Which first-line oral treatment is suitable for a healthy woman with community-acquired pneumonia and a penicillin allergy?

Doxycycline is a suitable first-line oral treatment for community-acquired pneumonia in a healthy woman with a penicillin allergy. This antibiotic is part of the tetracycline class and is effective against common pathogens associated with community-acquired pneumonia, such as Streptococcus pneumoniae and atypical organisms like Mycoplasma pneumoniae and Chlamydia pneumoniae.

In cases of community-acquired pneumonia, it's essential to choose an antibiotic that covers the typical bacteria involved. Doxycycline not only provides this coverage but is also well-tolerated and has an advantageous dosing schedule, which is beneficial for patient compliance.

The presence of a penicillin allergy limits the use of beta-lactams like amoxicillin-clavulanate or cefpodoxime, making doxycycline a favorable option. Additionally, while clarithromycin is effective, it would require the addition of a beta-lactam to cover for Streptococcus pneumoniae, which is unnecessary when doxycycline alone suffices. Moxifloxacin is a broader-spectrum fluoroquinolone that could be used, but it is generally reserved for cases where first-line treatments are ineffective or where there are specific patient factors that necessitate its use, such as comorbidities or concerns