Page 147 - HPP ANTIMICROBIAL GUIDELINE 2018

Suggested Treatment
Infection/ Condition Comments
Preferred Alternative

Infective Exacerbation Of Chronic Obstructive Pulmonary Disease (COPD)

Outpatient Amoxicillin/clavulanate 625mg PO Cefuroxime 500mg PO q12h Duration: 5 days
q8h
OR
Doxycycline 100mg PO q12h

Inpatient Amoxicillin/clavulanate 1.2gm IV q8h Ceftriaxone 2gm IV q24h Duration: 5 – 7 days

Hospital Acquired Pneumonia

Early Onset
(2-4 days of admission/intubation) Amoxicillin/clavulanate 1.2gm IV q8h Ceftriaxone 2gm IV q24h Duration: 5 – 7 days

Late Onset Piperacillin/tazobactam 4.5gm IV q6h Imipenem/cilastatin 500mg IV q6h Duration: 7 days
(5 days or more of
admission/intubation) OR OR Longer duration may be indicated
Cefepime 2gm IV q8h Meropenem1gm IV q8h depending upon clinical,
radiological and laboratory
parameters.

References:
1. Malaysian Society of Intensive Care. Guide to antimicrobial therapy in the adult ICU 2017. Available from: http://www.msic.org.my
2. Kalil AC, Metersky ML, Klompas M, Muscedere J, Sweeney DA, Palmer LB, et al. Management of adults with hospital-acquired and ventilator-
associated pneumonia: 2016
3. Clinical practice guidelines by the infectious diseases society of America and the American thoracic society. Clinical Infectious Diseases 2016;
63(5):e61-111.
4. Australian Clinical Practice Guidelines – Therapeutic guidelines antibiotic version 15
5. Global Initiative for Chronic Obstructive Lung Disease – Pocket Guide to COPD Diagnosis, Management and Prevention 2017 Report
6. Murtaza Mustafa, HM Iftikhar, RK Muniandy et al. Lung Abscess: Diagnosis, Treatment and Mortality. International Journal of Pharmaceutical
Science Invention 2015;4 (2):37- 41

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