Nosocomial Pneumoniae Treatment

Question 1

Drugs from the 1st group

Answer 1

Cefepime 2g q8h OR Ceftazidime 2gm q8h OR Imipenem 1gm q8h OR Meropenem 1gm q8h OR Piperacillin/Tazobactam 4.5mg q8h

Question 2

Drugs from the 2nd group

Answer 2

Ciprofloxacin 400mg q8h OR Levofloxacin 750mg q24h OR Amikacin 20mg/kg/qd OR Gentamicin 7mg/kg/qd OR Tobramycin 7mg/kg/day

Question 3

Drugs from 3rd group

Answer 3

Vanco 15mg/kg q12h OR Linezolid 600mg q12h

Question 4

How long should you treat IV?

Answer 4

8 days

Question 5

When would you add vanco or linezolid?

Answer 5

If you suspect MRSA

Question 6

What organisms are you providing double coverage for?

Answer 6

Pseudomonas, Klebsiella, Acinetobacter

Question 7

What do you need to add if you suspect Legionella?

Answer 7

Macrolide (Azithromycin, erythromycin, chlarithromycin) good for atypical coverage. bind irreversibly to 50S subunit

Question 8

Beta lactams

Answer 8

Imipenem, ertapenem, meropenem

Question 9

Side effects of vanco

Answer 9

“red man syndrome” from histamine release when given rapidly, phlebitis, ototoxicity and nephrotoxicity high levels or given with other toxic drugs

Question 10

Aminoglycosides

Answer 10

Gentamicin, tobramycin, amikacin, neomycin, streptomycin. Cidal-bind 30s subunit irreversibly. Preg cat D/C, nephrotoxic, ototoxic