Hospital-acquired (HAP) & Ventilator-associated pneumonia (VAP)

Hospital-acquired (HAP) & Ventilator-associated pneumonia (VAP)

Clinical Key Points

When culture susceptibilities available: change to PATHOGEN-DIRECTED therapy

Consider DISCONTINUING empiric therapy if lower respiratory tract cultures negative at 48 to 72hr and clinical improvement

  • Prior IV antibiotics within 90 days
  • Recent antibiotic use within 30 days
  • Prolonged hospital stay (5 days or more)
  • Septic shock
  • ARDS
  • Acute renal replacement therapy prior to VAP onset

Consider IV to PO step down if:

  • Afebrile x 24 to 48 hr
  • GI tract functioning
  • Hemodynamically stable, and
  • Clinical improvement while on IV treatment