What is the first-line therapy for pneumonia in a 55-year-old woman with productive cough and shaking chills?

The first-line therapy for pneumonia in a 55-year-old woman with productive cough and shaking chills is azithromycin. Azithromycin is a macrolide antibiotic that is effective against common pathogens associated with community-acquired pneumonia, particularly when patients present with typical symptoms such as a productive cough and fever.

In adults, especially those who are previously healthy, azithromycin helps cover the most frequent bacterial causes of pneumonia, including Streptococcus pneumoniae and atypical pathogens like Mycoplasma pneumoniae. Its favorable pharmacokinetics, including good lung penetration and the ability to maintain therapeutic levels, make it a suitable choice for outpatient management of pneumonia.

Other treatment options, while powerful and effective for more severe infections or specific resistant organisms, are generally reserved for cases that require hospitalization or are at risk for multi-drug resistant organisms. For instance, enoxaparin is primarily used for anticoagulation and does not target bacterial pathogens. Cefepime is a broad-spectrum cephalosporin suitable for health care-associated pneumonia or severe cases, but it is not first-line in uncomplicated community-acquired pneumonia. Vancomycin and meropenem are reserved for serious infections with resistant organisms, particularly in healthcare-associated pneumonia scenarios or certain