Intravenous to oral switch for patients with low- to moderate-severity HAP

In patients with low- to moderate-severity HAP who started with intravenous therapy, switch to oral antibiotic therapy once the patient has improved and is clinically stable. For guidance on when to switch to oral therapy, see Guidance for intravenous to oral switch. If directed therapy is not possible, use the following oral regimens:

For patients without penicillin hypersensitivity, use amoxicillin+clavulanate.
For patients with nonsevere (immediate or delayed) penicillin hypersensitivity, or severe immediate¹ penicillin hypersensitivity who tolerated ceftriaxone or cefotaxime, use cefuroxime.
For patients with severe immediate¹ penicillin hypersensitivity in whom ceftriaxone or cefotaxime was not used nor tolerated, or for patients with severe delayed² penicillin hypersensitivity, use moxifloxacin or trimethoprim+sulfamethoxazole.

¹ Severe immediate hypersensitivity reactions include anaphylaxis, compromised airway, airway angioedema, hypotension and collapse.Return

² Severe delayed hypersensitivity reactions include cutaneous adverse drug reactions (eg drug rash with eosinophilia and systemic symptoms [DRESS], Stevens–Johnson syndrome/toxic epidermal necrolysis [SJS/TEN], severe blistering or desquamative rash), and significant internal organ involvement (eg acute interstitial nephritis).Return