Hospital acquired pneumonia

For pneumonia presenting more than 3 days into hospital admission, it is important to give broad-spectrum antibiotics which are active against Gram-negative organisms in the first instance. In more severe infection, consider cover for Legionella, Staph aureus, both MSSA and MRSA. Use SIRS criteria for severity assessment.

For glossary of terms see Glossary

Drug details

Non severe

Co-trimoxazole (oral) 960mg twice daily (reduce dose to 480mg twice daily in renal impairment CrCl 30ml/min or less)

OR Doxycycline (oral) 100mg twice daily

Total IV/oral up to 8 days for clinical responders



Infection with an atypical pathogen is uncommon. If suspected, discuss with Microbiology.

IV aztreonam 2g every 6 hours

PLUS IV vancomycin
refer to NHS Highland vancomycin dosing guidelines

Total IV/oral up to 8 days for clinical responders

Last reviewed: 25 August 2022

Next review: 25 August 2025

Author(s): Antimicrobial Management Team

Version: 2

Approved By: TAM Subgroup of ADTC

Reviewer Name(s): Area Antimicrobial Pharmacist

Document Id: AMT160