Hap Flashcards
Risk factors for increased mortality:
S
Risk factor for MDR Pseudomonas, other gram-negative bacilli, and MRSA:
L
Risk factors for MDR Pseudomonas and other gram-negative bacilli:
L
Risk factor for MRSA
D
Ventilatory support for HAP
F
Septic shock
E
IV antibiotics within the past 90 days
R
Structural lung disease (bronchiectasis or cystic fibrosis)
D
A respiratory specimen Gram stain with numerous and predominant gram-
negative bacilli
R
Colonization with OR prior isolation of MDR Pseudomonas or other gram-negative
D
Risk factors for MRSA:
R
Treatment in a unit in which >20 percent of S. aureus isolates associated with HAP
are methicillin resistant
R
Treatment in a unit in which the prevalence of MRSA is not known
R
Colonization with OR prior isolation of MRSA
G
No MDR risk factors or increased risk of mortality—
D
Risk factors for MDR gram-negative bacilli and MRSA or for increased mortality
D
should receive one agent that has activity against Pseudomonas and MSSA.
D
Piperacillin-tazobactam
R
Cefepime
R
Levofloxacin
R
imipenem and meropenem as options,
R
two agents with activity against P. aeruginosa and other gram-negative bacilli and one agent with activity against MRSA.
E
Amikacin
D
Gentamicin
D
Tobramycin
R
have poor lung penetration, increased risk of nephrotoxicity and ototoxicity, and poorer clinical response rates compared with other antibiotic classes,
R
are not recommended as monotherapy for gram-negative infections
D
Linezolid
D
Vancomycin
D
Tedizolid
R
Telavancin
F
receive two agents with activity against P. aeruginosa; the regimen should also have activity against MSSA.
D
receive one agent with activity against P. aeruginosa and other gram-negative bacilli and one agent with activity against MRSA.
K
because they are more likely to have activity against gram-negative bacilli
than the fluoroquinolones or aztreonam.
O
DURATION
K
for seven days,
K
Other potential toxicities of antibiotics used for HAP and VAP include the following:
K
cannot be used to treat pneumonia because it is inactivated by surfactant and does not achieve adequate concentrations in the respiratory tract.
D
It has been approved by the FDA for community-acquired pneumonia (CAP) but not for CAP caused by MRSA, nor for HAP or VAP.
D
Ceftaroline
D
has been approved by the FDA for skin and skin structure infections and intra-abdominal infections caused by MRSA.
D
has also been approved for CAP but not for CAP caused by MRSA or for HAP or VAP.
D
Tigecycline
D
Ceftobiprole
E
It has not been approved by the FDA, but it has been approved in Europe and Canada for treatment of HAP and CAP but not VAP.
D
