Table 3.

Recommended therapy for suspected or confirmed multidrug resistant organisms and fungal VAP [1], [34], [35], [41]

Pathogen	Treatment
Methicillin-resistant Staphylococcus aureus (MRSA)	See Table 2
Pseudomonas aeruginosa	Double coverage recommended. See Table 2
Acinetobacter species	Carbapenem
	e. g., imipenem + cilastin; 1 g every 8 hours;
	meropenem 1 g every 8 hours
	OR
	Beta-Lactam/beta-lactamase inhibitor
	e. g., ampicillin + sulbactam: 3 g every 8
	hours
	OR
	Tigecycline: 100 mg loading dose, then 50 mg every 12 hours
Extended-spectrum beta-lactamase (ESBL) positive enterobacteriaceae	Carbepenem
	e. g., imipenem + cilastin: 1 g every 8 hours;
	meropenem: 1 g every 8 hours
Fungi	Fluconazole: 800 mg every 12 hours;
	caspofungin: 70 mg loading dose, then 50 mg daily;
	voriconazole (for aspergillus species): 4 mg/kg every 12 hours
Legionella	Macrolides (e. g., azithromycin)
	OR
	Fluoroquinolones (e. g., levofloxacin)