Q: What is the recommended antibiotics for community acquired pneumonia (CAP) for patients admitted in ICU?
Answer:
According to IDSA/ATS guidelines, for patients with severe CAP requiring ICU admission,
A beta-lactam (ceftriaxone, cefotaxime, ampicillin-sulbactam) plus either intravenous azithromycin or an antipneumococcal fluoroquinolone.
If Pseudomonas is a concern, an antipseudomonal agent (piperacillin-tazobactam, imipenem, meropenem, or cefepime) PLUS an antipseudomonal fluoroquinolone (ciprofloxacin or high-dose levofloxacin).
If MRSA is a concern, either vancomycin or linezolid should be added.
Reference:
Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. - Clin Infect Dis. 2007;44 Suppl 2:S27.
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