Specific Therapy for Pneumonia

Pneumococcal Pneumonia:

-Ceftriaxone (Rocephin) 2 gm IV q12h OR -Cefotaxime (Claforan) 2 gm IV q6h OR -Erythromycin 500 mg IV q6h OR -Vancomycin 1 gm IV q12h if drug resistance. Staphylococcus aureus Pneumonia: -Nafcillin 2 gm IV q4h OR -Oxacillin 2 gm IV q4h.

Klebsiella pneumoniae Pneumonia:

-Gentamicin 1.5-2 mg/kg IV, then 1.0-1.5 mg/kg IV q8h or 7 mg/kg in 50 mL

of D5W over 60 min IV q24h AND Ceftizoxime (Cefizox) 1-2 gm IV q8h OR Cefotaxime (Claforan) 1-2 gm IV q6h. Methicillin-resistant staphylococcus aureus:

-Vancomycin 1 gm IV q12h. Haemophilus influenzae:

-Ampicillin 1-2 gm IV q6h (beta-lactamase negative) OR -Ampicillin/sulbactam (Unasyn) 1.5-3.0 gm q6h OR -Cefuroxime (Zinacef) 1.5 gm IV q8h (beta-lactamase pos) OR

-Ceftizoxime (Cefizox) 1-2 gm IV q8h OR -Ciprofloxacin (Cipro) 400 mg IV q12h OR -Ofloxacin (Floxin) 400 mg IV q12h. -Levofloxacin (Levaquin) 500 mg IV q24h. Pseudomonas aeruginosa: -Tobramycin 1.5-2.0 mg/kg IV, then 1.5-2.0 mg/kg IV q8h or 7 mg/kg in 50 mL

of D5W over 60 min IV q24h AND EITHER Piperacillin, Ticarcillin, Mezlocillin or Azlocillin 3 gm IV q4h OR Ceftazidime 1-2 gm IV q8h. Mycoplasma pneumoniae: -Clarithromycin (Biaxin) 500 mg PO bid OR

-Azithromycin (Zithromax) 500 mg PO x 1, then 250 mg PO qd for 4 days OR -Erythromycin 500 mg PO or IV q6h OR -Doxycycline (Vibramycin) 100 mg PO/IV q12h OR -Levofloxacin (Levaquin) 500 mg PO/IV q24h. Legionella pneumoniae:

-Erythromycin 1.0 gm IV q6h OR -Levofloxacin (Levaquin) 500 mg PO/IV q24h.

-Rifampin 600 mg PO qd may be added to erythromycin or levofloxacin. Moraxella catarrhalis:

-Trimethoprim/sulfamethoxazole (Bactrim, Septra) one DS tab PO bid or 10

mL IV q12h OR -Ampicillin/sulbactam (Unasyn) 1.5-3 gm IV q6h OR -Cefuroxime (Zinacef) 0.75-1.5 gm IV q8h OR -Erythromycin 500 mg IV q6h OR -Levofloxacin (Levaquin) 500 mg PO/IV q24h.

Anaerobic Pneumonia:

-Penicillin G 2 MU IV q4h OR -Clindamycin (Cleocin) 900 mg IV q8h OR -Metronidazole (Flagyl) 500 mg IV q8h.

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