Guidelines
ICU Admission

ICU Admission

PTS Who Should Receive Expanded Coverage Against MRSA/P. aeruginosa

Non-severe: Withhold broadened coverage and expand if isolated by culture

Severe (septic shock with need for vasopressors or mechanical ventilation): Expand coverage for MRSA/P. aeruginosa

  • Blood and sputum cultures should be ordered
  • De-escalate antibiotics to ‘standard CAP’ therapy if MRSA/P. aeruginosa not isolated in 48-72 hours
  • Negative MRSA nasal surveillance cultures can be used to de-escalate anti-MRSA therapy

Expand coverage to pathogen previously isolated

  • Blood and sputum cultures should be ordered
  • De-escalate antibiotics to ‘standard CAP’ therapy if MRSA/P. aeruginosa not isolated in 48-72 hours
  • Negative MRSA nasal surveillance cultures can be used to de-escalate anti-MRSA therapy

Empiric Treatment (No Risk for MRSA or Pseudomonas)

Cephalosporin Allergy (No Risk for MRSA or Pseudomonas)

Associated w/ higher risk of C. difficile

WITH or WITHOUT

Empiric Treatment WITH Risk for MRSA or Pseudomonas

Clinical Considerations

Switch to oral/enteral therapy as soon as patient is clinically improving and able to tolerate oral medications