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Guidelines
Pathogens
Antimicrobials
Our hospital's MRSA prevalence of S. aureas isolates is >10-20%, so MRSA coverage should be included
Double cover for P. aeruginosa if patient has any of:
Ventilatroy support
Septic Shock
IV antibiotics within 90 days
Structural lung disease
There is an abundance of GNB on gram stain
Common Pathogens
Cefepime 2 g IV every 8 hr
OR
Zosyn 3.375 gm IV every 8 hr (4 hr infusion)
PLUS
Vancomycin
CONSIDER ADDING
Tobramycin IV 5mg/kg/day⁽¹⁾
⁽¹⁾ If double coverage for P. aeruginosa is recommended
Levofloxacin 750 mg IV every 24 hr⁽¹⁾⁽²⁾
⁽¹⁾ If double coverage for P. aeruginosa is recommended ⁽²⁾ If Legionella suspected.
Aztreonam 2 g IV every 8 hr
7 days is recommended versus a longer course, independent of microbial etiology.
