Treatment recommendations change markedly when dealing with CAP patients requiring hospitalization. In this situation the European Respiratory Society (or ERS) recommends a b-lactam plus b-lactamase inhibitor, second- or third-generation cephalosporin, benzylpenicillin, amoxicillin with or without a macrolide or respiratory fluoroquinolone. Canadian recommendations are for a fluoroquinolone as their preferred option or a second-fourth-generation cephalosporin in combination with a macrolide.