Spectrum: Local Antimicrobial Stewardship, for Fraser Health

Oral Step-Down & Duration

Positive Microbiology Results

See Pathogen-Directed Therapy for Pneumonia

Negative Microbiology Results

In the absence of positive microbiology, recommended step-down:

Amoxicillin-clavulanate 875-125 mg one tab PO BID

OR

If severe penicillin/cephalosporin allergy:

Moxifloxacin 400 mg PO q24h

Duration

7 days sufficient for the vast majority of HAP, including Pseudomonas

For HAP due to S. aureus

Without S. aureus bacteremia: 7 days

With S. aureus bacteremia: Minimum 14 days (ID Consult recommended)

If diagnosis of HAP was questionable and patient quickly improves, consider stopping therapy after 3 days