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Do you routinely discontinue atypical coverage in community-acquired pneumonia when PCR testing (i.e., respiratory pathogen panel) is negative for atypical organisms?

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How often do you use negative PCR testing to de-escalate atypical coverage in community-acquired pneumonia?

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2 Answers
Mednet Member
Mednet MemberInvited Expert
Hospital Medicine · Emory University Hospital
Answered on · Updated on

In community-acquired pneumonia (CAP), here is how I approach the decision to discontinue atypical coverage (e.g., azithromycin or doxycycline) when respiratory pathogen panel PCR testing is negative for atypical organisms (most commonly, Mycoplasma pneumoniae, Chlamydia pneumoniae, Legionella pneum...

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Mednet Member
Mednet Member
Hospital Medicine · Conemaugh Memorial Medical Center
Answered on

There isn't much guidance or evidence on early discontinuation of atypical coverage.

  • Respiratory panel PCR cost - $250
  • Azithromycin 500 mg po x3 days - $15

I found that this is not cost-effective and don't routinely use PCR for discontinuation of atypical coverage.

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