Table 2 Recommended doses of antimicrobials use in VAP caused by MDR pathogens in patients with normal renal function

Imipenem^*

Not required

1 g/6-8 h

Extended or prolonged infusion is not possible due to drug instability

Meropenem^*

Not required

1-2 g/8 h

Extended infusion (3-4 hours) is recommended.

Doripenem^*

Not required

500 mg-1 g/8 h

Extended infusion (3-4 hours) is recommended.

Colistin^*

4.5-9 UI

9 UI/day in 2 or 3 dose

Loading dose is necessary.

Tigecycline

200 mg

100 mg/ 12 h

Without approval by regulatory agencies.

Fosfomycin^*

Not required

24 g/day (in four doses)

Always in combination therapy.

Vancomycin^*

25-30 mg/kg (based on ABW)

15-20 mg/kg (based on ABW) every 8-12 hours

Monitor trough concentrations after the forth dose; serum trough levels of 15-20 mg/L for MRSA VAP.

Linezolid

Not required

600 mg/ 12 h

It should be changed to vancomycin in the directed therapy of patients with good clinical evolution and S aureus with vancomycin MIC ≤ 1 mg/L.