Antibiotic Guide for Ventilator-associated Pneumonia

Pneumonia developing after at least 48 hours of mechanical ventilation. For patients who develop pneumonia within the first 48 hours please refer to HAP or CAP guidelines as appropriate.

Samples to be taken prior to starting antibiotics:

• Take samples:
  • Tracheal aspirate +/- broncheolar lavage for culture ( If BAL, contact microbiology and ask for an urgent Gram stain).
  • Blood cultures.
  • Serum and urine for pneumococcal and legionella testing if atypical features
  • Sputum or throat swab for viral culture and immunofluorescence if immunocompromised patient or features suggestive of influenza infection during the influenza season.

Antibiotic treatment:

• Community admission, ventilated less than 2 days - please refer to CAP guidelines

• Inpatient admission, ventilated less than 2 days -  please refer to HAP guidelines

• Community admission, ventilated  2-4 days.

• Inpatient admission, ventilated 2-4 days

• Ventilated > 4 days

Notes

• Antibiotic treatment should be reviewed at 48 hours when microbiology results become available

Page last edited: 27/01/2009

Caution; the antibiotic doses recommended on this website are intended for adult patients with normal renal and liver function unless otherwise stated. Dosing advice for patients with renal impairment is available here.

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