American Thoracic Society Quick-Reference GUIDELINES Apps
Issue link: https://eguideline.guidelinecentral.com/i/769839
6 Treatment Optimization Î For patients with HAP/VAP, ATS and IDSA suggest that antibiotic dosing be determined using Pharmacokinetic/Pharmacodynamic (PK/PD) data, rather than the manufacturer's prescribing information (W-VL). Inhaled Antibiotic Î For patients with VAP due to Gram-negative bacilli that are susceptible to only aminoglycosides or polymyxins (colistin or polymyxin B), ATS and IDSA suggest both inhaled and systemic antibiotics, rather than systemic antibiotics alone (W-VL). Pathogen-Specific Therapy Î ATS and IDSA recommend that MRSA HAP/VAP be treated with either vancomycin or linezolid rather than other antibiotics or antibiotic combinations (S-M). Î For patients with HAP/VAP due to P. aeruginosa, ATS and IDSA recommend that the choice of an antibiotic for definitive (not empiric) therapy be based upon the results of antimicrobial susceptibility testing (S-L). Î For patients with HAP/VAP due to P. aeruginosa, ATS and IDSA recommend against aminoglycoside monotherapy (S-VL). Î For patients with HAP/VAP due to P. aeruginosa who are not in septic shock or at a high risk for death, and for whom the results of antibiotic susceptibility testing are known, ATS and IDSA recommend monotherapy using an antibiotic to which the isolate is susceptible rather than combination therapy (S-L). Î For patients with HAP/VAP due to P. aeruginosa who remain in septic shock or at a high risk for death when the results of antibiotic susceptibility testing are known, ATS and IDSA suggest combination therapy using 2 antibiotics to which the isolate is susceptible rather than monotherapy (W-VL). Î For patients with HAP/VAP due to P. aeruginosa, ATS and IDSA recommend against aminoglycoside monotherapy (S-VL). Î For patients with HAP/VAP due to extended-spectrum β-lactamase (ESBL)-producing Gram-negative bacilli, ATS and IDSA recommend that the choice of an antibiotic for definitive (not empiric) therapy be based upon the results of antimicrobial susceptibility testing and patient-specific factors (S-VL).