Gram negative risk factors:

  • bronchiectasis

  • immunosuppression

Empiric Therapy Dose Duration
Piperacillin-tazobactam 4.5g IV q6h 7-10 days
+    
Azithromycin 500mg IV/PO daily 3 days
+/-    
Vancomycin 25-30mg/kg IV once then 15mg/kg IV q8-12h 7-10 days

Penicillin allergy

Empiric Therapy Dose Duration
Ciprofloxacin 400mg IV q12h/500-750mg PO bid 7-10 days
+    
Vancomycin 25-30mg/kg IV once then 15mg/kg IV q8-12h