A -year-old man is evaluated in the hospital on the third day of his admission for community-acquired pneumonia. He initially presented with a two-day history of high fever, productive cough, and right-sided pleuritic chest pain. On admission, his temperature was (), blood pressure was , pulse was , and respirations were . Chest radiography showed a right lower lobe consolidation. He was subsequently started on empiric intravenous levofloxacin.
Today, the patient reports feeling significantly better. He has been afebrile for the past , and his cough has improved. Current vital signs are temperature (), blood pressure , pulse , and respirations . He is tolerating a regular diet.
Blood cultures drawn on admission are now positive for Streptococcus pneumoniae. Susceptibility testing of the isolate demonstrates the following:
| Antimicrobial | Interpretation |
|---|---|
| Penicillin | Susceptible |
| Amoxicillin | Susceptible |
| Ceftriaxone | Susceptible |
| Levofloxacin | Susceptible |
| Azithromycin | Resistant |
Which of the following is the most appropriate next step in pharmacotherapy?
- AContinue intravenous levofloxacin for a total of 5 days
- BTransition to oral amoxicillin-clavulanate
- Transition to oral amoxicillinAnswer
- DTransition to oral cefdinir
- ETransition to oral levofloxacin