Know When to Expand Empiric Treatment for HAP/VAP

We’re getting questions about how to empirically treat hospital-acquired (HAP) and ventilator-associated pneumonia (VAP).

Generally start with a single broad-spectrum agent (cefepime, etc) to cover Pseudomonas and methicillin-sensitive Staph aureus.

Use high doses, such as cefepime 2 g IV every 8 hours...or extended infusions, such as piperacillin/tazobactam 3.375 g to 4.5 g IV every 8 hours, with each dose infused over 4 hours.

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