An elderly male develops fever 3 days after cholecystectomy. He becomes sho of breath, andCXR shows a new right lower lobe infiltrate. Sputum Gram stain shows gram-positive cocci in clumps, and preliminary culture results suggest staphylococci. Initial antibiotic of choice is

In the treatment of hospital acquired staphylococcal pneumonia, the incidence of methicillin-resistant staph in the local facility will be very impoant. In most hospitals, methicillin-resistant staph is common enough to require initial therapy with vancomycin. Oxacillin would be the drug of choice only if the incidence of methicillin-resistant staph is very low. Quinolones are often useful in the treatment of community-acquired pneumonia, but they would not be effective against methicillin-resistant staph.