For pts meeting dx criteria¹ who are ≤65 yo, no abx in 30 days, not hospitalized in 5 days, no comorbidities, not immunocompromised, local <i>S. pneumo</i> PCN-resistance ≤10%:

¹ Dx: URI w/ 1) Persistent nonimproving s/sx ≥10 days; or 2) Severe sx: Temp ≥39°C and purulent nasal d/c or face pain for 3-4 days at onset; or 3) Worsening s/sx including new fever/HA/nasal d/c increase following typical 5-6 days URI that initially improved (double-sickening). [S/L-M]<br><br>² Broaden coverage/switch to different abx class if pt worsens after 48-72 h or fails to improve after 3-5 days. [S/M]

<br><br>³ Not recommended: oral cephalosporins as empiric mono-tx [W/M], macrolides, TMP/SMX. [S/M]