Family Nurse Practitioner Exam

According to the American Thoracic Society, what is the first-line antibiotic for community-acquired pneumonia in patients under 60 without comorbidities?

1. First-generation cephalosporins

2. Second-generation cephalosporins

3. Macrolides

4. Beta-lactam antibiotics

The correct answer is: Macrolides

The first-line antibiotic for community-acquired pneumonia in patients under 60 without comorbidities is a macrolide, typically azithromycin or clarithromycin. Macrolides are preferred due to their effectiveness against common pathogens that cause pneumonia, such as Streptococcus pneumoniae and atypical organisms like Mycoplasma pneumoniae and Chlamydophila pneumoniae. In patients without significant health issues or recent antibiotic exposure, macrolides provide a targeted approach that minimizes resistance and ensures effective treatment of the most common respiratory pathogens. They also offer advantages in terms of patient adherence due to their dosing schedules. In contrast to the other options, using cephalosporins (either first- or second-generation) might be reserved for more complex cases or when there are specific indications, such as concern for resistant organisms or in patients with comorbidities. Beta-lactam antibiotics may be used in combination regimens or in patients with underlying health conditions. Thus, the selection of macrolides as first-line therapy aligns with current guidelines promoting effective and appropriate treatment strategies for uncomplicated community-acquired pneumonia.