lower respiratory tract
1. Community-acquired pneumonia, 3-5 days, S pneumoniae, Moraxella, H influenza, Legionella, mycoplasma, Chlamydia -ceftriaxone 1 2 g IV Q 24 hour plus azithromycin 500 mg IV Q 24 hour for 3 days, alternative levofloxacin 750 mg IV Q 24 hour if suspected MRSA necrotizing PNA consider adding vancomycin.

2. Community aspiration pneumonia (abscess, cavitary, empyema,LOC D/T EtOH or seizure, periodontal disease), 5 days, above plus Bacteroides species, peptostreptococcus, fusobacterium, prevotella, -ampicillin/sulbactam 3 g IV q.6 hours, alternative levofloxacin 750 mg IV Q 24 hour plus metronidazole 500 mg IV Q 8

3. Nosocomial pneumonia (VA P, hospital, SNF, jail,), 7 days, Staphylococcus aureus, Pseudomonas aeruginosa, A baumani, consider 10-14 days, vanco per pharmacy dose plus Zosyn 4.5 g IV Q 8/4 hour, alternative vanco per pharmacy dose plus cefepime 2 g IV Q 8 hour
# complicating factor, empyema, lung abscess, bloodstream infection, drug resistance organism
# Organism with a complicated drug resistance for example S. maltophilia, A baumani, B cepacea.