Pneumonia in Adults with Underlying Medical Conditions or >65 Years of Age

Medicine Treatment 

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J18.0-2/J18.8-9

A chest X-ray should ideally be taken in all patients to confirm the diagnosis. Send one sputum specimen for TB DNA PCR (Xpert® MTB/RIF)to exclude pulmonary tuberculosis.

Common underlying conditions include:

• Diabetes mellitus
• HIV infection
• Cardiac failure
• COPD
• Alcoholism
• Chronic liver disease
• Chronic kidney disease

Most of these patients will require referral to a doctor.

MEDICINE TREATMENT

Mild pneumonia:

• Amoxicillin/ clavulanic acid 875/125 mg, oral, 12 hourly for 5 days

Severe Penicillin allergy: 
Z88.0

• Moxifloxacin, oral, 400 mg daily for 5 days

A follow-up chest X-ray should ideally be taken to ensure resolution of the pneumonia, in patients >50 years of age.

LoE:IIIb³⁶

Click here to access the pdf.

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Standard Treatment Guidelines and Essential Medicines List for South Africa, Primary Healthcare, 2020-4-Version 1.0_16 September 2024

Chapter 17: Respiratory Conditions_17.3. Respiratory infections_17.3.4. Pneumonia_17.3.4.2. Pneumonia in Adults_17.3.4.2.2. Pneumonia in Adults with Underlying Medical Conditions or > 65 Years of Age