A 63-year-old male,post head trauma,is intubated and has been mechanically ventilated for 78 hours.The respiratory therapist notes the following during ICU rounds: partial pressure of oxygen in the arteries (PₐO₂)is 82 mm Hg on 60% supplemental oxygen with a positive end-expiratory pressure (PEEP)of 8 cm H₂O; static compliance is averaging 38-41 cm H₂O/L; breath sounds are diminished bilaterally.Bronchoalveolar lavage (BAL)results are pending,but MRSA is suspected.Chest radiograph shows bilateral,patchy infiltrates.Patient has a temperature of 38.8° C,and the most recent white blood cell (WBC)count is 11,300 $\mu$L.The most appropriate recommendation for this patient is which of the following?

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This patient has late-onset ventilator-associated pneumonia because he has been intubated and has received mechanical ventilation for longer than 72 hours.Because MRSA is suspected,combination antibiotic therapy should be used.According to Table 14-2 this would include two antipseudomonal agents plus either vancomycin or linezolid.Therapy should be adjusted once the microbiological data confirm the organism.

A 63-Year-Old Male,post Head Trauma,is Intubated and Has Been Mechanically μ\muμ

A 63-Year-Old Male,post Head Trauma,is Intubated and Has Been Mechanically $\mu$