12th January 2024

A 64-year-old woman is on the Respiratory Ward being treated for community-acquired pneumonia.

A 64-year-old woman is on the Respiratory Ward being treated for community-acquired pneumonia. She initially improved and was stepped down to oral amoxicillin and clarithromycin three days ago; however, today, her fever has returned. A chest X-ray shows evidence of a moderate right-sided pleural effusion, and a pleural aspirate from this has a pH of 7.12. Which of the following is the most important next step in the management of this patient?

Select the SINGLE most appropriate option from the list below. Select ONE option only.