Template:Pneumonia Antibiotics: Difference between revisions

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**[[Doxycycline]] 100mg PO BID x 7-10 days OR
**[[Doxycycline]] 100mg PO BID x 7-10 days OR
**[[Clarithromycin]] 500mg PO BID x 7-10 days
**[[Clarithromycin]] 500mg PO BID x 7-10 days


===Inpatient===
===Inpatient===

Revision as of 05:56, 6 May 2015

Outpatient, community-acquired PNA

Coverage targeted at S. pneumoniae, H. influenzae. M. pneumoniae, C. pneumoniae, and Legionella

Healthy

Unhealthy

Chronic heart, lung, liver, or renal disease; DM, alcholism, malignancy.

Inpatient

  • Monotherapy or combination therapy is acceptable. Combination therapy includes a cephalosporin and macrolide targeting atypicals and Strep Pneumonia [1]

Community Acquired (Non-ICU)

Coverage against community acquired organisms plus M. catarrhalis, Klebsiella, S. aureus


Health Care-associated PNA

  1. 3-drug regimen recommended
    1. (Cefepime 1-2gm q8-12h OR ceftazidime 2gm q8h) + cipro 400mg q8h + vanco 15mg/kg q12 OR
    2. Imipenem 500mg q6hr + cipro 400mg q8hr + vanco 15mg/kg q12 OR
    3. Piperacillin-Tazobactam 4.5gm q6h + cipro 400mg q8h + vanco 15mg/kg q12

ICU, low risk of pseudomonas

  1. Ceftriaxone 1gm IV and Azithromycin 500mg IV OR
  2. Ceftriaxone 1gm IV and (moxifloxacin 400mg IV or levofloxacin 750mg IV)
  3. Penicillin allergy
    1. (Moxifloxacin or levofloxacin) + (aztreonam 1-2gm IV or clindamycin 600mg IV)

ICU, risk of pseudomonas

  1. Cefipime, Imipenem, OR Piperacillin/Tazobactam + IV cipro/levo
  2. Cefipime, imipenem, OR piperacillin-tazobactam + gent + azithromycin
  3. Cefipime, imipenem, OR piperacillin-tazobactam + gent + cipro/levo
  1. Chokshi R, Restrepo MI, Weeratunge N, Frei CR, Anzueto A, Mortensen EM. Monotherapy versus combination antibiotic therapy for patients with bacteremic Streptococcus pneumoniae community-acquired pneumonia. Eur J Clin Microbiol Infect Dis. Jul 2007;26(7):447-51