VAP and HAP

Question 1

Episodes of pneumonia NOT associated w/ mechanical ventilation

Answer 1

HAP

Question 2

The greatest difference b/w VAP and HAP

Answer 2

Return to dependence on expectorated sputum for a microbiologic diagnosis of VAP which is further complicated by frequent colonization by pathogens in patients w/ HAP

Question 3

3 FACTORS WHICH ARE CRITICAL IN THE PATHOGENESIS OF VAP:

Answer 3

colonization of the oropharynx with pathogenic microorganisms

aspiration of these organisms from the oropharynx into the lower respiratory tract

compromise of the normal host defense mechanisms

Question 4

NO Risk Factors for Resistant Gram (-) Pathogen

Answer 4

PIPERACILLIN TAZOBACTAM 4.5 g IV q6h

CEFEPIME 2 g IV q8h

LEVOFLOXACIN 750 mg IV q24h

Question 5

NO Risk Factors for Resistant Gram (-) Pathogen

Answer 5

PIPERACILLIN TAZOBACTAM 4.5 g IV q6h

CEFEPIME 2 g IV q8h

LEVOFLOXACIN 750 mg IV q24h

Question 6

Risk Factors for Resistant Gram (-) Pathogen

Answer 6

CHOOSE ONE FROM EACH COLUMN

PIPERACILLLIN-TAZOBACTAM 4.5 g IV q6h
CEFEPIME 2 g IV q8h
CEFTAZIDIME 2 g IV q8h
IMIPENEM 500 mg IV q6h
MEROPENEM 1 g IV q8h

AMIKACIN 15-20 mg/kg IV q24h
GENTAMICIN 5-7 mg/kg IV q24h
TOBRAMYCIN 5-7 mg/kg IV q24h
CIPROFLOXACIN 400 mg IV q8h
LEVOFLOXACIN 750 mg IV q24h
COLISTIN (loading dose of 5 mg/kg IV followed by maintenance doses of 2.5 mg IV q12h
POLYMYXIN B 2.5-3.0 mg/kg per day IV in 2 divided doses

Question 7

Risk Factors for MRSA

Answer 7

Add to above

LINEZOLID 600 mg IV q12h
OR
adjusted dose VANCOMYCIN (trough level 15-20 mg/dL)