Adult Outpatient Previously Healthy

First-line therapeutic options for treating previously healthy adults include use of a macrolide (erythromycin, clarithromycin) or an azalide (azithromycin) or doxycyc-line28 If a patient has failed therapy with a macrolide, azalide, or doxycycline, one has to consider why the patient failed. The most common reasons are either medication adherence issues or the presence of resistant organisms. If a resistant organism is suspected then use of one of the fluoroquinolones active against S. pneumoniae (gemi-floxacin, levofloxacin, or moxifloxacin) is warranted.

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