Spectrum: Local Antimicrobial Stewardship, for Providence Health Care

Not Critically Ill

Duration of Therapy

Based on response to therapy

Suggested Regimen

Piperacillin/Tazobactam 3.375g IV Q6H

AND

Vancomycin loading dose 25 mg/kg IV then maintenance dose of 15 mg/kg Q12H (refer to clinical pharmacist to adjust the dose)

View vancomycin nomogram

Oral Stepdown

Based on culture results