Spectrum: Local Antimicrobial Stewardship, for Fraser Health

Hospital Acquired Pneumonia

Likely Pathogens

Site/unit dependent

Variable resistance patterns

S. aureus

H. influenza

Enterobacter

P. aeruginosa

Empiric Antibiotic Options

Cefotaxime 33 to 67 mg/kg IV Q8H

OR

Piperacillin-tazobactam 75 mg/kg (piperacillin component) IV Q6H

+/-

Vancomycin 20 mg/kg IV Q6H

Penicillin Allergy*

Cefotaxime 33 to 67 mg/kg IV Q8H

+/-

Vancomycin 20 mg/kg IV Q6H

+/-

Gentamicin 2.5 mg/kg IV Q8H

*Avoid all beta-lactams antibiotics (ie cephalosporins, carbapenems) if anaphylaxis to penicillin

NOTE

Cefotaxime may be interchanged with ceftriaxone for pediatric patients if not receiving calcium containing IV products.

Ceftriaxone 80 to 100 mg/kg IV Q24H*

*For severe infections