Hospital-acquired
- Anaerobes may be more significant in witnessed aspiration and/or recent abdominal surgery.
Usual Pathogens
Polymicrobial:
S. aureus
Enterobacteriaceae
Pseudomonas spp
Oral anaerobes
Occasionally:
H. influenzae
S. pneumoniae
≤ 4 days hospitalization
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Amoxicillin-clavulanate | 40mg/kg/d PO div tid | 7-14 days |
| or | ||
| [Ceftriaxone | 100mg/kg IV q24h | |
| + | ||
| Metronidazole IV/PO] | 30mg/kg/d IV div q12h/15-30mg/kg/d PO div bid | |
| or | ||
| [Clindamycin | 20-40 mg/kg/d IV div q8h | |
| + | ||
| Gentamicin] | 7mg/kg IV q24h |
> 4 days hospitalization
| Empiric Therapy | Duration | |
|---|---|---|
| [Piperacillin-tazobactam | 240-300mg piperacillin/kg/d IV div q6-8h | |
| or | ||
| Imipenem] | 100mg/kg/d IV div q6h | |
| +/- | ||
| Tobramycin | 7mg/kg IV q24h | 5 days |