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Table 1 Empirical antibiotic therapy protocol for HAP-VAP in ARC patients (CLCR > 150 ml/min)

From: Increased β-Lactams dosing regimens improve clinical outcome in critically ill patients with augmented renal clearance treated for a first episode of hospital or ventilator-acquired pneumonia: a before and after study

 Control period (June 2016 to November 2017)
Conventional dosing regimen
Treatment period (November 2017 to January 2019)
Increased dosing regimen
Early HAP-VAP (< 5 days of hospitalization) without risk factors for NF-GNB or multidrug-resistant pathogens• Amoxicillin-clavulanic acid (2 g IV q 8 h)• Amoxicillin-clavulanic acid (2 g IV q 6 h)
• Cefotaxime (2 g IV q 8 h)• Cefotaxime (2 g IV q 6 h)
• Ceftriaxone (2 g IV once/day)• Ceftriaxone (2 g IV q 12 h)
Late HAP-VAP (≥ 5 days of hospitalization) and/or risk factors for NF-GNB or multidrug-resistant pathogens and/or immunosuppressive disease or therapyBroad-spectrum β-lactam:Broad-spectrum β-lactam:
• Piperacillin-tazobactam (16 g/day continuously after a loading dose of 4 g)• Piperacillin-tazobactam (20 g/day continuously after a loading dose of 4 g)
• Cefepime (6 g/day continuously after a loading dose of 2 g over 30 min)• Cefepime (6 g/day continuously after a loading dose of 2 g over 30 mins)
• Ceftazidime (6 g/day continuously after a loading dose of 2 g over 30 min)• Ceftazidime (6 g/day continuously after a loading dose of 2 g over 30 min)
• Meropenem (6 g/day continuously or 2 g q 8 h over 240 min)• Meropenem (6 g/day continuously or 2 g q 8 h over 240 min)
If risk factors for MRSAGram-positive antibiotics with MRSA activity: glycopeptides (vancomycin 15 mg/kg/day continuously after a loading dose of 25 mg/kg*) or oxazolidinones (linezolid 600 mg IV twice/day)
If septic shock or ARDS at time of HAP-VAPAminoglycosides or fluoroquinolones: amikacine (20–30 mg/kg*), gentamycin (7–10 mg/kg*), or levofloxacin (500 mg twice/day)
  1. *Glycopeptides (vancomycin) and aminoglycosides (gentamycin, amikacin) were subsequently dosed by therapeutic monitoring