Respiratory Infections
Severe

Severe

Microbiology

Empiric Treatment

AND

CONSIDER ADDING

Add if MRSA risk factors (see clinical considerations below)

  • Vancomycin dosing recommendations are based on 70kg patient with normal renal function; (recommended dose 15-20 mg/kg/dose unless otherwise stated)
  • Please contact pharmacy for patients requiring vancomycin or aminoglycoside monitoring

Second Line Treatment

CONSIDER ADDING

Add if MRSA risk factors (see clinical considerations below)

  • Vancomycin dosing recommendations are based on 70kg patient with normal renal function; (recommended dose 15-20 mg/kg/dose unless otherwise stated)
  • Please contact pharmacy for patients requiring vancomycin or aminoglycoside monitoring

Duration of Therapy

Signs of CAP-associated instability:

  • Systolic blood pressure ≤90 mmHg
  • Heart rate ≥100/min
  • SaO2 ≤90% or pO2 ≤60 mmHg on room air
  • Respiratory rate ≥24/min
  • Altered mental status
  • Cannot tolerate oral intake

Clinical Considerations

  • Colonization with MRSA
  • Injection drug user
  • History of substance abuse
  • Homeless in the last year
  • From crowded living conditions

Piperacillin/tazobactam should not be used empirically as it is unnecessarily broad and may have decreased in vitro activity vs S. pneumoniae compared to ceftriaxone