Suspected staphylococcal pneumonia in patients with VAP
Consider adding vancomycin for patients with VAP who have microbiological evidence suggestive of staphylococcal pneumonia (eg profuse gram-positive cocci resembling staphylococci identified on Gram stain of a lower respiratory tract sample1).
Consider adding to the empirical therapy regimen for VAP in adults and children:
vancomycin intravenously vancomycin vancomycin vancomycin
adult: 25 mg/kg (actual body weight) rounded up to nearest 125 mg, up to 3 g, as a loading dose. See Calculated vancomycin loading dosage in critically ill adults for calculated weight-based loading doses. Subsequent doses are dependent on weight and kidney function; see Intermittent vancomycin dosing in critically ill adults
child: for initial dosing, see Intermittent vancomycin dosing in young infants and children.
Review therapy at 24 to 48 hours and consider stopping vancomycin based on the results of investigations – see Review of patients with VAP.