●Combination therapy with ceftriaxone (1 to 2 g intravenously [IV] daily), cefotaxime (1 to 2 g IV every eight hours), ceftaroline (600 mg IV every 12 hours), ertapenem (1 g IV daily), or ampicillin-sulbactam (1.5 to 3 g IV every six hours) plus a macrolide (azithromycin [500 mg IV or orally daily] or clarithromycin [500 mg twice daily] or clarithromycin XL [two 500 mg tablets once daily]). Doxycycline (100 mg orally or IV twice daily) may be used as an alternative to a macrolide. Oral therapy with a macrolide or doxycycline is appropriate only for selected patients without evidence of or risk factors for severe pneumonia.
●Monotherapy with a respiratory fluoroquinolone given IV or orally (levofloxacin 750 mg daily or moxifloxacin 400 mg daily).
●Monotherapy with tigecycline should be limited to patients intolerant of beta-lactams and fluoroquinolones since it has been associated with increased mortality [45-47]. (See 'Tigecycline' below.)