Hosam Mohamed-
resistant >=2 classes of ABs
MDR=
-
zosyn, cefepime, levofloxacin, imipenem, meropenem
What are the treatments when mortality risk is low + NO
factors increasing MRSA? (5) *Hospital Acquired
-
add vancomycin or linezolid
What are the treatments when mortality risk is low, but MRSA factors ARE
present? (2) *Hospital Acquired
-
zosyn, cefepime, levofloxacin, imipenem, meropenem, aztreonam, AG's, + vancomycin or linezolid
What are the treatments when the mortality risk is HIGH? (9)
*Hospital Acquired
-
risk factors for resistance, MRSA>10-20%, gm (-) resistance > 10% to any monotherapy, unknown unit susceptibilities
When do we use triple therapy? (4)
-
2 gm (-) + 1 MRSA agent
What is the coverage of triple therapy?
-
Ventilator- acquired ; IV ABs in prior 90 days
Triple therapy is reserved for __________ pneumonia or _________.
-
Beta-lactams + FQs or AG's or Polymyxin; + Linezolid or Vancomycin
What are the treatment options for VAP?
-
amikacin, tobramycin, gentamicin
Which AGs can we use in HAP/VAP? (3)
-
2 agents from same class; 2 agents w same MOA
When using combination therapy, what are NOT good options? (2)
-
a
Which is dosed 1-3x a day?
a) aminoglycosides
b) FQ's
-
a
Which is IV only?
a) aminoglycosides
b) FQ's
-
b
Which covers more resistant CAP organisms?
a) aminoglycosides
b) FQ's
-
5 days; 7 days
What is the minimum treatment duration for CA & HA/VA respectively?
