PANCE Infectious Disease Practice Test

Which single-agent regimen is acceptable for CAP in patients with significant comorbidities?

Amoxicillin-clavulanate plus macrolide Levofloxacin monotherapy Amoxicillin alone Doxycycline alone

Correct Answer:

Levofloxacin monotherapy

Explanation:

In CAP for patients with significant comorbidities, you want a single agent that can cover both typical bacteria and atypical pathogens. Levofloxacin has broad activity against Streptococcus pneumoniae (including penicillin-resistant strains), Haemophilus influenzae, Moraxella, and atypicals such as Mycoplasma, Chlamydophila, and Legionella, so it provides comprehensive coverage without needing a second drug. Amoxicillin alone misses atypicals, and amoxicillin-clavulanate plus a macrolide involves two agents; doxycycline alone may be less reliable against resistant pneumococcus and isn’t the preferred sole therapy in more ill patients.

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