Pneumonia (Ventilator Associated - VAP)

Pneumonia (VAP)

(Mild to moderate infection AND multi-drug resistance unlikely):

Ceftriaxone 1-2 grams IV q24h OR
Ampicillin-sulbactam (Unasyn) 3.0 grams ivpb q6h OR
Levofloxacin 750 mg IV/PO once daily OR
Ertapenem 1 gm IV q24h

PLUS (If MRSA suspected)
Vancomycin - (patient-specific regimen - trough goal 15-20 mcg/ml)

(Severe infection OR multi-drug resistance LIKELY):

Cefepime 2 grams IV every 12 hours OR
Piperacillin-tazobactam 4.5 grams IV Q6H OR
Meropenem 1 gm IV q8h

PLUS
Vancomycin - (patient-specific regimen - trough goal 15-20 mcg/ml)

PLUS
Ciprofloxacin 400mg IV q8h OR
Levofloxacin 750 mg IV/PO once daily OR
Aminoglycoside (Tobra) - patient-specific regimen.