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Guidelines
Hospital-acquired Pneumonia

Hospital-acquired Pneumonia

Consults

Respirology, ID and/or relevant subspecialty team(s) if required

Clinical Considerations

Before starting antimicrobial therapy, take blood/urine/CSF and/or other relevant samples for culture wherever possible.

Consider the need for dose adjustments (e.g. renal impairment) and age-related contraindications for antimicrobials.

First Choice

Cefotaxime
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Cefotaxime may be interchanged with ceftriaxone for children over 30 days old and not on calcium-containing parenteral products (e.g. TPN)

OR

+/-

Vancomycin
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  • As anti-MRSA agent (current local MRSA rates are available via the hospital antibiogram)
  • Please be cautious when using Vancomycin and Piperacillin-Tazobactam together due to the risk of renal toxicity

Penicillin Allergy

Cefotaxime
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Cefotaxime may be interchanged with ceftriaxone for children over 30 days old and not on calcium-containing parenteral products (e.g. TPN)

+/-

+/-

Review Daily

Adjust treatment according to microbiologic results as soon as they become available.

Additional Information

The following factors have been associated with MRSA in previous studies:

  • Previous known MRSA infection in child or a significant contact (e.g. family member)
  • Family member is a healthcare worker
  • First nations child or Pacific Island origin (e.g. Samoan)
  • Day care attendance
  • Prolonged hospitalization in the last 1 year
  • Antibiotic therapy in the last 2 months
  • Critically ill
  • Chronic skin condition (e.g. atopic eczema)