Late onset, prior broad spectrum antibiotics, structural lung disease, immunosuppression
- Tailor antibiotics to C&S results.
Usual Pathogens
Enterobacteriaceae
P. aeruginosa
Acinetobacter spp
S. aureus/MRSA
| Empiric Therapy | Duration | |
|---|---|---|
| [Piperacillin-tazobactam | 240-300mg piperacillin/kg/d IV div q6-8h | 7-14 days |
| or | ||
| Imipenem | 100mg/kg/d IV div q6h | |
| or | ||
| Meropenem] | 120mg/kg/d IV div q8h | |
| +/- | ||
| Tobramycin | 7mg/kg IV q24h | 5 days |
If MRSA suspected, add:
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Vancomycin | 60mg/kg/d IV div q6h | Minimum 14 days for confirmed MRSA |
| or | ||
| Linezolid | < 5 years old: 30mg/kg/d IV/PO div q8h | Minimum 14 days for confirmed MRSA |
| > 5 years old: 20mg/kg/d IV/PO div q12h |