HAP Empiric Treatment

Treatment Options

Non-ICU:

Ceftriaxone 1g q24h

  • PO step-down:  amoxicillin/clavulanate 875mg q12h

Duration:  7 days

Non-ICU with Risk Factors for Multi-drug Resistant (MDR) pathogens:

Risk factors for MDR pathogens include:

  • recent previous culture positive for MDR organism
  • recent antimicrobial treatment
  • recent admission to ICU

If MRSA suspected –> add vancomycin

If P. aeruginosa suspected –> start empiric monotherapy Piperacillin-tazobactam 4.5g IV q8h infused over 4 hours

 

Clinical Pearls

  • Switch to PO regimen as soon as clinically appropriate.
  • Respiratory fluoroquinolones (i.e. moxifloxacin) should be avoided due to side effects and increased risk of developing C. difficile Associated Diarrhea.  Use only if patient has severe allergic reaction to beta-lactams.

 

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