoroquinolone (NEJM JW Gen Med Dec 1 2019 and Am J Respir Crit Care Med 2019; 200:e45). Substituting doxycycline for a macrolide also is an option in some clinical settings (e.g., prolonged PR interval). Empirical coverage for Staphylococcus aureus or Pseudomonas aeruginosa is recommended for patients with risk factors or history of these pathogens.
In a retrospective study of 23,500 patients from 19 Canadian hospitals, researchers assessed whether mortality differ…