Table 3. Pneumonia in common neurocritical conditions.
NIHSS: NIH Stroke Scale; MCA: middle cerebral artery; GCS: Glasgow Coma Scale; CNS: central nervous system; CSF: cerebrospinal fluid; COPD: chronic obstructive pulmonary disease [16,55,65-66,69,72,81-82]
| CNS Condition | Risk Factors for Pneumonia | Common Pathogens | Antibiotics |
| Stroke | Dysphagia, higher NIHSS, non-lacunar basal-ganglia infarction, older age, large MCA infarction, multiple hemispheric or vertebrobasilar infarction mechanical ventilation on admission | Gram-negative bacilli | Ceftriaxone |
| Levofloxacin | |||
| Moxifloxacin | |||
| Ciprofloxacin | |||
| Ampicillin/Sulbactam | |||
| Ertapenem | |||
| Piperacillin-Tazobactam | |||
| Staphylococcus aureus | Ceftriaxone | ||
| Levofloxacin | |||
| Moxifloxacin | |||
| Ciprofloxacin | |||
| Ampicillin/Sulbactam | |||
| Ertapenem | |||
| Piperacillin-Tazobactam | |||
| Anaerobic bacteria | Ampicillin/Sulbactam | ||
| Ertapenem | |||
| Piperacillin-Tazobactam | |||
| Subarachnoid hemorrhage | Prolonged length of stay, older age, lower GCS score, history of hypertension | Methicillin-susceptible Staphylococcus aureus | Ceftriaxone |
| Levofloxacin | |||
| Moxifloxacin | |||
| Ciprofloxacin | |||
| Ampicillin/Sulbactam | |||
| Ertapenem | |||
| Piperacillin-Tazobactam | |||
| Haemophilus influenza | Ceftriaxone | ||
| Levofloxacin | |||
| Moxifloxacin | |||
| Ciprofloxacin | |||
| Ampicillin/Sulbactam | |||
| Traumatic brain injury | Surgical intervention, prolonged hospitalization, damage to the CNS, CSF leak, nasal carriage of S. aureus, use of barbiturate, need for intubation and mechanical ventilation, male gender, younger age, early intubation, lower GCS score, longer mechanical ventilation, higher NIHSS injuries to thorax | Methicillin-susceptible Staphylococcus aureus | Ceftriaxone |
| Levofloxacin | |||
| Moxifloxacin | |||
| Ciprofloxacin | |||
| Ampicillin/Sulbactam | |||
| Ertapenem | |||
| Piperacillin-Tazobactam | |||
| Haemophilus influenza | Ceftriaxone | ||
| Levofloxacin | |||
| Moxifloxacin | |||
| Ciprofloxacin | |||
| Ampicillin/Sulbactam | |||
| Streptococcus pneumoniae | Ceftriaxone | ||
| Levofloxacin | |||
| Moxifloxacin | |||
| Ciprofloxacin | |||
| Ampicillin/Sulbactam | |||
| Ertapenem | |||
| Piperacillin-Tazobactam | |||
| Acinetobacter species | Ceftazidime | ||
| Ampicillin/Sulbactam | |||
| Meropenem | |||
| Intracerebral hemorrhage | Mechanical ventilation, tube feeding, dysphagia, tracheostomy, older age, current smoking, excessive alcohol consumption, COPD, ICH severity, infratentorial ICH location, hematoma volume, early hospital admission, intubation | Methicillin-susceptible Staphylococcus aureus | Ceftriaxone |
| Levofloxacin | |||
| Moxifloxacin | |||
| Ciprofloxacin | |||
| Ampicillin/Sulbactam | |||
| Ertapenem | |||
| Piperacillin-Tazobactam | |||
| Haemophilus influenza | Ceftriaxone | ||
| Levofloxacin | |||
| Moxifloxacin | |||
| Ciprofloxacin | |||
| Ampicillin/Sulbactam |