I. Community Acquired,
   Non-ICU Admission

(choose one of two options)

Option 1

Ceftriaxone [ROCEPHIN] 1 gm IV Q24H Q12H
  &
Azithromycin [ZITHROMAX] 500 mg IV Q24H

Option 2

Levofloxacin [LEVAQUIN] 750 mg IV Q24H Q48H  (Q48H if CrCl < 50ml/min)

II. Community Acquired,
     ICU Admission

(choose one of three options)

Option 1

Ceftriaxone [ROCEPHIN] 1gm IV Q24H Q12H
  &
Azithromycin [ZITHROMAX] 500 mg IV Q24H

Option 2

Ceftriaxone [ROCEPHIN] 1 gm IV Q24H Q12H
  &
Levofloxacin [LEVAQUIN] 750 mg IV Q24H Q48H  (Q48H if CrCl < 50ml/min)

~

If severe Penicillin allergy or any cephalosporin allergy

Option 3

Levofloxacin [LEVAQUIN] 750 mg IV Q24H Q48H  (Q48H if CrCl < 50ml/min)
  &
Aztreonam [AZACTAM] 1 2  gm IV Q8H

III. Community Acquired w/
      Pseudomonas Risk or
      HCAP (includes both ICU
      + Non ICU)

(choose one of five options
 +/- vancomycin)

Option 1

Cefepime [MAXIPIME] 1 2  gm IVPB Q8H Q12H
  &
Ciprofloxacin [CIPRO] 400 mg IV Q8H Q12H  (400mg Q12H if CrCl < 60ml/min)

Option 2

Piperacillin-Tazobactam [ZOSYN] 2.25 gm IV now, then Piperacillin-Tazobactam [ZOSYN] 13.5 gm continuous infusion Q24H
  &
Ciprofloxacin [CIPRO] 400 mg IV Q8H Q12H  (400mg Q12H if CrCl < 60ml/min)

Option 3

Meropenem [MERREM] 500 mg IV Q6H
&
Ciprofloxacin [CIPRO] 400 mg IV Q8H Q12H  (400mg Q12H if CrCl < 60ml/min)

~

If Ciprofloxacin Contraindicated

Option 4

Cefepime [MAXIPIME] 1 2  gm IVPB Q8H Q12H
  &
Azithromycin [ZITHROMAX] 500 mg IV Q24H
  &
Tobramycin [NEBCIN] 5mg/Kg IV x 1, then pharmacy to dose (use dosing wt.)

Option 5

Piperacillin-Tazobactam [ZOSYN] 2.25 gm IV now, then Piperacillin-Tazobactam [ZOSYN] 13.5 gm continuous infusion Q24H

  &
Azithromycin [ZITHROMAX] 500 mg IV Q24H
  &
Tobramycin [NEBCIN] 5mg/Kg IV x 1, then pharmacy to dose (use dosing wt.)

Option 6

Meropenem {MERREM} 500 mg IV Q6H
 &
Azithromycin [ZITHROMAX] 500 mg IV Q24H
  &
Tobramycin [NEBCIN] 5mg/Kg IV x 1, then pharmacy to dose (use dosing wt.)

~

If severe Penicillin allergy or any cephalosporin allergy

Option 7

Aztreonam [AZACTAM] 1 2  gm IV Q8H
  &
Levofloxacin [LEVAQUIN] 750 mg IV Q24H Q48H  (Q48H if CrCl < 50ml/min)
 Tobramycin 5mg/Kg IV x 1,  then pharmacy to dose (use dosing wt.)

~

(plus, for HCAP patients)

Clindamycin [CLEOCIN] 600 mg IV Q6H, for Anaerobic Coverage

Vancomycin [VANCOMYCIN] 20mg/Kg IV x 1dose, then pharmacy to dose

Linezolid [ZYVOX] 600 mg IV Q12H

~

Pharmacy to adjust antibiotic dosing based on the patient's renal function.

Pharmacy to switch to Oral antibiotics once the patient meets criteria per protocol.