Empirical Antibiotic Treatment of Hospital-Acquired and Ventilator-Associated Pneumonia | ||
| NO RISK FACTORS FOR RESISTANT GRAM-NEGATIVE PATHOGEN | RISK FACTORS FOR RESISTANT GRAM-NEGATIVE PATHOGENa (CHOOSE ONE FROM EACH COLUMN) | |
|---|---|---|
Piperacillin-tazobactam (4.5 g IV q6hb ) Cefepime (2 g IV q8h) Levofloxacin (750 mg IV q24h) | Piperacillin-tazobactam (4.5 g IV q6hb ) Cefepime (2 g IV q8h) Ceftazidime (2 g IV q8h) Meropenem (1 g IV q8h) | Amikacin (15-20 mg/kg IV q24h) Gentamicin (5-7 mg/kg IV q24h) Tobramycin (5-7 mg/kg IV q24h) Ciprofloxacin (400 mg IV q8h) Levofloxacin (750 mg IV q24h) Colistin (loading dose of 5 mg/kg IV followed by maintenance doses of 2.5 mg × [1.5 × CrCl + 30] IV q12h) Polymyxin B (2.5-3.0 mg/kg per day IV in 2 divided doses) |
| Risk factors for MRSAb (add to above) | ||
Linezolid (600 mg IV q12h) or Adjusted-dose vancomycin (trough level, 15-20 mg/dL) | ||
a Prior antibiotic therapy, prior hospitalization, local antibiogram.
b Prior antibiotic therapy, prior hospitalization, known MRSA colonization, chronic hemodialysis, local documented MRSA pneumonia rate >10% (or local rate unknown).
Abbreviations: CrCl, creatinine clearance rate; MRSA, methicillin-resistant Staphylococcus aureus.