6th May 2024

A 72-year-old man, hospitalised for stroke rehabilitation, develops a fever of 38.6°C, increased cough with purulent sputum, and new onset shortness of breath.

A 72-year-old man, hospitalised for stroke rehabilitation, develops a fever of 38.6°C, increased cough with purulent sputum, and new onset shortness of breath. His medical history includes chronic obstructive pulmonary disease (COPD) and type 2 diabetes. A chest X-ray reveals new infiltrates in the right lower lobe. Blood tests show elevated white cell count. The patient is diagnosed with hospital-acquired pneumonia (HAP).

Which of the following is the most appropriate initial management?