View source for Infectious Disease Project Pathogen-Based Infections

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{{Pathogen-Based Infections}}
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====Bacteria – Gram-Positive Cocci==== 

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==Enterococcus faecalis==

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{{PBI|Enterococcus faecalis}}
:* 1. '''Bacteremia'''<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
::* 1.1 '''Ampicillin or penicillin susceptible'''
:::* Preferred regimen (1): [[Ampicillin]] 2 g IV q4-6h
:::* Preferred regimen (2): [[Ampicillin]] 2 g IV q4-6h {{and}} [[Gentamicin]] 1 mg/kg IV/IM q8h
::* 1.2 '''Ampicillin resistant and vancomycin susceptible or penicillin allergy'''
:::* Preferred regimen (1): [[Vancomycin]] 15 mg/kg IV q12h {{and}} [[Gentamicin]] 1 mg/kg IV/IM q8h
:::* Preferred regimen (2): [[Linezolid]] 600 mg IV q12h 
:::* Preferred regimen (3): [[Daptomycin]] 6 mg/kg IV q24h
::* 1.3 '''Ampicillin and vancomycin resistant'''
:::* Preferred regimen (1): [[Linezolid]] 600 mg IV q12h 
:::* Preferred regimen (2): [[Daptomycin]] 6 mg/kg IV q24h
:* 2. '''Endocarditis'''<ref name="Baddour-2005">{{Cite journal  | last1 = Baddour | first1 = LM. | last2 = Wilson | first2 = WR. | last3 = Bayer | first3 = AS. | last4 = Fowler | first4 = VG. | last5 = Bolger | first5 = AF. | last6 = Levison | first6 = ME. | last7 = Ferrieri | first7 = P. | last8 = Gerber | first8 = MA. | last9 = Tani | first9 = LY. | title = Infective endocarditis: diagnosis, antimicrobial therapy, and management of complications: a statement for healthcare professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association: endorsed by the Infectious Diseases Society of America. | journal = Circulation | volume = 111 | issue = 23 | pages = e394-434 | month = Jun | year = 2005 | doi = 10.1161/CIRCULATIONAHA.105.165564 | PMID = 15956145 }}</ref><ref>{{Cite web | title =Infective Endocarditis Diagnosis, Antimicrobial Therapy, and Management of Complications A Statement for Healthcare Professionals From the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association| url =http://circ.ahajournals.org/content/111/23/e394.full.pdf+html}}</ref>
::* 2.1 '''Endocarditis in adults''' 
:::* 2.1.1 '''Strains susceptible to penicillin, gentamicin, and vancomycin'''
::::* Preferred regimen: ([[Ampicillin|Ampicillin]] 12 g IV q24h for 4–6 weeks {{or}} [[Penicillin G|Aqueous crystalline penicillin G sodium]] 18–30 MU IV q24h for 4–6 weeks) {{and}} [[Gentamicin|Gentamicin sulfate]] 3 mg/kg IV/IM q24h for 4–6 weeks
::::* Alternative regimen: [[Vancomycin|Vancomycin hydrochloride]] 30 mg/kg IV q24h for 6 weeks {{and}} [[Gentamicin|Gentamicin sulfate]] 3 mg/kg IV/IM q24h for 6 weeks
::::* Note (1): In case of native valve endocarditis with symptoms ≤ 3 months, a 4-week course of therapy is recommended.
::::* Note (2): In case of native valve endocarditis with symptoms > 3 months, a 6-week course of therapy is recommended.
::::* Note (3): In case of prosthetic valve or other prosthetic cardiac material, a minimum of 6-week course of therapy is recommended.
:::* 2.1.2 '''Strains susceptible to penicillin, streptomycin, and vancomycin and resistant to gentamicin'''
::::* Preferred regimen: ([[Ampicillin]] 12 g IV q24h for 4–6 weeks {{or}} [[Penicillin G|Aqueous crystalline penicillin G sodium]] 24 MU IV q24h for 4–6 weeks) {{and}} [[Streptomycin|Streptomycin sulfate]] 15 mg/kg IV/IM q24h for 4–6 weeks 
::::* Alternate regimen: [[Vancomycin|Vancomycin hydrochloride]] 30 mg/kg IV q24h  for 6 weeks {{and}} [[Streptomycin|Streptomycin sulfate]] 15 mg/kg IV/IM q24h for 6 weeks 
:::* 2.1.3 '''Strains resistant to penicillin and susceptible to aminoglycoside and vancomycin'''
::::* 2.1.3.1 '''β Lactamase–producing strain''' 
:::::* Preferred regimen: [[Ampicillin-sulbactam]] 12 g IV q24h for 6 weeks {{and}} [[Gentamicin|Gentamicin sulfate]] 3 mg/kg IV/IM q24h 6 weeks 
:::::* Alternate regimen: [[Vancomycin|Vancomycin hydrochloride]] 30 mg/kg IV q24h for 6 weeks {{and}} [[Gentamicin|Gentamicin sulfate]] 3 mg/kg IV/IM q24h for 6 weeks
::::*2.1.3.2 '''Intrinsic penicillin resistance''' 
:::::* Preferred regimen: [[Vancomycin|Vancomycin hydrochloride]] 30 mg/kg IV q24h for 6 weeks {{and}} [[Gentamicin|Gentamicin sulfate]] 3 mg/kg IV/IM q24h for 6 weeks
:::*2.1.4 '''Strains resistant to penicillin, aminoglycoside, and vancomycin''' 
::::* Preferred regimen (1): ([[Imipenem]] {{or}} [[Cilastatin]] 2 g/day IV for ≥ 8weeks) {{and}} [[Ampicillin|Ampicillin]] 12 g/day IV for ≥ 8 weeks
::::* Preferred regimen (2): [[Ceftriaxone sodium]] 4 g IV/IM q24h for ≥ 8weeks {{and}} [[ampicillin|Ampicillin]] 12 g IV q24h for ≥ 8 weeks
::* 2.2 '''Endocarditis in pediatrics'''
:::* 2.2.1 '''Strains susceptible to penicillin, gentamicin, and vancomycin'''
::::* Preferred regimen: ([[Ampicillin]] 300 mg/kg IV q24h for 4–6 weeks {{or}} [[Penicillin]] 0.3 MU/kg IV q24h for 4–6 weeks) {{and}} [[Gentamicin]] 3 mg/kg IV/IM q24h 4–6 weeks
::::* Note (1): In case of native valve endocarditis with symptoms ≤ 3 months, a 4-week course of therapy is recommended.
::::* Note (2): In case of native valve endocarditis with symptoms > 3 months, a 6-week course of therapy is recommended.
::::* Note (3): In case of prosthetic valve or other prosthetic cardiac material, a minimum of 6-week course of therapy is recommended.
::::* Alternate regimen : [[Vancomycin]] 40 mg/kg IV q24h for 6 weeks {{and}} [[Gentamicin]] 3 mg/kg IV/IM q24h for 6 weeks
:::* 2.2.2 '''Strains susceptible to penicillin, streptomycin, and vancomycin and resistant to gentamicin'''
::::* Preferred regimen: ([[Ampicillin]] 300 mg/kg IV q24h for 4–6 weeks {{or}} [[Penicillin]] 0.3 MU/kg IV q24h for 4–6 weeks) {{and}} [[Streptomycin]] 20–30 mg/kg IV/IM q24h for 4–6 weeks
::::* Alternate regimen: [[Vancomycin|Vancomycin hydrochloride]] 40 mg/kg IV q24h for 6 weeks {{and}} [[Streptomycin|Streptomycin sulfate]] 15 mg/kg IV/IM q24h for 6 weeks 
:::* 2.2.3 '''Strains resistant to penicillin and susceptible to aminoglycoside and vancomycin'''
::::* 2.2.3.1 '''β Lactamase–producing strain'''  
:::::* Preferred regimen: [[Ampicillin-sulbactam]] 300 mg/kg IV q24h for 6 weeks {{and}} [[Gentamicin]] 3 mg/kg IV/IM q24h for 6 weeks
:::::* Alternate regimen: [[Vancomycin]] 40 mg/kg IV q24h for 6 weeks {{and}} [[Gentamicin]] 3 mg/kg IV/IM q24h for 6 weeks
::::* 2.2.3.2 '''Intrinsic penicillin resistance''' 
:::::*Preferred regimen: [[Vancomycin]] 40 mg/kg IV q24h {{and}} [[Gentamicin]] 3 mg/kg IV/IM q24h for 6 weeks
:::* 2.2.4 '''Strains resistant to penicillin, aminoglycoside, and vancomycin'''
::::* Preferred regimen: [[Imipenem]]/[[Cilastatin]] 60–100 mg/kg IV q24h for ≥ 8 weeks {{and}} [[Ampicillin]] 300 mg/kg IV q24h for ≥ 8 weeks
::::* Alternate regimen: [[Ceftriaxone]] 100 mg/kg IV/IM q24h {{and}} [[Ampicillin]] 300 mg/kg IV q24h for ≥ 8 weeks
:* 3. '''Meningitis'''<ref name="pmid15494903">{{cite journal| author=Tunkel AR, Hartman BJ, Kaplan SL, Kaufman BA, Roos KL, Scheld WM et al.| title=Practice guidelines for the management of bacterial meningitis. | journal=Clin Infect Dis | year= 2004 | volume= 39 | issue= 9 | pages= 1267-84 | pmid=15494903 | doi=10.1086/425368 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15494903  }}</ref>
::* 3.1 '''Ampicillin susceptible'''
:::* Preferred regimen: [[Ampicillin]] 12 g/day IV q4h {{and}} [[Gentamicin]] 5 mg/kg/day IV q8h
::* 3.2 '''Ampicillin resistant'''
:::* Preferred regimen: [[Vancomycin]] 30–45 mg/kg/day IV q8–12h {{and}} [[Gentamicin]] 5 mg/kg/day IV q8h
::* 3.3 '''Ampicillin and vancomycin resistant'''
:::* Preferred regimen: [[Linezolid]] 600 mg IV q12h
:* 4. '''Urinary tract infections''' <ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
::* Preferred regimen (1): [[Nitrofurantoin]] 100 mg PO q6h for 5 days 
::* Preferred regimen (2): [[Fosfomycin]] 3 g PO single dose
::* Preferred regimen (3): [[Amoxicillin]] 875 mg to 1 g PO q12h for 5 days
:* 5. '''Intra abdominal or wound infections''' <ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
::* Preferred regimen (1): [[Penicillin]] 
::* Preferred regimen (2): [[Ampicillin]]
::* Alternative regimen (Penicillin allergy or high-level Penicillin resistance): [[Vancomycin]]
::* Alternative regimen (For complicated skin-skin structure and intra-abdominal infection): [[Tigecycline]] 100 mg IV single dose and 50 mg IV q12h

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{{PBI|Enterococcus faecium}}

:* 1. '''Bacteremia'''<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
::* 1.1 '''Ampicillin or penicillin susceptible'''
:::* Preferred regimen (1): [[Ampicillin]] 2 g IV q4-6h
:::* Preferred regimen (2): [[Ampicillin]] 2 g IV q4-6h {{and}} [[Gentamicin]] 1 mg/kg IV/IM q8h
::* 1.2 '''Ampicillin resistant and vancomycin susceptible or penicillin allergy'''
:::* Preferred regimen (1): [[Vancomycin]] 15 mg/kg IV q12h {{and}} [[Gentamicin]] 1 mg/kg IV/IM q8h
:::* Preferred regimen (2): [[Linezolid]] 600 mg IV q12h 
:::* Preferred regimen (3): [[Daptomycin]] 6 mg/kg IV q24h.
::* 1.3 '''Ampicillin and vancomycin resistant'''
:::* Preferred regimen (1): [[Linezolid]] 600 mg IV q12h 
:::* Preferred regimen (2): [[Daptomycin]] 6 mg/kg IV q24h
:* 2. '''Endocarditis'''<ref name="Baddour-2005">{{Cite journal  | last1 = Baddour | first1 = LM. | last2 = Wilson | first2 = WR. | last3 = Bayer | first3 = AS. | last4 = Fowler | first4 = VG. | last5 = Bolger | first5 = AF. | last6 = Levison | first6 = ME. | last7 = Ferrieri | first7 = P. | last8 = Gerber | first8 = MA. | last9 = Tani | first9 = LY. | title = Infective endocarditis: diagnosis, antimicrobial therapy, and management of complications: a statement for healthcare professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association: endorsed by the Infectious Diseases Society of America. | journal = Circulation | volume = 111 | issue = 23 | pages = e394-434 | month = Jun | year = 2005 | doi = 10.1161/CIRCULATIONAHA.105.165564 | PMID = 15956145 }}</ref><ref>{{Cite web | title =Infective Endocarditis Diagnosis, Antimicrobial Therapy, and Management of Complications A Statement for Healthcare Professionals From the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association| url =http://circ.ahajournals.org/content/111/23/e394.full.pdf+html}}</ref>
::* 2.1 '''Endocarditis in adults''' 
:::* 2.1.1 '''Strains susceptible to penicillin, gentamicin, and vancomycin'''
::::* Preferred regimen: ([[Ampicillin|Ampicillin]] 12 g IV q24h for 4–6 weeks {{or}} [[Penicillin G|Aqueous crystalline penicillin G sodium]] 18–30 MU IV q24h for 4–6 weeks) {{and}} [[Gentamicin|Gentamicin sulfate]] 3 mg/kg IV/IM q24h for 4–6 weeks
::::* Alternative regimen: [[Vancomycin|Vancomycin hydrochloride]] 30 mg/kg IV q24h for 6 weeks {{and}} [[Gentamicin|Gentamicin sulfate]] 3 mg/kg IV/IM q24h for 6 weeks
::::* Alternate regimen: [[Vancomycin|Vancomycin hydrochloride]] 30 mg/kg IV q24h for 6 weeks {{and}} [[Gentamicin|Gentamicin sulfate]] 3 mg/kg IV/IM q24h for 6 weeks 

::::* Note (1): In case of native valve endocarditis with symptoms ≤ 3 months, a 4-week course of therapy is recommended.
::::* Note (2): In case of native valve endocarditis with symptoms > 3 months, a 6-week course of therapy is recommended.
::::* Note (3): In case of prosthetic valve or other prosthetic cardiac material, a minimum of 6-week course of therapy is recommended.
:::* 2.1.2 '''Strains susceptible to penicillin, streptomycin, and vancomycin and resistant to gentamicin'''
::::* Preferred regimen: ([[Ampicillin]] 12 g IV q24h for 4–6 weeks {{or}} [[Penicillin G|Aqueous crystalline penicillin G sodium]] 24 MU/day IV q24h for 4–6 weeks) {{and}} [[Streptomycin|Streptomycin sulfate]] 15 mg/kg IV/IM q24h for 4–6 weeks 
::::* Alternate regimen: [[Vancomycin|Vancomycin hydrochloride]] 30 mg/kg IV q24h for 6 weeks {{and}} [[Streptomycin|Streptomycin sulfate]] 15 mg/kg IV/IM q24h for 6 weeks 
:::* 2.1.3 '''Strains resistant to penicillin and susceptible to aminoglycoside and vancomycin'''
::::* 2.1.3.1 '''β Lactamase–producing strain''' 
:::::* Preferred regimen: [[Ampicillin-sulbactam]] 12 g IV q24h for 6 weeks {{and}} [[Gentamicin|Gentamicin sulfate]] 3 mg/kg IV/IM q24h for 6 weeks 
:::::* Alternate regimen: [[Vancomycin|Vancomycin hydrochloride]] 30 mg/kg IV q24h for 6 weeks {{and}} [[Gentamicin|Gentamicin sulfate]] 3 mg/kg IV/IM q24h for 6 weeks
::::* 2.1.3.2 '''Intrinsic penicillin resistance''' 
:::::* Preferred regimen: [[Vancomycin|Vancomycin hydrochloride]] 30 mg/kg IV q24h for 6 weeks {{and}} [[Gentamicin|Gentamicin sulfate]] 3 mg/kg IV/IM q24h for 6 weeks
:::* 2.1.4 '''Strains resistant to penicillin, aminoglycoside, and vancomycin'''  
::::* Preferred regimen (1): [[Linezolid]] 1200 mg IV/PO q24h ≥ 8 weeks 
::::* Preferred regimen (2): [[Quinupristin]]-[[Dalfopristin]] 22.5 mg/kg IV q24h ≥ 8 weeks
::* 2.2 '''Endocarditis in pediatrics'''
:::* 2.2.1 '''Strains susceptible to penicillin, gentamicin, and vancomycin'''
::::* Preferred regimen: ([[Ampicillin]] 300 mg/kg IV q24h for 4–6 weeks {{or}} [[Penicillin]] 0.3MU/kg IV q24h for 4–6 weeks) {{and}} [[Gentamicin]] 3 mg/kg IV/IM q24h 4–6 weeks
::::* Alternate regimen: [[Vancomycin]] 40 mg/kg IV q24h for 6 weeks {{and}} [[Gentamicin]] 3 mg/kg IV/IM q24h for 6 weeks
::::* Note (1): In case of native valve endocarditis with symptoms ≤ 3 months, a 4-week course of therapy is recommended.
::::* Note (2): In case of native valve endocarditis with symptoms > 3 months, a 6-week course of therapy is recommended.
::::* Note (3): In case of prosthetic valve or other prosthetic cardiac material, a minimum of 6-week course of therapy is recommended.
:::* 2.2.2 '''Strains Susceptible to penicillin, streptomycin, and vancomycin and resistant to gentamicin'''
::::* Preferred regimen: ([[Ampicillin]] 300 mg/kg IV q24h for 4–6 weeks {{or}} [[Penicillin]] 0.3MU/kg IV q24h for 4–6 weeks) {{and}} [[Streptomycin]] 20–30 mg/kg IV/IM q24h for 4–6 weeks
::::* Alternate regimen: [[Vancomycin|Vancomycin hydrochloride]] 40 mg/kg IV q24h for 6 weeks {{and}} [[Streptomycin|Streptomycin sulfate]] 15 mg/kg IV/IM q24h for 6 weeks 
:::* 2.2.3 '''Strains resistant to penicillin and susceptible to aminoglycoside and vancomycin'''
::::* 2.2.3.1 '''β Lactamase–producing strain'''  
:::::* Preferred regimen: [[Ampicillin-sulbactam]] 300 mg/kg IV q24h for 6 weeks {{and}} [[Gentamicin]] 3 mg/kg IV/IM q24h for 6 weeks
:::::* Alternate regimen: [[Vancomycin]] 40 mg/kg IV q24h for 6 weeks {{and}} [[Gentamicin]] 3 mg/kg IV/IM q24h for 6 weeks
::::* 2.2.3.2 '''Intrinsic penicillin resistance''' 
::::* Preferred regimen: [[Vancomycin]] 40 mg/kg IV q24h {{and}} [[Gentamicin]] 3 mg/kg IV/IM q24h for 6 weeks
:::* 2.2.4 '''Strains resistant to penicillin, aminoglycoside, and vancomycin'''
::::* Preferred regimen (1): [[Linezolid]] 30 mg/kg IV/PO q24h ≥ 8 weeks 
::::* Preferred regimen (2): [[Quinupristin]]-[[Dalfopristin]] 22.5 mg/kg IV q24h ≥ 8 weeks

:* 3. '''Meningitis'''<ref name="pmid15494903">{{cite journal| author=Tunkel AR, Hartman BJ, Kaplan SL, Kaufman BA, Roos KL, Scheld WM et al.| title=Practice guidelines for the management of bacterial meningitis. | journal=Clin Infect Dis | year= 2004 | volume= 39 | issue= 9 | pages= 1267-84 | pmid=15494903 | doi=10.1086/425368 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15494903  }}</ref>  
::* 3.1 '''Ampicillin susceptible'''
:::* Preferred regimen: [[Ampicillin]] 12 g/day IV q4h {{and}} [[Gentamicin]] 5 mg/kg/day IV q8h
::* 3.2 '''Ampicillin resistant'''
:::* Preferred regimen: [[Vancomycin]] 30–45 mg/kg/day IV q8–12h {{and}} [[Gentamicin]] 5 mg/kg/day IV q8h
::* 3.3 '''Ampicillin and vancomycin resistant'''
:::* Preferred regimen: [[Linezolid]] 600 mg IV q12h

:* 4. '''Urinary tract infections'''<ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
::* Preferred regimen (1): [[Nitrofurantoin]] 100 mg PO q6h for 5 days 
::* Preferred regimen (2): [[Fosfomycin]] 3 g PO single dose
::* Preferred regimen (3): [[Amoxicillin]] 875 mg to 1 g PO q12h for 5 days

:* 5. '''Intra abdominal or wound infections''' <ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
::* Preferred regimen (1): [[Penicillin]] 
::* Preferred regimen (2): [[Ampicillin]]
::* Alternative regimen (penicillin allergy or high-level penicillin resistance): [[Vancomycin]]
::* Alternative regimen (for complicated skin-skin structure and intra-abdominal infection): [[Tigecycline]] 100 mg IV single dose and 50 mg IV q12h

----

{{PBI|Staphylococcus aureus}}

:* [[Staphylococcus aureus]] treatment
::* 1. '''Infectious endocarditis'''<ref name="pmid15956145">{{cite journal| author=Baddour LM, Wilson WR, Bayer AS, Fowler VG, Bolger AF, Levison ME et al.| title=Infective endocarditis: diagnosis, antimicrobial therapy, and management of complications: a statement for healthcare professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association: endorsed by the Infectious Diseases Society of America. | journal=Circulation | year= 2005 | volume= 111 | issue= 23 | pages= e394-434 | pmid=15956145 | doi=10.1161/CIRCULATIONAHA.105.165564 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15956145  }} </ref>
:::* 1.1 In adults
::::* Preferred regimen (1): [[Vancomycin]] 15-20 mg/kg IV q8-12h 
::::* Preferred regimen (2): [[Daptomycin]] 6mg/kg/dose IV qd

::* 2. '''Intravascular catheter-related infections'''<ref name="pmid19489710">{{cite journal| author=Mermel LA, Allon M, Bouza E, Craven DE, Flynn P, O'Grady NP et al.| title=Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 Update by the Infectious Diseases Society of America. | journal=Clin Infect Dis | year= 2009 | volume= 49 | issue= 1 | pages= 1-45 | pmid=19489710 | doi=10.1086/599376 | pmc=PMC4039170 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19489710  }} </ref>
:::* 2.1 '''Methicillin susceptible Staphylococcus aureus (MSSA)'''
::::* Preferred regimen (1): [[Nafcillin]] 2 g IV q6h 
::::* Preferred regimen (2): [[Oxacillin]] 2 g IV q6h
::::* Alternative regimen (1): [[Cefazolin]] 2 g IV q8h 
::::* Alternative regimen (2): [[Vancomycin]] 15 mg/kg IV q12h
:::::* 2.1.1 '''Pediatric dose of Nafcillin'''  
::::::* 2.1.1.1 '''Neonates (< 4 weeks)'''
:::::::* For < 1200 g: [[Nafcillin]] 50 mg/kg/day q12h
:::::::* For ≤ 7 days of age and 1200–2000 g: [[Nafcillin]] 50 mg/kg/day q12h
:::::::* For ≤ 7 days of age and > 2000 g: [[Nafcillin]] 75 mg/kg/day q8h
:::::::* For > 7 days of age and 1200–2000 g: [[Nafcillin]] 75 mg/kg/day q8h
:::::::* For > 7 days of age and > 2000 g: [[Nafcillin]] 100 mg/kg/day q6h
::::::* 2.1.1.2 '''Infants and children (> 4 weeks)'''
:::::::* [[Nafcillin]] 100–200 mg/kg/day q4–6h
:::::* 2.1.2 '''Pediatric dose of Oxacillin'''
::::::* 2.1.2.1 '''Neonates (< 4 weeks)'''
:::::::* For < 1200 g: [[Oxacillin]] 50 mg/kg/day q12h
:::::::* For Postnatal age < 7 days and 1200–2000 g: [[Oxacillin]] 50–100 mg/kg/day q12h
:::::::* For Postnatal age < 7 days and > 2000 g: [[Oxacillin]] 75–150 mg/kg/day q8h
:::::::* For Postnatal age ≥ 7 days and 1200–2000 g: [[Oxacillin]] 75–150 mg/kg/day q8h
:::::::* For Postnatal age ≥ 7 days and > 2000 g: [[Oxacillin]] 100–200 mg/kg/day q6h
::::::* 2.1.2.2 '''Infants and children'''(> 4weeks)
:::::::* [[Oxacillin]] 150–200 mg/kg/day q4–6h
:::::* 2.1.3 '''Pediatric dose of Cefazolin'''
::::::* 2.1.3.1 '''Neonates (< 4 weeks)'''
:::::::* Postnatal age ≤ 7 days: [[Cefazolin]] 40 mg/kg/day q12h
:::::::* Postnatal age > 7 days and ≤ 2000 g: [[Cefazolin]] 40 mg/kg/day q12h

:::::::* Postnatal age > 7 days and > 2000 g: [[Cefazolin]] 60 mg/kg/day q8h
::::::* 2.1.3.2 '''Infants and children (> 4 weeks)''' 
:::::::* [[Cefazolin]] 50 mg/kg/day q8h.
:::::* 2.1.4 '''Pediatric dose of Vancomycin'''
::::::* 2.1.4.1 '''Neonates (< 4 weeks)'''
:::::::* Postnatal age ≤ 7 days and < 1200 g: [[Vancomycin]] 15 mg/kg/day q24h.
:::::::* Postnatal age ≤ 7 days and 1200–2000 g: [[Vancomycin]] 10–15 mg/kg q12–18h.
:::::::* Postnatal age ≤ 7 days and > 2000 g: [[Vancomycin]] 10–15 mg/kg q8–12h.
:::::::* Postnatal age > 7 days and < 1200 g: [[Vancomycin]] 15 mg/kg/day q24h.
:::::::* Postnatal age > 7 days and 1200–2000 g: [[Vancomycin]] 10–15 mg/kg q8–12h.
:::::::* Postnatal age > 7 days and > 2000 g: [[Vancomycin]] 15–20 mg/kg q8h.
::::::* 2.1.4.2 '''Infants and children (> 4 weeks)''' 
:::::::* [[Vancomycin]] 40 mg/kg/day q6–8h.
:::* 2.2 '''Methicillin resistant Staphylococcus aureus (MRSA)'''
::::* Preferred regimen (1): [[Vancomycin]] 15 mg/kg IV q12h  
::::* Preferred regimen (2): [[Daptomycin]] 6–8 mg/kg/day IV
::::* Preferred regimen (3): [[Linezolid]] 10 mg/kg IV/PO q12h  
::::* Preferred regimen (4): [[Vancomycin]] 15 mg/kg IV q12h {{and}} ([[Rifampicin]] IV or [[Gentamycin]] IV) 
::::* Preferred regimen (5): [[Trimethoprim-Sulfamethoxazole]] 6–12 mg TMP/kg/day q12h alone (if susceptible)
:::::* 2.2.1 '''Pediatric dose of Linezolid'''
::::::* 2.2.1.1 '''Neonates (< 4 weeks)'''
:::::::* For < 1200 g: [[Linezolid]] 10 mg/kg q8–12h (note: q12h in patients < 34 weeks gestation and < 1 week of age).
:::::::* For < 7 days of age and ≥ 1200 g: [[Linezolid]] 10 mg/kg q8–12h (note: q12h in patients < 34 weeks gestation and < 1 week of age).
:::::::* For ≥ 7 days and ≥ 1200 g: [[Linezolid]] 10 mg/kg q8h

::::::* 2.2.1.2 '''Infants and children < 12 years (> 4 weeks)''' 
:::::::* [[Linezolid]] 10 mg/kg q8h 
::::::* 2.2.1.3 '''Children ≥ 12 years and adolescents'''

:::::::* [[Linezolid]] 10 mg/kg q12h
:::::* 2.2.2 '''Pediatric dose of Gentamycin'''
::::::* 2.2.2.1 '''Neonates (< 4 weeks)'''
:::::::* Premature neonates and < 1000 g: [[Gentamycin]] 3.5 mg/kg q24h
:::::::* < 1200 g: [[Gentamycin]] 2.5 mg/kg q18-24h.
:::::::* Postnatal age ≤ 7 days: [[Gentamycin]] 2.5 mg/kg q12h.
:::::::* Postnatal age > 7 days and 1200–2000 g: [[Gentamycin]] 2.5 mg/kg q8-12h.
:::::::* Postnatal age > 7 days and > 1200 g: [[Gentamycin]] 2.5 mg/kg q8h.
:::::::* Premature neonates with normal renal function: [[Gentamycin]] 3.5–4 mg/kg q24h.
:::::::* Term neonates with normal renal function: [[Gentamycin]] 3.5–5 mg/kg q24h.
::::::* 2.2.2.2 '''Infants and children < 5 years (> 4 weeks)''' 
:::::::* [[Gentamycin]] 2.5 mg/kg q8h; qd dosing in patients with normal renal function, [[Gentamycin]] 5–7.5 mg/kg q24h.
::::::* 2.2.2.3 '''Children ≥ 5 years ''' 
:::::::* [[Gentamycin]] 2–2.5 mg/kg q8h; qd with normal renal function, [[Gentamycin]] 5–7.5 mg/kg q24h.
:::::* 2.2.3 '''Pediatric dose of Trimethoprim-Sulfamethoxazole'''
::::::* 2.2.3.1 '''Infants > 2 months of age and children of mild-to-moderate infections '''
:::::::* [[Trimethoprim-Sulfamethoxazole]] 6–12 mg TMP/kg/day q12h; serious infection- [[Trimethoprim-Sulfamethoxazole]] 15–20 mg TMP/kg/day  q6-8h.

::* 3. '''Cellulitis'''<ref name="pmid24973422">{{cite journal| author=Stevens DL, Bisno AL, Chambers HF, Dellinger EP, Goldstein EJ, Gorbach SL et al.| title=Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. | journal=Clin Infect Dis | year= 2014 | volume= 59 | issue= 2 | pages= e10-52 | pmid=24973422 | doi=10.1093/cid/ciu444 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24973422  }} </ref>
::: 3.1 '''Purulent cellulitis''' (defined as cellulitis associated with purulent drainage or exudate in the absence of a drainable abscess)
::::* 3.1.1 '''In adults'''
:::::* Preferred regimen (1): [[Clindamycin]] 300–450 mg PO tid 
:::::* Preferred regimen (2): [[Trimethoprim-Sulfamethoxazole]] 1–2 DS (double strength) tab PO bid 
:::::* Preferred regimen (3): [[Doxycycline]] 100 mg PO bid 
:::::* Preferred regimen (4): [[Minocycline]] 200 mg as a single dose {{then}} 100 mg PO bid 
:::::* Preferred regimen (5): [[Linezolid]] 600 mg PO bid
:::* 3.1.2 '''In children'''
::::* Preferred regimen (1): [[Clindamycin]] 10–13 mg/kg PO q6–8h, not to exceed 40 mg/kg/day 
::::* Preferred regimen (2): [[Trimethoprim]] 4–6 mg/kg, [[Sulfamethoxazole]] 20–30 mg/kg PO q12h  
::::* Preferred regimen (3)
:::::* 3.1 If patient body weight < 45kg then [[Doxycycline]] 2 mg/kg PO q12h
:::::* 3.2 If patient body weight 45kg then [[Doxycycline]] adult dose  
::::* Preferred regimen (4): [[Minocycline]] 4 mg/kg PO 200 mg as a single dose, {{then}} [[Minocycline]] 2 mg/kg PO q12h   
::::* Preferred regimen (5): [[Linezolid]] 10 mg/kg PO q8h, (max: 600 mg) 
::* 3.2 '''Nonpurulent cellulitis''' (defined as cellulitis with no purulent drainage or exudate and no associated abscess)
:::* 3.2.1 '''In adults'''
::::* Preferred regimen (1): Beta-lactam (eg, [[Cephalexin]] and [[Dicloxacillin]]) 500 mg PO qid
::::* Preferred regimen (2): [[Clindamycin]] 300–450 mg PO tid 
::::* Preferred regimen (3): [[Amoxicillin]] 500 PO mg tid 
::::* Preferred regimen (4): [[Linezolid]] 600 mg PO bid
::::* Note (1): Empirical therapy for beta-hemolytic streptococci is recommended. Empirical coverage for CA-MRSA is recommended in patients who do not respond to beta-lactam therapy and may be considered in those with systemic toxicity.
::::* Note (2): Provide coverage for both beta-hemolytic streptococci and CA-MRSA beta-lactam (eg, [[Amoxicillin]]) with or without [[Trimethoprim-Sulfamethoxazole]] or a [[Tetracycline]]
:::* 3.2.2 '''In children'''
::::* Preferred regimen (1): [[Clindamycin]] 10–13 mg/kg PO q6–8h, not to exceed 40 mg/kg/day   
::::* Preferred regimen (2): [[Trimethoprim]] 4–6 mg/kg, [[Sulfamethoxazole]] 20–30 mg/kg PO q12h  
::::* Preferred regimen (3): [[Linezolid]] 10 mg/kg PO q8h, not to exceed 600 mg
::::* Note (1): [[Clindamycin]] causes Clostridium difficile–associated disease may occur more frequently, compared with other oral agents.
::::* Note (2): [[Trimethoprim-Sulfamethoxazole]] not recommended for women in the third trimester of pregnancy and for children ,2 months of age.
::::* Note (3): [[Tetracyclines]] are not recommended for children under 8 years of age and are pregnancy category D. 

::* 4. '''Brain abscess'''<ref>{{cite book | last = Bennett | first = John | title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases | publisher = Elsevier/Saunders | location = Philadelphia, PA | year = 2015 | isbn = 978-1455748013 }}</ref><ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref><ref>{{Cite journal| doi = 10.1093/cid/ciq146| issn = 1537-6591| volume = 52| issue = 3| pages = –18-55| last1 = Liu| first1 = Catherine| last2 = Bayer| first2 = Arnold| last3 = Cosgrove| first3 = Sara E.| last4 = Daum| first4 = Robert S.| last5 = Fridkin| first5 = Scott K.| last6 = Gorwitz| first6 = Rachel J.| last7 = Kaplan| first7 = Sheldon L.| last8 = Karchmer| first8 = Adolf W.| last9 = Levine| first9 = Donald P.| last10 = Murray| first10 = Barbara E.| last11 = J Rybak| first11 = Michael| last12 = Talan| first12 = David A.| last13 = Chambers| first13 = Henry F.| last14 = Infectious Diseases Society of America| title = Clinical practice guidelines by the infectious diseases society of america for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children| journal = Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America| date = 2011-02-01| pmid = 21208910}}</ref>
:::* 4.1 '''Methicillin-resistant Staphylococcus aureus (MRSA)'''
::::* 4.1.1 '''In adults'''
:::::* Preferred regimen: [[Vancomycin]] 30–45 mg/kg/day IV q8–12h for 4–6 weeks
:::::* Alternative regimen (1): [[Linezolid]] 600 mg PO/IV q12h for 4–6 weeks  
:::::* Alternative regimen (2): [[Trimethoprim-Sulfamethoxazole]] 5 mg/kg PO/IV q8–12h for 4–6 weeks
::::* 4.1.2 '''In children'''
:::::* Preferred regimen (1): [[Vancomycin]]15 mg/kg/dose IV q6h 
:::::* Preferred regimen (2): [[Linezolid]] 10 mg/kg/dose PO/IV q8h
:::::* Note: Consider the addition of [[Rifampin]] 600 mg qd {{or}} 300–450 mg bid to [[Vancomycin]].
:::* 4.2 '''Methicillin-susceptible Staphylococcus aureus (MSSA)'''
::::* Preferred regimen (1): [[Nafcillin]] 2 g IV q4h  
::::* Preferred regimen (2): [[Oxacillin]] 2 g IV q4h
::::* Alternative regimen: [[Vancomycin]] 30–45 mg/kg/day IV q8–12h

::* 5. '''Cerebrospinal fluid shunt infection'''<ref>{{Cite journal| doi = 10.1086/425368| issn = 1537-6591| volume = 39| issue = 9| pages = 1267–1284| last1 = Tunkel| first1 = Allan R.| last2 = Hartman| first2 = Barry J.| last3 = Kaplan| first3 = Sheldon L.| last4 = Kaufman| first4 = Bruce A.| last5 = Roos| first5 = Karen L.| last6 = Scheld| first6 = W. Michael| last7 = Whitley| first7 = Richard J.| title = Practice guidelines for the management of bacterial meningitis| journal = Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America| date = 2004-11-01| pmid = 15494903}}</ref><ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
:::* 5.1 '''Methicillin-resistant Staphylococcus aureus (MRSA)'''
::::* Preferred regimen: [[Vancomycin]] 30–45 mg/kg/day IV q8–12h with or without [[Rifampin]] 600 mg IV or PO q24h
::::* Note: Shunt removal is recommended, and it should not be replaced until cerebrospinal fluid cultures are repeatedly negative.
:::* 5.2 '''Methicillin-susceptible Staphylococcus aureus (MSSA)'''
::::* Preferred regimen (1): [[Nafcillin]] 2 g IV q4h with or without [[Rifampin]] 600 mg IV/PO q24h
::::* Preferred regimen (2): [[Oxacillin]] 2 g IV q4h

::* 6. '''Spinal epidural abscess'''<ref>{{cite book | last = Kasper | first = Dennis | title = Harrison's principles of internal medicine | publisher = McGraw Hill Education | location = New York | year = 2015 | isbn = 978-0071802154 }}</ref><ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref><ref>{{Cite journal| doi = 10.1056/NEJMra055111| issn = 1533-4406| volume = 355| issue = 19| pages = 2012–2020| last = Darouiche| first = Rabih O.| title = Spinal epidural abscess| journal = The New England Journal of Medicine| date = 2006-11-09| pmid = 17093252}}</ref><ref>{{Cite journal| doi = 10.1093/cid/ciq146| issn = 1537-6591| volume = 52| issue = 3| pages = –18-55| last1 = Liu| first1 = Catherine| last2 = Bayer| first2 = Arnold| last3 = Cosgrove| first3 = Sara E.| last4 = Daum| first4 = Robert S.| last5 = Fridkin| first5 = Scott K.| last6 = Gorwitz| first6 = Rachel J.| last7 = Kaplan| first7 = Sheldon L.| last8 = Karchmer| first8 = Adolf W.| last9 = Levine| first9 = Donald P.| last10 = Murray| first10 = Barbara E.| last11 = J Rybak| first11 = Michael| last12 = Talan| first12 = David A.| last13 = Chambers| first13 = Henry F.| last14 = Infectious Diseases Society of America| title = Clinical practice guidelines by the infectious diseases society of america for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children| journal = Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America| date = 2011-02-01| pmid = 21208910}}</ref>
:::* 6.1 '''Penicillin-susceptible Staphylococcus aureus or Streptococcus'''
::::* Preferred regimen: [[Penicillin G]] 4 MU IV q4h for 2–4 weeks, {{then}} PO to complete 6–8 weeks
:::* 6.2 '''Methicillin-susceptible Staphylococcus aureus or Streptococcus'''
::::* Preferred regimen (1): [[Cefazolin]] 2 g IV q8h for 2–4 weeks, {{then}} PO to complete 6–8 weeks  
::::* Preferred regimen (2): [[Nafcillin]] 2 g IV q4h for 2–4 weeks, {{then}} PO to complete 6–8 weeks 
::::* Preferred regimen (3): [[Oxacillin]] 2 g IV q4h for 2–4 weeks, {{then}} PO to complete 6–8 weeks
::::* Alternative regimen: [[Clindamycin]] 600 mg IV q6h for 2–4 weeks, {{then}} PO to complete 6–8 weeks
:::* 6.3 '''Methicillin-resistant Staphylococcus aureus (MRSA)'''
::::* 6.3.1 '''In adults'''
:::::* Preferred regimen: [[Vancomycin]] loading dose 25–30 mg/kg IV {{then}} [[Vancomycin]] 15–20 mg/kg IV q8–12h for 2–4 weeks, {{then}} PO to complete 6–8 weeks
:::::* Alternative regimen (1): [[Linezolid]] 600 mg PO/IV q12h for 4–6 weeks 
:::::* Alternative regimen (2): [[Trimethoprim-Sulfamethoxazole]] 5 mg/kg PO/IV q8–12h for 4–6 weeks
::::* 6.3.2 '''Pediatric dose'''
:::::* Preferred regimen (1): [[Vancomycin]] 15 mg/kg IV q6h 
:::::* Preferred regimen (2): [[Linezolid]] 10 mg/kg PO/IV q8h
:::::* Note: Consider the addition of [[Rifampin]] 600 mg qd or 300–450 mg bid to [[Vancomycin]] in adult patients.

::* 7. ''' Bacterial meningitis'''
:::* 7.1 '''Methicillin susceptible Staphylococcus aureus (MSSA)'''
::::* Preferred regimen (1): [[Nafcillin]] 9–12 g/day IV q4h 
::::* Preferred regimen (2): [[Oxacillin]] 9–12 g/day IV q4h
::::* Alternative regimen (1): [[Vancomycin]] 30–45 mg/kg/day IV q8–12h
::::* Alternative regimen (2): [[Meropenem]] 6 g/day IV q8h
:::* 7.2 '''Methicillin resistant Staphylococcus aureus (MRSA)'''
::::* Preferred regimen: [[Vancomycin]] 30–45 mg/kg/day IV q8–12h
::::* Alternative regimen (1): [[Trimethoprim-Sulfamethoxazole]] 10–20 mg/kg/day q6–12h  
::::* Alternative regimen (2): [[Linezolid]] 600 mg IV q12h
::::* Note: Consider the addition of [[Rifampin]] 600 mg qd or 300–450 mg bid to [[Vancomycin]] in adult patients.

::* 8. '''Septic thrombosis of cavernous or dural venous sinus'''<ref>{{Cite journal| doi = 10.1093/cid/ciq146| issn = 1537-6591| volume = 52| issue = 3| pages = –18-55| last1 = Liu| first1 = Catherine| last2 = Bayer| first2 = Arnold| last3 = Cosgrove| first3 = Sara E.| last4 = Daum| first4 = Robert S.| last5 = Fridkin| first5 = Scott K.| last6 = Gorwitz| first6 = Rachel J.| last7 = Kaplan| first7 = Sheldon L.| last8 = Karchmer| first8 = Adolf W.| last9 = Levine| first9 = Donald P.| last10 = Murray| first10 = Barbara E.| last11 = J Rybak| first11 = Michael| last12 = Talan| first12 = David A.| last13 = Chambers| first13 = Henry F.| last14 = Infectious Diseases Society of America| title = Clinical practice guidelines by the infectious diseases society of america for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children| journal = Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America| date = 2011-02-01| pmid = 21208910}}</ref>
:::* 8.1 '''Methicillin-resistant Staphylococcus aureus (MRSA)'''
::::* 8.1.1 '''In adults'''
:::::* Preferred regimen: [[Vancomycin]] 15–20 mg/kg IV q8–12h for 4–6 weeks
:::::* Alternative regimen (1): [[Linezolid]] 600 mg PO/IV q12h for 4–6 weeks  
:::::* Alternative regimen (2): [[Trimethoprim-Sulfamethoxazole]] 5 mg/kg/dose PO/IV q8–12h for 4–6 weeks
::::* 8.1.2 '''Pediatric dose'''
:::::* Preferred regimen (1): [[Vancomycin]] 15 mg/kg IV q6h 
:::::* Preferred regimen (2): [[Linezolid]] 10 mg/kg PO/IV q8h
:::::* Note (1): Surgical evaluation for incision and drainage of contiguous sites of infection or abscess is recommended whenever possible.
:::::* Note (2): Consider the addition of [[Rifampin]] 600 mg qd or 300–450 mg bid to [[Vancomycin]].

::* 9. '''Subdural empyema'''
:::* 9.1 '''Methicillin-resistant Staphylococcus aureus (MRSA)'''<ref>{{Cite journal| doi = 10.1093/cid/ciq146| issn = 1537-6591| volume = 52| issue = 3| pages = –18-55| last1 = Liu| first1 = Catherine| last2 = Bayer| first2 = Arnold| last3 = Cosgrove| first3 = Sara E.| last4 = Daum| first4 = Robert S.| last5 = Fridkin| first5 = Scott K.| last6 = Gorwitz| first6 = Rachel J.| last7 = Kaplan| first7 = Sheldon L.| last8 = Karchmer| first8 = Adolf W.| last9 = Levine| first9 = Donald P.| last10 = Murray| first10 = Barbara E.| last11 = J Rybak| first11 = Michael| last12 = Talan| first12 = David A.| last13 = Chambers| first13 = Henry F.| last14 = Infectious Diseases Society of America| title = Clinical practice guidelines by the infectious diseases society of america for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children| journal = Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America| date = 2011-02-01| pmid = 21208910}}</ref>
::::* 9.1.1 '''In adults'''
:::::* Preferred regimen: [[Vancomycin]] 30–45 mg/kg/day IV q8–12h for 4–6 weeks
:::::* Alternative regimen (1): [[Linezolid]] 600 mg PO/IV q12h for 4–6 weeks 
:::::* Alternative regimen (2): [[Trimethoprim-Sulfamethoxazole]] 5 mg/kg PO/IV q8–12h for 4–6 weeks
::::* 9.1.2 '''In children'''
:::::* Preferred regimen (1): [[Vancomycin]] 15 mg/kg IV q6h 
:::::* Preferred regimen (2): [[Linezolid]] 10 mg/kg PO/IV q8h
:::::* Note: Consider the addition of [[Rifampin]] 600 mg qd or 300–450 mg bid to [[Vancomycin]].

::* 10. ''' Acute conjunctivitis'''<ref>{{Cite journal| doi = 10.1001/jama.2013.280318| issn = 1538-3598| volume = 310| issue = 16| pages = 1721–1729| last1 = Azari| first1 = Amir A.| last2 = Barney| first2 = Neal P.| title = Conjunctivitis: a systematic review of diagnosis and treatment| journal = JAMA| date = 2013-10-23| pmid = 24150468| pmc = PMC4049531}}</ref>
:::* 10.1 '''Methicillin-resistant Staphylococcus aureus (MRSA)'''
::::* Preferred regimen: [[Vancomycin]] ointment 1% qid

::* 11. '''Appendicitis'''
:::* 11.1 '''Health care–associated complicated intra-abdominal infection'''<ref name="pmid20034345">{{cite journal| author=Solomkin JS, Mazuski JE, Bradley JS, Rodvold KA, Goldstein EJ, Baron EJ et al.| title=Diagnosis and management of complicated intra-abdominal infection in adults and children: guidelines by the Surgical Infection Society and the Infectious Diseases Society of America. | journal=Clin Infect Dis | year= 2010 | volume= 50 | issue= 2 | pages= 133-64 | pmid=20034345 | doi=10.1086/649554 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20034345  }} </ref>
::::* 11.1.1 '''Methicillin-resistant Staphylococcus aureus (MRSA)'''
:::::* Preferred regimen: [[Vancomycin]] 15–20 mg/kg IV q8–12h

::* 12. '''Diverticulitis'''
:::* 12.1 '''Health care–associated complicated intra-abdominal infection'''<ref name="pmid20034345">{{cite journal| author=Solomkin JS, Mazuski JE, Bradley JS, Rodvold KA, Goldstein EJ, Baron EJ et al.| title=Diagnosis and management of complicated intra-abdominal infection in adults and children: guidelines by the Surgical Infection Society and the Infectious Diseases Society of America. | journal=Clin Infect Dis | year= 2010 | volume= 50 | issue= 2 | pages= 133-64 | pmid=20034345 | doi=10.1086/649554 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20034345  }} </ref>
::::* 12.1.1 '''Methicillin-resistant Staphylococcus aureus (MRSA)'''
:::::* Preferred regimen: [[Vancomycin]] 15–20 mg/kg IV q8–12h.

::* 13. '''Peritonitis secondary to bowel perforation, peritonitis secondary to ruptured appendix, peritonitis secondary to ruptured  appendix, typhlitis'''
:::* 13.1 '''Health care–associated complicated intra-abdominal infection'''<ref name="pmid20034345">{{cite journal| author=Solomkin JS, Mazuski JE, Bradley JS, Rodvold KA, Goldstein EJ, Baron EJ et al.| title=Diagnosis and management of complicated intra-abdominal infection in adults and children: guidelines by the Surgical Infection Society and the Infectious Diseases Society of America. | journal=Clin Infect Dis | year= 2010 | volume= 50 | issue= 2 | pages= 133-64 | pmid=20034345 | doi=10.1086/649554 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20034345  }} </ref>
::::* 13.1.1 '''Methicillin-resistant Staphylococcus aureus (MRSA)'''
:::::* Preferred regimen: [[Vancomycin]] 15–20 mg/kg IV q8–12h

::* 14. '''Cystic fibrosis'''<ref name="pmid23540878">{{cite journal| author=Mogayzel PJ, Naureckas ET, Robinson KA, Mueller G, Hadjiliadis D, Hoag JB et al.| title=Cystic fibrosis pulmonary guidelines. Chronic medications for maintenance of lung health. | journal=Am J Respir Crit Care Med | year= 2013 | volume= 187 | issue= 7 | pages= 680-9 | pmid=23540878 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23540878  }} </ref>
:::* 14.1 '''Adults'''
::::* 14.1.1 '''If methicillin sensitive staphylococcus aureus'''
:::::* Preferred Regimen (1): [[Nafcillin]] 2 gm IV q4h
:::::* Preferred Regimen (2): [[Oxacillin]] 2 gm IV q4h
::::* 14.1.2 '''If methicillin resistant staphylococcus aureus'''
:::::* Preferred Regimen (1): [[Vancomycin]] 15-20 mg/kg IV q8-12h  
:::::* Preferred Regimen (2): [[Linezolid]] 600 mg PO/IV q12h
:::* 14.2 '''Pediatric'''
::::* 14.2.1 '''If methicillin sensitive staphylococcus aureus'''
:::::* Preferred Regimen (1): [[Nafcillin]] 5 mg/kg q6h (Age >28 days) 
:::::* Preferred Regimen (2): [[Oxacillin]] 75 mg/kg q6h (Age >28 days)
::::* 14.2.2 '''If methicillin resistant staphylococcus aureus'''
:::::* Preferred Regimen (1): [[Vancomycin]] 40 mg/kg  q6-8h (Age >28 days) 
:::::* Preferred Regimen (2): [[Linezolid]] 10 mg/kg PO/IV q8h (up to age 12)

::* 15. '''Bronchiectasis'''<ref name="pmid20627931">{{cite journal| author=Pasteur MC, Bilton D, Hill AT, British Thoracic Society Bronchiectasis non-CF Guideline Group| title=British Thoracic Society guideline for non-CF bronchiectasis. | journal=Thorax | year= 2010 | volume= 65 Suppl 1 | issue=  | pages= i1-58 | pmid=20627931 | doi=10.1136/thx.2010.136119 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20627931  }} </ref>
:::* 15.1 '''In adults'''
::::* 15.1.1 '''Recommended first-line treatment and length of treatment'''
:::::* 15.1.1.1 '''Methicillin-susceptible Staphylococcus aureus (MSSA)'''
::::::* Preferred regimen: [[Flucloxacillin]] 500 mg PO qds for 14 days
:::::* 15.1.1.2  '''Methicillin-resistant Staphylococcus aureus (MRSA)'''
::::::* '''Patient's body weight is < 50 kg'''
:::::::* Preferred regimen: [[Rifampicin]] 450 mg PO qd {{and}} [[Trimethoprim]] 200 mg PO bd for 14 days 
::::::* '''Patient's body weight is > 50 kg'''
:::::::* Preferred regimen: [[Rifampicin]] 600 mg PO qd {{and}} [[Trimethoprim]] 200 mg PO bd for 14 days
:::::* 15.1.1.3 '''Methicillin-resistant Staphylococcus aureus (MRSA)'''
::::::* Preferred regimen (1): [[Vancomycin]] 1 g IV bd (monitor serum levels and adjust dose accordingly) 
::::::* Preferred regimen (2): [[Teicoplanin]] 400 mg qd for 14 days
::::* 15.1.2 '''Recommended second-line treatment and length of treatment'''
:::::* 15.1.2.1 '''Methicillin-susceptible Staphylococcus aureus (MSSA)'''
::::::* Preferred regimen: [[Clarithromycin]] 500 mg PO bd 14 days
:::::* 15.1.2.2 '''Methicillin-resistant Staphylococcus aureus (MRSA)'''
::::::* '''Patient's body weight is < 50 kg '''
:::::::* Preferred regimen: [[Rifampicin]] 450 mg PO qd {{and}} [[Doxycycline]] 200 mg PO qd for 14 days
::::::* '''Patient's body weight is > 50 kg''' 
:::::::* Preferred regimen: [[Rifampicin]] 600 mg PO qd {{and}} [[Doxycycline]] 200 mg PO qd for 14 days 
::::::* '''Third-line''': [[Linezolid]] 600 mg bd for 14 days
:::::* 15.1.2.3 '''Methicillin-resistant Staphylococcus aureus (MRSA)'''
::::::* Preferred regimen: [[Linezolid]] 600 mg IV bd for 14 days
:::* 15.2 '''In children'''
::::* 15.2.1 '''Recommended first-line treatment and length of treatment'''
:::::* 15.2.1.1 '''Methicillin-susceptible Staphylococcus aureus (MSSA)'''
::::::* Preferred regimen: [[Flucloxacillin]] 
:::::* 15.2.1.2 '''Methicillin-resistant Staphylococcus aureus (MRSA)'''
::::::* 15.2.1.2.1 '''Children''' (< 12 yr)
:::::::* Preferred regimen: [[Trimethoprim]] 4-6 mg/kg/day PO q12h  
::::::* 15.2.1.2.2 '''Children''' (> 12 yr)  
:::::::* Preferred regimen (1): [[Trimethoprim]] 100-200 mg PO q12h  
:::::::* Preferred regimen (2): [[Rifampicin]] 450 mg PO od (or [[Rifampicin]] 600 mg PO od) 
:::::* 15.2.1.3 '''Methicillin-resistant Staphylococcus aureus (MRSA)''' 
::::::* Preferred regimen (1): [[Vancomycin]] 45-60 mg/kg/day IV q8-12h   
::::::* Preferred regimen (2): [[Teicoplanin]] 400 mg qd for 14 days 
::::* 15.2.2 '''Recommended second-line treatment and length of treatment'''
:::::* 15.2.2.1 '''Methicillin-susceptible Staphylococcus aureus (MSSA)'''
::::::* Preferred regimen: [[Clarithromycin]] 15 mg/kg/day PO q12h  
:::::* 15.2.2.2 '''Methicillin-resistant Staphylococcus aureus (MRSA)'''
::::::* Preferred regimen (1): [[Rifampicin]] {{and}} [[Doxycycline]] 2-5 mg/kg/day PO/IV q12-24h  (max dose: 200 mg/24 hr)   
::::::* Preferred regimen (2): [[Rifampicin]] {{and}} [[Doxycycline]] 2-5 mg/kg/day PO/IV q12-24h  (max dose: 200 mg/24 hr)  
::::::* '''Third-line''': [[Linezolid]] 10 mg/kg PO/IV q12h 
:::::* 15.2.2.3 '''Methicillin-resistant Staphylococcus aureus (MRSA)'''
::::::* Preferred regimen: [[Linezolid]] 10 mg/kg PO/IV q12h 
:::*  15.3 '''Long-term oral antibiotic treatment'''
::::* 15.3.1 '''In adults'''
:::::* 15.3.1.1 '''Recommended first-line treatment and length of treatment'''
::::::* 15.3.1.1.1 '''Methicillin-susceptible Staphylococcus aureus (MSSA)'''
:::::::* Preferred regimen: [[Flucloxacillin]] 500 mg PO bd
:::::* 15.3.1.2 '''Recommended second-line treatment and length of treatment'''
::::::* 15.3.1.2.1 '''Methicillin-susceptible Staphylococcus aureus (MSSA)'''
:::::::* Preferred regimen: [[Clarithromycin]] 250 mg PO bd

::* 16. '''Empyema'''<ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
:::* Preferred regimen (1): [[Nafcillin]]  2 gm IV q4h 
:::* Preferred regimen (2): [[oxacillin]]  2 gm IV q4h (if MSSA) 
:::* Alternative regimen (1): [[Vancomycin]]  1 gm IV q12h 
:::* Alternative regimen (2): [[Linezolid]]  600 mg PO bid (if MRSA)

::* 17. '''Community-acquired pneumonia'''<ref name="pmid17278083">{{cite journal| author=Mandell LA, Wunderink RG, Anzueto A, Bartlett JG, Campbell GD, Dean NC et al.| title=Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. | journal=Clin Infect Dis | year= 2007 | volume= 44 Suppl 2 | issue=  | pages= S27-72 | pmid=17278083 | doi=10.1086/511159 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17278083  }} </ref>
:::* 17.1 '''Methicillin-susceptible Staphylococcus aureus (MSSA)'''
::::* Preferred Regimen (1): [[Nafcillin]] 1000-2000 mg q4h  
::::* Preferred Regimen (2): [[Oxacillin]] 2 g IV q4h  
::::* Preferred Regimen (3): [[Flucloxacillin]] 250 mg IM/IV q6h
::::* Alternative Regimen (1): [[Cefazolin]] 500 mg IV q12h  
::::* Alternative Regimen (2): [[Clindamycin]] 150-450 mg PO q6-8h
:::* 17.2 '''Methicillin-resistant Staphylococcus aureus (MRSA)'''
::::* Preferred Regimen (1): [[Vancomycin]] 45-60 mg/kg/day q8-12h (max: 2000 mg/dose) for 7-21 days 
::::* Preferred Regimen (2): [[Linezolid]] 600 mg PO/IV q12h for 10-14 days
::::* Alternative Regimen: [[Trimethoprim-Sulfamethoxazole]] 1-2 double-strength tablets (800/160 mg) q12-24h

::* 18. '''Olecranon bursitis or prepatellar bursitis'''
:::* 18.1 '''Methicillin-susceptible Staphylococcus aureus (MSSA)'''
::::* Preferred regimen (1): [[Nafcillin]] 2 g IV q4h  
::::* Preferred regimen (2): [[Oxacillin]] 2 g IV q4h 
::::* Preferred regimen (3): [[Dicloxacillin]] 500 mg PO qid
:::* 18.2 '''Methicillin-resistant Staphylococcus aureus (MRSA)'''
::::* Preferred regimen (1): [[Vancomycin]] 1 g IV q12h 
::::* Preferred regimen (2): [[Linezolid]] 600 mg PO qd
::::* Note: Initially aspirate q24h and treat for a minimum of 2–3 weeks.

::* 19. '''Septic arthritis'''
:::* 19.1 '''In adults'''
::::* 19.1.1 '''Methicillin-resistant Staphylococcus aureus (MRSA)'''
:::::* Preferred regimen: [[Vancomycin]] 15–20 mg/kg IV q8–12h
:::::* Alternative regimen (1): [[Daptomycin]] 6 mg/kg IV q24h in adults 
:::::* Alternative regimen (2): [[Linezolid]] 600 mg PO/IV q12h
:::::* Alternative regimen (3): [[Clindamycin]] 600 mg PO/IV q8h
:::::* Alternative regimen (4): TMP-SMX 3.5–4.0 mg/kg PO/IV q8–12h 
::::* 19.2.1 '''Methicillin-susceptible Staphylococcus aureus (MSSA)'''
:::::* Preferred regimen (1): [[Nafcillin]] 2 g IV q6h 
:::::* Preferred regimen (2): [[Clindamycin]] 900 mg IV q8h
:::::* Alternative regimen (1): [[Cefazolin]] 0.25–1 g IV/IM q6–8h 
:::::* Alternative regimen (2): [[Vancomycin]] 500 mg IV q6h or 1 g IV q12h
:::* 19.2 '''In childern'''
::::* Preferred regimen (1): [[Vancomycin]] 15 mg/kg IV q6h 
::::* Preferred regimen (2): [[Daptomycin]] 6–10 mg/kg IV q24h 
::::* Preferred regimen (3): [[Linezolid]] 10 mg/kg PO/IV q8h 
::::* Preferred regimen (4): [[Clindamycin]] 10–13 mg/kg PO/IV q6–8h

::* 20. '''Septic arthritis, prosthetic joint infection (device-related osteoarticular infections)'''
:::* 20.1 ''' Methicillin-susceptible Staphylococcus aureus (MSSA)'''
::::* Preferred regimen (1): [[Nafcillin]] 2 g IV q4–6h 
::::* Preferred regimen (2): [[Oxacillin]] 2 g IV q4–6h 
::::* Alternative regimen (1): [[Cefazolin]] 1–2 g IV q8h  
::::* Alternative regimen (2): [[Ceftriaxone]] 2 g IV q24h
::::* Alternative regimen (if allergic to penicillins) (3): [[Clindamycin]] 900 mg IV q8h 
::::* Alternative regimen (if allergic to penicillins) (4): [[Vancomycin]] 15–20 mg/kg IV q8–12h, (max: 2 g per dose)
:::* 20.2 '''Methicillin-resistant Staphylococcus aureus (MRSA)'''
::::* Early-onset (2 months after surgery) or acute hematogenous prosthetic joint infections involving a stable implant with short duration (< 3 weeks) of symptoms and debridement (but device retention)
::::* Preferred regimen: [[Vancomycin]] {{and}} [[Rifampin]] 600 mg PO qd or 300–450 mg PO bid for 2 weeks
::::* Alternative regimen (1): [[Daptomycin]] 6 mg/kg IV q24h {{and}} [[Rifampin]] 600 mg PO qd or 300–450 mg PO bid for 2 weeks 
::::* Alternative regimen (2): [[Linezolid]] 600 IV q8h {{and}} [[Rifampin]] 600 mg PO qd or 300–450 mg PO bid for 2 weeks
::::* Note: The above regimen should be followed by [[Rifampin]] and a [[Fluoroquinolone]], TMP/SMX, a [[Tetracycline]] or [[Clindamycin]] for 3-6 months for hips and knees, respectively.

::* 21. '''Hematogenous osteomyelitis'''
:::* 21.1 '''Adult''' (> 21 yrs)
::::* 21.1.1 '''Methicillin-resistant Staphylococcus aureus (MRSA)''' possible
:::::* Preferred regimen: [[Vancomycin]] 1 gm IV q12h (if over 100 kg, 1.5 gm IV q12h)
::::* 21.1.2 '''Methicillin-resistant Staphylococcus aureus (MRSA)''' unlikely 
:::::* Preferred regimen (1): [[Nafcillin]]  
:::::* Preferred regimen (2): [[Oxacillin]] 2 gm IV q4h
:::* 21.2 '''Children''' (> 4 months)-Adult
::::* 21.2.1 '''Methicillin-resistant Staphylococcus aureus (MRSA)''' possible
:::::* Preferred regimen: [[Vancomycin]] 40 mg IV q6–8h 
::::* 21.2.2 '''Methicillin-resistant Staphylococcus aureus (MRSA)''' unlikely 
:::::* Preferred regimen (1): [[Nafcillin]] 
:::::* Preferred regimen (2): [[Oxacillin]] q6h (max. 8–12 gm per day) 
:::::* Note: Add [[Ceftazidime]] 50 mg q8h or [[Cefepime]] 150 mg q8h if Gram negative bacilli on Gram stain  
:::* 21.3 '''Newborn''' (< 4 months.)
::::* 21.3.1 '''Methicillin-resistant Staphylococcus aureus (MRSA)''' possible
:::::* Preferred regimen (1): [[Vancomycin]] {{and}} [[Ceftazidime]] 2 gm IV q8h 
:::::* Preferred regimen (2): [[Vancomycin]] {{and}} [[Cefepime]] 2 gm IV q12h 
::::* 21.3.2 '''Methicillin-resistant Staphylococcus aureus (MRSA)''' unlikely 
:::::* Preferred regimen (1): [[Nafcillin]]  {{and}} [[Ceftazidime]] 
:::::* Preferred regimen (2): [[Oxacillin]] {{and}} [[Cefepime]]
:::* 21.4 '''Specific therapy'''
::::* 21.4.1 ''' Methicillin-susceptible Staphylococcus aureus (MSSA)'''
:::::* Preferred regimen (1): [[Nafcillin]] 
:::::* Preferred regimen (2): [[Oxacillin]] 2 gm IV q4h 
:::::* Preferred regimen (3): [[Cefazolin]] 2 gm IV q8h 
:::::* Alternative regimen: [[Vancomycin]] 1 gm IV q12h (if over 100 kg, 1.5 gm IV q12h)
::::* 21.4.2 '''Methicillin-resistant Staphylococcus aureus (MRSA)'''
:::::* Preferred regimen: [[Vancomycin]] 1 gm IV q12h
:::::* Alternative regimen: [[Linezolid]] 600 mg q12h PO/IV with or without [[Rifampin]] 300 mg PO/IV bid

::* 22. '''Diabetic foot osteomyelitis'''
:::* High risk for MRSA
::::* Preferred regimen (1): [[Linezolid]] 600 mg IV or PO q12h 
::::* Preferred regimen (2): [[Daptomycin]] 4 mg/kg IV q24h 
::::* Preferred regimen (3): [[Vancomycin]] 15–20 mg/kg IV q8–12h (trough: 10–20 mg/L)

::* 23. ''' Necrotizing fasciitis'''<ref name="pmid24947530">{{cite journal| author=Stevens DL, Bisno AL, Chambers HF, Dellinger EP, Goldstein EJ, Gorbach SL et al.| title=Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the infectious diseases society of America. | journal=Clin Infect Dis | year= 2014 | volume= 59 | issue= 2 | pages= 147-59 | pmid=24947530 | doi=10.1093/cid/ciu296 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24947530  }} </ref>
:::* 23.1 '''In adult'''
::::* Preferred regimen (1): [[Nafcillin]] 1–2 g IV  q4h (severe Pencillin allergy: [[Vancomycin]], [[linezolid]], [[quinupristin]]/[[dalfopristin]], daptomycin)
::::* Preferred regimen (2): [[Oxacillin]] 1–2 g IV  q4h 
::::* Preferred regimen (3): [[Cefazolin]] 1 g IV  q8h 
::::* Preferred regimen (4): [[Vancomycin]] 15 mg/kg IV bid
::::* Preferred regimen (5): [[Clindamycin]] 600–900 mg IV  q8h 
:::* 23.2 '''In childern'''
::::* Preferred regimen (1): [[Nafcillin]] 50 mg/kg/dose IV  q6h  (severe Pencillin allergy: [[Vancomycin]], [[linezolid]], [[quinupristin]]/[[dalfopristin]], [[daptomycin]])
::::* Preferred regimen (2): [[Oxacillin]] 50 mg/kg/dose IV q6h 
::::* Preferred regimen (3): [[Cefazolin]] 33 mg/kg/dose IV q8h 
::::* Preferred regimen (4): [[Vancomycin]] 15 mg/kg/dose IV q6h 
::::* Preferred regimen (5): [[Clindamycin]] 10–13 mg/kg/dose IV q8h  ([[Bacteriostatic]]; potential cross-resistance and emergence of resistance in [[erythromycin]]-resistant strains; inducible resistance in methicillin resistent staphylococcus aureus)

::* 24. '''Staphylococcal toxic shock syndrome'''<ref name="pmid19393958">{{cite journal| author=Lappin E, Ferguson AJ| title=Gram-positive toxic shock syndromes. | journal=Lancet Infect Dis | year= 2009 | volume= 9 | issue= 5 | pages= 281-90 | pmid=19393958 | doi=10.1016/S1473-3099(09)70066-0 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19393958  }} </ref>
:::* 24.1 '''Methicillin sensitive Staphylococcus aureus'''
::::* Preferred regimen (1): [[Cloxacillin]]  250-500 mg PO q6h (max dose: 4 g/24 hr) 
::::* Preferred regimen (2): [[Nafcillin]]  4-12 g/24 hr IV q4-6hr (max dose: 12 g/24 hr) 
::::* Preferred regimen (3): [[Cefazolin]] 0.5-2g IV/IM q8h (max dose: 12 g/24 hr) {{and}} [[Clindamycin]] 150-600 mg IV, IM/PO q6-8h  (max dose: 5 g/24 hr IV or IM or 2 g/24 hr PO)
::::* Alternative regimen (1): [[Clarithromycin]] 250-500 mg PO q12h (max dose: 1 g/24 hr) {{and}} [[Clindamycin]] 150-600 mg IV, IM/PO q6-8h  (max dose: 5 g/24 hr IV/IM or 2 g/24h PO)
::::* Alternative regimen (2): [[Rifampicin]] {{and}} [[Linezolid]] 600 mg IV/PO q12h 
::::* Alternative regimen (3): [[Daptomycin]] 
::::* Alternative regimen (4): [[Tigecycline]] 100 mg loading dose {{then}} 50 mg IV q12h
:::* 24.2 '''Methicillin resistant Staphylococcus  aureus'''
::::* Preferred regimen (1): [[Clindamycin]] 150-600 mg IV, IM/PO q6-8h (max dose: 5 g/24h IV/IM or 2 g/24h PO) 
::::* Preferred regimen (2): [[Linezolid]] 600 mg IV/PO q12h {{and}} [[Vancomycin]] 15-20 mg/kg IV q8-12h, (max: 2 g per dose)
::::* Preferred regimen (3): [[Teicoplanin]]
::::* Alternative regimen (1): [[Rifampicin]] {{and}} [[Linezolid]] 600 mg IV/PO q12h 
::::* Alternative regimen (2): [[Daptomycin]] 
::::* Alternative regimen (3): [[Tigecycline]] 100 mg loading dose {{then}} 50 mg IV q12h 
:::* 24.3 '''Glycopeptide resistant or intermediate Staphylococcus aureus'''
::::* Preferred regimen: [[Linezolid]] 600 mg IV/PO q12h {{and}} [[Clindamycin]] 150-600 mg IV, IM/PO q6-8h (max dose: 5 g/24 hr IV/IM or 2 g/24h PO) (if sensitive)
::::* Alternative regimen (1): [[Daptomycin]] 
::::* Alternative regimen (2): [[Tigecycline]] 100 mg loading dose {{then}} 50 mg IV q12h 

::* '''Staphylococcus aureus ,prophylaxis'''
:::* 1. '''Prophylaxis for coronary artery bypass graft-associated acute mediastinitis'''<ref name="pmid22070836">{{cite journal| author=Hillis LD, Smith PK, Anderson JL, Bittl JA, Bridges CR, Byrne JG et al.| title=2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery. A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Developed in collaboration with the American Association for Thoracic Surgery, Society of Cardiovascular Anesthesiologists, and Society of Thoracic Surgeons. | journal=J Am Coll Cardiol | year= 2011 | volume= 58 | issue= 24 | pages= e123-210 | pmid=22070836 | doi=10.1016/j.jacc.2011.08.009 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22070836  }} </ref>
::::* 1.1 '''Methicillin susceptible staphylococcus aureus (MSSA)'''
:::::* Preferred regimen: A first- or second-generation [[Cephalosporin]] is recommended for prophylaxis in patients without MRSA colonization.

::::* 1.2 '''Methicillin resistant staphylococcus aureus (MRSA)'''
:::::* Preferred regimen: [[Vancomycin]] alone or in combination with other antibiotics to achieve broader coverage is recommended for prophylaxis in patients with proven or suspected MRSA colonization
:::::* Note (1): Preoperative antibiotics should be administered to all patients to reduce the risk of mediastinitis in cardiac surgery.
:::::* Note (2): The use of intranasal [[Mupirocin]] is reasonable in nasal carriers of Staphylococcus aureus.

----

{{PBI|Staphylococcus haemolyticus}}
:* 1. '''Methicillin-susceptible strain'''<ref>{{cite book | last = Abramowicz | first = Mark | title = Handbook of antimicrobial therapy : selected articles from Treatment guidelines with updates from The medical letter | publisher = The Medical Letter | location = New Rochelle, N.Y | year = 2011 | isbn = 978-0981527826 }}</ref><ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
::* Preferred regimen (1): [[Nafcillin]] 1–2 g IV q4-6h (maximum 12 g/day)
::* Preferred regimen (2): [[Oxacillin]] 1–2 g IVq4-6h (maximum 12 g/day)
::* Preferred regimen (3): [[Cefazolin]] 0.5–2 g IV q6-8h
::* Alternative regimen (1): [[TMP-SMX]] 4–5 mg/kg IV q6–12h
::* Alternative regimen (2): [[Doxycycline]] 100–200 mg IV q12-24h
:* 2. '''Methicillin-resistant, Glycopeptide-susceptible strain'''
::* Preferred regimen: [[Vancomycin]] 15–20 mg/kg IV q8–12h
:* 3. '''Methicillin-resistant, Glycopeptide-resistant strain'''
::* Preferred regimen (1): [[Daptomycin]] 4–6 mg/kg IV q24h
::* Preferred regimen (2): [[Linezolid]] 600 mg PO/IV q12h

----


{{PBI|Staphylococcus epidermidis}}
*Staphylococcus epidermidis<ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
:*1. '''Methicillin-sensitive Staphylococcus epidermidis'''
::*Preferred regimen (1): [[Oxacillin]] 1-2 g IV q4h
::*Preferred regimen (2): [[Nafcillin]] 1-2 g IV q4h
::*Preferred regimen (3): [[Cephalothin]]
::*Alternative regimen: [[Rifampin]] 600 mg/day PO qd {{plus}} [[Sulfamethoxazole]] and [[Trimethoprim]] {{or}} [[Fluoroquinolones]] {{and}} [[Daptomycin]] 600 mg PO/IV q12h<ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
::*Note: 75% of the S. epidermidis are methicillin-resistant.
:*2. '''Methicillin-resistant Staphylococcus epidermidis'''
::*Preferred regimen: [[Vancomycin]] 1 g IV q12h {{withorwithout}} [[Rifampin]] 600 mg/day PO qd
:*Note: For deep-seated infections consider adding [[Gentamicin]] {{and}}/{{or}} [[Rifampin]] 600 mg/day PO qd to the regimen<ref name="pmid15956145">{{cite journal| author=Baddour LM, Wilson WR, Bayer AS, Fowler VG, Bolger AF, Levison ME et al.| title=Infective endocarditis: diagnosis, antimicrobial therapy, and management of complications: a statement for healthcare professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association: endorsed by the Infectious Diseases Society of America. | journal=Circulation | year= 2005 | volume= 111 | issue= 23 | pages= e394-434 | pmid=15956145 | doi=10.1161/CIRCULATIONAHA.105.165564 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15956145  }} </ref>
:*3. '''Prosthetic device infections'''
::*Preferred regimen: [[Oxacillin]] 1-2 g IV q4h {{or}} [[Vancomycin]] 1 g IV q12h {{plus}} [[Rifampin]] 600 mg/day PO qd {{and}} [[Gentamicin]] 3 mg/kg/day IV/IM q8-24h is appropriate<ref name="pmid15956145">{{cite journal| author=Baddour LM, Wilson WR, Bayer AS, Fowler VG, Bolger AF, Levison ME et al.| title=Infective endocarditis: diagnosis, antimicrobial therapy, and management of complications: a statement for healthcare professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association: endorsed by the Infectious Diseases Society of America. | journal=Circulation | year= 2005 | volume= 111 | issue= 23 | pages= e394-434 | pmid=15956145 | doi=10.1161/CIRCULATIONAHA.105.165564 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15956145  }} </ref>
:*Note: Duration depends on site of infection and severity.


----

{{PBI|Staphylococcus lugdunensis}}
:* Staphylococcus lugdunensis treatment
::* 1. '''Skin and soft tissue infections'''<ref name="pmid172078">{{cite journal| author=Tashima Y, Hasegawa M| title=Specific inhibition of ouabain sensitive and K+-dependent p-nitrophenylphosphatase by polyamines. | journal=Biochem Biophys Res Commun | year= 1975 | volume= 66 | issue= 4 | pages= 1344-8 | pmid=172078 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=172078  }} </ref>
:::* Preferred regimen: [[Oxacillin]] 1-2 g IV q4h for 1-2 weeks 
::::* Note:  Abscesses should be drained if possible.
::* 2. ''' Endocarditis'''<ref name="pmid15657200">{{cite journal| author=Anguera I, Del Río A, Miró JM, Matínez-Lacasa X, Marco F, Gumá JR et al.| title=Staphylococcus lugdunensis infective endocarditis: description of 10 cases and analysis of native valve, prosthetic valve, and pacemaker lead endocarditis clinical profiles. | journal=Heart | year= 2005 | volume= 91 | issue= 2 | pages= e10 | pmid=15657200 | doi=10.1136/hrt.2004.040659 | pmc=PMC1768720 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15657200  }} </ref>
:::* 2.1 '''Native valve infectious endocarditis'''
::::* Preferred regimen (1): [[Vancomycin]] 15 mg/kg IV q12h (target trough concentration, 10 to 15 mcg/mL) 
::::* Preferred regimen (for most patients with normal renal function) (2): [[Vancomycin]] 15 to 20 mg/kg (actual body weight) IV q8-12h -for trough concentration of 15 to 20 mcg/mL (minimum inhibitory concentration, 1 mcg/mL or less)
:::::* Note: should consist of 6 weeks of parenteral beta-lactam therapy or [[Vancomycin]] (depending on susceptibility testing and beta-lactam hypersensitivity).
:::* 2.2 '''Prosthetic valve infective endocarditis''' 
::::* Preferred regimen: Combination therapy including a beta-lactam (or [[Vancomycin]]) with an [[Aminoglycoside]]- [[Gentamicin]] 3 mg/kg/day in 1-3 divided doses and [[Rifampin]] 300 mg PO/IV q8h for at least 6 weeks 
:::::* Note (1): Combine with [[Vancomycin]] for the entire duration of therapy and [[Gentamicin]] for the first 2 weeks.
:::::* Note (2): The [[Gentamicin]] should be administered for the first 2 weeks of therapy; the beta-lactam (or [[Vancomycin]]) and [[Rifampin]] should be continued for 6 weeks. 
:::::* Note (3): Surgery must be considered given the frequency of valvular compromise in the setting of Staphylococcus lugdunensis infective endocarditis.
:::::* Note (4): The treatment of Staphylococcus lugdunensis pacemaker endocarditis includes antibiotic therapy as well as removal of the pacer system
::* 3. '''Bacteremia'''<ref name="pmid19489710">{{cite journal| author=Mermel LA, Allon M, Bouza E, Craven DE, Flynn P, O'Grady NP et al.| title=Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 Update by the Infectious Diseases Society of America. | journal=Clin Infect Dis | year= 2009 | volume= 49 | issue= 1 | pages= 1-45 | pmid=19489710 | doi=10.1086/599376 | pmc=PMC4039170 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19489710  }} </ref>
:::* Preferred regimen: [[Oxacillin]] 1-2 g IV q4h for 1-2 weeks 
::::* Note (1): Bacteremia without endocarditis (often related to an intravascular catheter) appears to have a good prognosis. 
::::* Note (2): For intravascular catheter-related Staphylococcus lugdunensis bacteremia, the catheter should be removed, followed by 14 days of antibiotics, provided that all of the following are applicable
:::::* 2.1 The patient is not diabetic or immunosuppressed. 
:::::* 2.2 There is no prosthetic material, thrombophlebitis, infective endocarditis, evidence of metastatic infection. 
:::::* 2.3 The patient’s fever and bacteremia resolve within 72 hours after initiation of appropriate antibiotic therapy.
::* 4. '''Prosthetic devices'''<ref name="pmid21208910">{{cite journal| author=Liu C, Bayer A, Cosgrove SE, Daum RS, Fridkin SK, Gorwitz RJ et al.| title=Clinical practice guidelines by the infectious diseases society of america for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children. | journal=Clin Infect Dis | year= 2011 | volume= 52 | issue= 3 | pages= e18-55 | pmid=21208910 | doi=10.1093/cid/ciq146 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21208910  }} </ref>,<ref name="pmid19489710">{{cite journal| author=Mermel LA, Allon M, Bouza E, Craven DE, Flynn P, O'Grady NP et al.| title=Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 Update by the Infectious Diseases Society of America. | journal=Clin Infect Dis | year= 2009 | volume= 49 | issue= 1 | pages= 1-45 | pmid=19489710 | doi=10.1086/599376 | pmc=PMC4039170 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19489710  }} </ref>
:::* Preferred regimen (1): [[Vancomycin]] 15 mg/kg IV q12h (target trough concentration, 10 to 15 mcg/mL) 
:::* Preferred regimen (for most patients with normal renal function) (2): [[Vancomycin]] 15 to 20 mg/kg (actual body weight) IV q8-12h -for trough concentration of 15 to 20 mcg/mL (minimum inhibitory concentration, 1 mcg/mL or less)
:::* Preferred regimen (3): [[Daptomycin]] 6 mg/kg IV qd for 3 to 4 weeks
:::* Preferred regimen (4): [[Linezolid]] 600 mg IV q12h 
::* 5. '''Vertebral osteomyelitis, discitis'''
:::* Preferred regimen: [[Vancomycin]] 15 to 20 mg/kg IV q8-12h, not to exceed 2 g per dose
::* 6. '''Septic arthritis in adults'''
:::* Preferred regimen: [[Vancomycin]] 15 mg/kg IV bd, not to exceed 2 g per 24 hours (unless cncentrations in serum are inappropriately low) for 4 weeks

----

{{PBI|Staphylococcus saprophyticus}}
:* 1. '''Urinary tract infections'''<ref>{{cite book | last = Abramowicz | first = Mark | title = Handbook of antimicrobial therapy : selected articles from Treatment guidelines with updates from The medical letter | publisher = The Medical Letter | location = New Rochelle, N.Y | year = 2011 | isbn = 978-0981527826 }}</ref>
::* Preferred regimen (1): [[Cephalexin]] 500 mg PO qid
::* Preferred regimen (2): [[Amoxicillin-Clavulanate]] 875/125 mg PO bid
::* Preferred regimen (3): [[TMP-SMX]] 160–800 mg PO bid
::* Alternative regimen: [[Levofloxacin]] 500 mg PO qd

----

{{PBI|Streptobacillus moniliformis}}
:* Streptococcus moniliformis treatment<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>

::* 1. '''Migratory arthropathy and arthritis'''
:::* Preferred regimen (uncomplicated disease): [[Penicillin G]] 2.4-4.8 MU/day IV divided q6h. If better after 1 wk, switch to oral [[Amoxicillin]] {{or}} Penicillin Vk complete 14 days.

::* 2. '''Diarrhea, (especially kids) liver or spleen abscess'''
:::* Preferred regimen (uncomplicated disease): [[Penicillin G]] 2.4-4.8 MU/day IV divided q6h. If better after 1 wk, switch to oral [[Amoxicillin]] {{or}} Penicillin Vk complete 14 days.

::* 3. '''Undifferentiated fever'''
:::* Preferred regimen (uncomplicated disease): [[Penicillin G]] 2.4-4.8 MU/day IV divided q6h. If better after 1 wk, switch to oral [[Amoxicillin]] {{or}} Penicillin Vk complete 14 days.

::* 4. '''Endocarditis, myocarditis, pericarditis (cardiac)'''
:::* Preferred regimen: [[Penicillin]] 20 MU/day IV divided q4h. Optimal duration recommendation for infective endocarditis is 4 weeks.
:::* Alternative regimen: [[Cephalosporins]]-[[Ceftriaxone]] {{or}} [[Clindamycin]] {{or}} [[Erythromycin]] {{or}} [[Chloramphenicol]] {{and}} [[Streptomycin]].

::* 5. '''Meningitis, brain abscess'''
:::* Preferred regimen: [[Penicillin]] 20 MU/day IV divided q4h.
:::* Alternative regimen: [[Cephalosporins]]-[[Ceftriaxone]] {{or}} [[Clindamycin]] {{or}} [[Erythromycin]] {{or}} [[Chloramphenicol]] {{and}} [[Streptomycin]].

::* 6. '''Anemia'''
:::* Preferred regimen (uncomplicated disease): [[Penicillin G]] 2.4-4.8 MU/day IV divided q6h. If better after 1 wk, switch to oral [[Amoxicillin]] {{or}} Penicillin Vk complete 14 days.

::* 7. ''' Pneumonia'''
:::* Preferred regimen (uncomplicated disease): [[Penicillin G]] 2.4-4.8 MU/day IV divided q6h. If better after 1 wk, switch to oral [[Amoxicillin]] {{or}} Penicillin Vk complete 14 days.

::* 8. '''Amnionitis''' (pregnancy)
:::* Preferred regimen (uncomplicated disease): [[Penicillin G]] 2.4-4.8 MU/day IV divided q6h. If better after 1 wk, switch to oral [[Amoxicillin]] {{or}} Penicillin Vk complete 14 days.

::* 9. '''Renal abscess'''
:::* Preferred regimen (uncomplicated disease): [[Penicillin G]] 2.4-4.8 MU/day IV divided q6h. If better after 1 wk, switch to oral [[Amoxicillin]] {{or}} Penicillin Vk complete 14 days.

----

{{PBI|Streptococcus anginosus}}
:* 1. '''Dental abscess'''<ref>{{cite book | last = Abramowicz | first = Mark | title = Handbook of antimicrobial therapy : selected articles from Treatment guidelines with updates from The medical letter | publisher = The Medical Letter | location = New Rochelle, N.Y | year = 2011 | isbn = 978-0981527826 }}</ref>
::* Preferred regimen: [[Penicillin V]] 500 mg PO qid
::* Alternative regimen: [[Vancomycin]] 15–20 mg/kg IV q8–12h
:* 2. '''Brain abscess'''
::* Preferred regimen (1): [[Penicillin G]] 18–24 MU/day IV q4–6h
::* Preferred regimen (2): [[Ceftriaxone]] 2 g IV q12h
::* Alternative regimen: [[Vancomycin]] 15–20 mg/kg IV q8–12h

----

{{PBI|Streptococcus pneumoniae}} 
:* Streptococcus pneumonia treatment
::* 1. '''Lung (Community-acquired pneumonia)'''<ref name="pmid17278083">{{cite journal| author=Mandell LA, Wunderink RG, Anzueto A, Bartlett JG, Campbell GD, Dean NC et al.| title=Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. | journal=Clin Infect Dis | year= 2007 | volume= 44 Suppl 2 | issue=  | pages= S27-72 | pmid=17278083 | doi=10.1086/511159 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17278083  }} </ref>
:::* 1.1 '''Penicillin sensitive (minimum inhibitory concentration < 2 mcg/ml)'''
::::* Preferred regimen: [[Penicillin G]] 5 to 24 MU IV in equally divided doses q4-6h, [[Amoxicillin]] 1 g PO tid (+/- macrolide)
::::* Alternative regimen:  Macrolides ([[Azithromycin]] (IV) 500 mg IV qd for at least 2 days followed by 500 mg PO qd 7 to 10 days or [[Clarithromycin]] extended-release tablets 1000 mg PO qd for 7 days) and Oral Cephalosporins-[[Cefpodoxime]] 200 mg PO bd, ([[Cefprozil]] 500 mg PO bd, [[Cefditoren]] 400 mg PO bd, [[Cefdinir]] 300 mg PO bd), {{or}} parenteral Cephalosporins-[[Ceftriaxone]] 2 g IV q24h (or [[Cefotaxime]] 1-2 g IV q6-8h), [[Clindamycin]] 600 to 1200 mg IV or IM q6-12h, do not give single IM doses >600 mg; IV infusion rates should not exceed 30 mg/min , [[Doxycycline]] 100 mg PO bd, respiratory flouroquniolones.
:::* 1.2 '''[[Penicillin]]-resistant ([[Penicillin]] minimum inhibitory concentration ≥2)'''
::::* Preferred regimen: [[Ceftriaxone]] 2 g IV q24h (or [[Cefotaxime]] 1-2 g IV q6-8h), respiratory [[Flouroquniolones]] [[Levofloxacin]] (Levaquin) 500 mg IV/PO q24h for 7 to 14 days or 750 mg IV/PO q24h for 5 days  (or [[Moxifloxacin]] (Avelox) 400 mg PO/IV over 60 minutes q24h for 7 to 14 days) 
::::* Alternative regimen: [[Vancomycin]] 2 g/day IV q6-12h over at least 60 minutes, [[Linezolid]]  600 mg IV/PO q12h for 7 to 21 days , high-dose [[Amoxicillin]] (3 g qd with [[Penicillin]] minimum concentration of inhibitory <4 mcg/mL).
::* 2.'''Endocarditis'''<ref name="pmid15956145">{{cite journal| author=Baddour LM, Wilson WR, Bayer AS, Fowler VG, Bolger AF, Levison ME et al.| title=Infective endocarditis: diagnosis, antimicrobial therapy, and management of complications: a statement for healthcare professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association: endorsed by the Infectious Diseases Society of America. | journal=Circulation | year= 2005 | volume= 111 | issue= 23 | pages= e394-434 | pmid=15956145 | doi=10.1161/CIRCULATIONAHA.105.165564 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15956145 }}</ref>
:::* Preferred regimen (1):  Aqueous crystalline [[Penicillin-G]]  6 MU q4-6h IV  for 4 weeks
:::* Preferred regimen (2) (who are unable to tolerate beta lactams therapy): [[Vancomycin]] 15 mg/kg IV every 12 hours (target trough concentration, 10 to 15 mcg/mL) [9]; for troughs of 15 to 20 mcg/mL (MIC, 1 mcg/mL or less), dose 15 to 20 mg/kg (actual body weight) IV every 8 to 12 hours for most patients with normal renal function
:::* Preferred regimen (3) (If the isolate is resistant (MIC 2 g/mL) to cefotaxime): [[Cefotaxime]] 1-2 g q8-12h IV or IM (max dose: 12 g/24 hr) {{and}} [[Vancomycin]] 15 mg/kg/day IV q12h {{and}} [[Rifampin]] 300 mg IV/PO q8h for 6 weeks, in combination with appropriate antimicrobial therapy
:::* Alternative regimen (1): [[Cefazolin]]  0.5-2 g q8h IV or IM (max dose: 12 g/24 hr)
:::* Alternative regimen (2): [[Ceftriaxone]] 2 g IV q12h
::::* Note : Streptococcus pneumoniae with intermediate doses minimum inhibitory concentration (MIC) 0.12 g/mL–0.5 g/mL [[Penicillin]] resistance (MIC 0.1 to 1.0 g/mL) or high [[Penicillin]] resistance (MIC 2.0 g/mL) is being recovered from patients with bacteremia. 
::* 3. '''Sinuses (sinusitis)'''<ref name="pmid22438350">{{cite journal| author=Chow AW, Benninger MS, Brook I, Brozek JL, Goldstein EJ, Hicks LA et al.| title=IDSA clinical practice guideline for acute bacterial rhinosinusitis in children and adults. | journal=Clin Infect Dis | year= 2012 | volume= 54 | issue= 8 | pages= e72-e112 | pmid=22438350 | doi=10.1093/cid/cir1043 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22438350  }} </ref>
:::* Empiric therapy
::::* 3.1 '''For initial empiric treatment of acute bacterial rhinosinusitis in adults'''
:::::* Preferred regimen: [[Amoxicillin]] 500 mg/[[Clavulanate]] 125 mg PO tid or [[Amoxicillin]] 875 mg/[[Clavulanate]] 125 mg PO bid for 5 to 7 days recommended by the Infectious Disease Society of America (IDSA)
:::::* Alternative regimen (1): [[Doxycycline]] 100 mg PO q12h
::::::* Note: [[Doxycycline]] can be used in patients with [[Penicillin]] allergy. 
:::::* Alternative regimen (2): A respiratory [[Fluoroquinolone]] ([[Levofloxacin]] or [[Moxifloxacin]]) is another recommended drug for [[Penicillin]]-allergic patients.
::::* 3.2 '''For second-line high-dose therapy for acute bacterial rhinosinusitis in adults'''
:::::* Preferred regimen: [[Amoxicillin]] 2 g/[[Clavulanate]] 125 mg PO bid recommended by the Infectious Disease Society of America (IDSA). 
:::::* Note: The second line high dose therapy  is recommended in adults who have failed initial therapy, in regions of high endemic rates (10% or greater) of invasive [[Penicillin]]-nonsusceptible Streptococcus pneumoniae, severe infection.
::* 4. '''Bronchi (acute exacerbation of chronic bronchitis)'''<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
:::* Preferred regimen (1): [[Amoxicillin]] 875 mg PO q12h or 500 mg PO q8h
:::* Preferred regimen (2): [[Doxycycline]] 100 mg PO q12h
::* 5. '''CNS (meningitis)'''<ref name="pmid15494903">{{cite journal| author=Tunkel AR, Hartman BJ, Kaplan SL, Kaufman BA, Roos KL, Scheld WM et al.| title=Practice guidelines for the management of bacterial meningitis. | journal=Clin Infect Dis | year= 2004 | volume= 39 | issue= 9 | pages= 1267-84 | pmid=15494903 | doi=10.1086/425368 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15494903  }} </ref>
:::* Empiric therapy
::::* Preferred regimen: [[Vancomycin]] 15 mg/kg/day IV q12h {{and}} a third-generation cephalosporin ([[Ceftriaxone]] 2 g IV q12h {{or}} [[Cefotaxime]] 2 g IV q4h or 3 g q6h) {{and}} [[Rifampin]] 600 mg IV qd in combination with [[Vancomycin]]
::::* Alternative regimen: [[Meropenem]], fluoroquinolones   
::::: Note: Middle ear infections (otitis media), peritoneum infections (spontaneous bacterial peritonitis), pericardium infections (purulent pericarditis), skin infections (cellulitis) and eye infections (conjunctivitis) caused by Streptococcus pneumonia.
::* '''Prevention'''
:::* 1. Pneumovax (23-valent) prevents bacteremia; impact on rates of CAP are modest or nil.
:::* 2. Prevnar vaccine for children <2 yrs age  prevents invasive pneumococcal infection in adults by herd effect. Impact is impressive with rates of invasive pneumococcal infection down 80% in peds and 20-40% in adults.
:::* 3. Risk for bacteremia in splenectomy, HIV, smokers, black race, multiple myeloma, asthma.

----


{{PBI|Streptococcus pyogenes}}
*1. '''Streptococcus pyogenes tonsilitis'''<ref name="pmid8215292">{{cite journal| author=Betriu C, Sanchez A, Gomez M, Cruceyra A, Picazo JJ| title=Antibiotic susceptibility of group A streptococci: a 6-year follow-up study. | journal=Antimicrob Agents Chemother | year= 1993 | volume= 37 | issue= 8 | pages= 1717-9 | pmid=8215292 | doi= | pmc=PMC188051 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8215292  }} </ref>
:*Preferred regimen (1): [[Penicillin V]] 250 mg PO bid or tid (for children) 250 mg PO qid or 500 mg PO bid (for adults) for 10 days<ref name="pmid19246689">{{cite journal| author=Gerber MA, Baltimore RS, Eaton CB, Gewitz M, Rowley AH, Shulman ST et al.| title=Prevention of rheumatic fever and diagnosis and treatment of acute Streptococcal pharyngitis: a scientific statement from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee of the Council on Cardiovascular Disease in the Young, the Interdisciplinary Council on Functional Genomics and Translational Biology, and the Interdisciplinary Council on Quality of Care and Outcomes Research: endorsed by the American Academy of Pediatrics. | journal=Circulation | year= 2009 | volume= 119 | issue= 11 | pages= 1541-51 | pmid=19246689 | doi=10.1161/CIRCULATIONAHA.109.191959 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19246689  }} </ref>
:*Preferred regimen (2): [[Benzathine penicillin G]] if <27kg: 600,000 U, if >27kg 1,200,000 U IM single-dose<ref name="pmid23091044">{{cite journal| author=Shulman ST, Bisno AL, Clegg HW, Gerber MA, Kaplan EL, Lee G et al.| title=Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America. | journal=Clin Infect Dis | year= 2012 | volume= 55 | issue= 10 | pages= 1279-82 | pmid=23091044 | doi=10.1093/cid/cis847 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23091044  }} </ref>
:*Alternative regimen (1): [[Amoxicillin]] 50 mg/kg/day PO qd for 10 days {{or}} 25 mg/kg/day PO bid for 10 days. Its oral suspension is more tolerable to children and it is better absorbed by the GI tract<ref name="pmid12739920">{{cite journal| author=Curtin-Wirt C, Casey JR, Murray PC, Cleary CT, Hoeger WJ, Marsocci SM et al.| title=Efficacy of penicillin vs. amoxicillin in children with group A beta hemolytic streptococcal tonsillopharyngitis. | journal=Clin Pediatr (Phila) | year= 2003 | volume= 42 | issue= 3 | pages= 219-25 | pmid=12739920 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12739920  }} </ref>
:*Alternative regimen (2): first generation [[Cephalosporins]] are acceptable for treating recurrent group A streptococcus infection but not as first-line therapy<ref name="pmid15805383">{{cite journal| author=Pichichero ME| title=A review of evidence supporting the American Academy of Pediatrics recommendation for prescribing cephalosporin antibiotics for penicillin-allergic patients. | journal=Pediatrics | year= 2005 | volume= 115 | issue= 4 | pages= 1048-57 | pmid=15805383 | doi=10.1542/peds.2004-1276 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15805383  }} </ref><ref name="pmid23091044">{{cite journal| author=Shulman ST, Bisno AL, Clegg HW, Gerber MA, Kaplan EL, Lee G et al.| title=Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America. | journal=Clin Infect Dis | year= 2012 | volume= 55 | issue= 10 | pages= 1279-82 | pmid=23091044 | doi=10.1093/cid/cis847 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23091044  }} </ref>
:*Alternative regimen (3): [[Clarithromycin]] 250 mg PO bid for 10 days {{or}} [[Azithromycin]] 12 mg/kg maximum 500 mg PO on day 1 {{then}} 6 mg/kg maximum 250 mg PO qd on days 2 through 5 {{or}} [[Erythromycin]] 20 mg/kg/day PO or 40 mg/kg/day (ethylsuccinate) PO bid for 10 days.
:*Alternative regimen (4): [[Clindamycin]] for penicillin-intolerant patients with erythromycin-resistant strains.
:*Note: Intramuscular penicillin is the only therapy that has been shown to prevent initial attacks of rheumatic fever in controlled studies<ref name="pmid14837911">{{cite journal| author=WANNAMAKER LW, RAMMELKAMP CH, DENNY FW, BRINK WR, HOUSER HB, HAHN EO et al.| title=Prophylaxis of acute rheumatic fever by treatment of the preceding streptococcal infection with various amounts of depot penicillin. | journal=Am J Med | year= 1951 | volume= 10 | issue= 6 | pages= 673-95 | pmid=14837911 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14837911  }} </ref>
*2. '''Recurrent Streptococcus pyogenes tonsilitis'''<ref name="pmid12087516">{{cite journal| author=Bisno AL, Gerber MA, Gwaltney JM, Kaplan EL, Schwartz RH, Infectious Diseases Society of America| title=Practice guidelines for the diagnosis and management of group A streptococcal pharyngitis. Infectious Diseases Society of America. | journal=Clin Infect Dis | year= 2002 | volume= 35 | issue= 2 | pages= 113-25 | pmid=12087516 | doi=10.1086/340949 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12087516  }} </ref>
:*Preferred regimen (1): [[Clindamycin]] 20-30 mg/kg/day PO tid (for children), 600 mg/day bid, tid or qid (for adults) for 10 days
:*Preferred regimen (2): [[Amoxicillin-clavulanic acid]] 40 mg/kg/day PO tid (for children), 500 mg bid (for adults) for 10 days
:*Alternative regimen: [[Benzathine penicillin G]] if <27kg: 600,000 U, if >27kg 1,200,000 U IM single-dose {{withorwithout}} [[Rifampin]] 20 mg/kg/day PO bid for 4 days
*3. '''Secondary prophylaxis for rheumatic fever'''<ref name="pmid23091044">{{cite journal| author=Shulman ST, Bisno AL, Clegg HW, Gerber MA, Kaplan EL, Lee G et al.| title=Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America. | journal=Clin Infect Dis | year= 2012 | volume= 55 | issue= 10 | pages= 1279-82 | pmid=23091044 | doi=10.1093/cid/cis847 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23091044  }} </ref>
:*Preferred regimen (1): [[Benzathine penicillin G]] if <27kg: 600,000 U, if >27kg 1,200,000 U IM every 4 weeks
:*Alternative regimen (1): [[Penicillin V]] potassium 250 mg PO bid 
:*Alternative regimen (2): [[Sulfadiazine]] if <27kg 0.5 g PO qd, if >27kg 1 g PO qd
:*Duration of treatment: if residual cardiac disease, keep treatment until 40 patient is 40 years old or for 10 years (whichever is longer); if there's no residual cardiac disease keep treatment for 10 years or until age 21 years (whichever is longer); if there's rheumatic fever without carditis keep it for 5 years or until age 21 years (whichever is longer).
:*Note: For patients allergic to penicillin and sulfadiazine, consider a macrolide or azalide antibiotic
*4. '''Streptococcus pyogenes bacteremia'''<ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
:*Preferred regimen: [[Penicillin G]] 4 million units IV q4h {{and}} [[Clindamycin]] 900 mg IV q8h for at least 14 days
:* [[Penicillin]] is added to the regimen to cover any other group A streptococcus which might be resistant to [[Clindamycin]].
:*Alternative regimen (1): [[Erythromycin]]
:*Alternative regimen (2): [[Azithromycin]]
:*Alternative regimen (3): [[Clarithromycin]] 
:*Alternative regimen (4): any other β-lactam<ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
:*Note (1): Macrolide resistance is increasing.
:*Note (2): Consider using intravenous immune globulin in patients with invasive infection and signs of shock. Immunoglobulin-G IV 1 g/kg day 1, then 0.5 g/kg days 2 & 3.
:*Note (3): If shock, administer massive IV fluids (10-20 L/day), [[Albumin]] if <2 g/dL, debridement of necrotic tissue.
*5. '''Streptococcus pyogenes celulitis'''
:*Preferred regimen: treat as Streptococcus pyogenes bacteremia
*6 '''Epiglottitis in childern'''<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
:*Preferred regimen (1): [[Cefotaxime]] 50 mg/kg IV q8h
:*Preferred regimen (2): [[Ceftriaxone]] 50 mg/kg IV q24h
:*Alternative regimen (1): [[Amoxicillin]]-SB 100–200 mg/kg qd q6h 
:*Alternative regimen (2): [[Trimethoprim-Sulfamethoxazole]] 8–12 mg/kg bid
:*Note: Have tracheostomy set “at bedside.” Chloro is effective, but potentially less toxic alternative agents available.
*7 '''Burn wound sepsis'''<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
:*Preferred regimen: [[Vancomycin]] 1 gm IV q12h {{and}} ([[Amikacin]] 10 mg/kg IV loading dose then 7.5 mg/kg IV q12h) {{and}} [ [[Piperacillin]] 4 g IV q4h (give ½ q24h dose of [[Piperacillin]] into subeschar tissues with surgical eschar removal within 12 hours]. Can use [[Piperacillin]]-[[Tazobactam]] if [[Piperacillin]] not available.
*8. '''Soft tissue'''<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
:*Note: For necrotizing fasciitis, surgical consultation for emergent fasciotomy and debridement; repeat debridements usually necessary.
*9. '''Muscle'''<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
:*Note: For myositis-debirdement is recommended.
*10.''' Eye'''<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
:*10.1 '''Keratitis '''
::*10.1.1 '''Acute bacterial keratitis'''
:::*Preferred regimen: [[Moxifloxacin]] eye gtts. 1 gtt tid for 7 days
:::*Alternative therapy: [[Gatifloxacin]] eye gtts. 1-2 gtts q2h while awake for 2 days, then q4h for 3-7 days.
:::*Note: Prefer [[Moxifloxacin]] due to enhanced lipophilicity and penetration into aqueous humor (1 gtt = 1 drop).
::*10.1.2 '''Keratitis due to dry cornea, diabetes, immunosuppression'''
:::*Preferred regimen: [[Cefazolin]] (50 mg/mL) {{and}} ([[Gentamicin]] {{or}} [[Tobramycin]] (14 mg/mL) q15–60 min around clock for  24–72 hrs, then slow reduction)
:::*Alternative therapy: [[Vancomycin]] (50 mg/mL) {{and}} [[Ceftazidime]] (50 mg/mL) q15–60 min around clock for 24–72 hrs, then slow reduction.
:::*Note: Specific therapy guided by results of alginate swab culture and sensitivity. [[Ciprofloxacin]] 0.3% found clinically equivalent to [[Cefazolin]]{{and}} [[Tobramycin]]; only concern was efficacy of [[Ciprofloxacin]] vs S. pneumoniae
:*10.2 '''Dacryocystitis (lacrimal sac)'''
::*Preferred regimen: [[Moxifloxacin]] 1 gtt tid for 7 days {{or}} [[Cefazolin]] (50 mg/mL) (1 gtt = 1 drop)
*11.''' Suppurative phlebitis'''<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
:*Preferred regimen: [[Vancomycin]] 15 mg/kg IV q12h (normal weight)
:*Alternative regimen: [[Daptomycin]] 6 mg/kg IV q12h
:*Note: Retrospective study for suppurative phlebitis recommends 2-3 weeks IV therapy and 2 weeks PO therapy.
*12. ''' Infected prosthetic joint'''<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
:*Preferred regimen: [[Penicillin G]] 2 million units IV q4h {{or}} [[Ceftriaxone]] 2 g IV q24h for 4 weeks
:*Note: Debridement & prosthesis retention with intravenous antibiotics.
*13. ''' “Hot” tender parotid swelling'''<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
:*Preferred regimen: [[Nafcillin]] {{or}} [[Oxacillin]] 2 g IV q4h
:*Note: Predisposing factors are stone(s) in Stensen’s duct, dehydration. Therapy depends on ID of specific etiologic organism.
*14. '''Diabetic foot ulcer (ulcer with <2 cm of superficial inflammation)'''<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
:*Preferred regimen: ([[Trimethoprim-Sulfamethoxazole]] 800/160 mg 1-2 tabs PO bid {{or}} [[Minocycline]] 100 mg PO bid) {{and}} ([[Penicillin VK]] 500 mg PO qid {{or}} selected  [[Cephalosporins]] 2nd, 3rd generation - cefprozil 500 mg PO bid {{or}} cefuroxime axetil 500 mg PO bid {{or}} cefdinir 300 mg PO bid or 600 mg PO qd {{or}} cefpodoxime 200 mg PO bid {{or}} [[Fluoroquinolones]] Levofloxacin 750 mg PO qd).
*15. ''' Recurrent cellulitis, chronic lymphedema prophylaxis'''<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
:* Preferred regimen: [[Clindamycin]] 150 mg PO qd {{or}} [[Trimethoprim]]-[[Sulfamethoxazole]] 800/160 mg 1 tablet PO qd {{or}} “stand-by therapy” immediate treatment with [[Penicillin V]] {{or}} [[Amoxicillin]] 500-750 mg PO bd at onset of symptoms.


----

{{PBI|Streptococcus agalactiae}}
:*'''Streptococcus agalactiae treatment''' (GBS-group B Streptococcus)
::* 1. '''Early onset group B streptococcal infections'''<ref>{{cite web|title=group B Streptococcus infections|url=http://redbook.solutions.aap.org/book.aspx?bookid=1484}}</ref>
:::* 1.1 '''Bacteremia or sepsis or pneumonia'''
::::* 1.1.1 '''Empiric therapy'''
:::::* Preferred regimen: [[Ampicillin]] 150 mg/kg IV q12h for 10 days {{and}} [[Gentamicin]] 4 mg/kg IV q12h for 10 days-for infants born at ≥ 35 weeks gestation; [[Gentamicin]] 3 mg/kg IV q24h for 10 days-for infants born at < 35 weeks gestation
::::* 1.1.2 '''Definitive therapy'''
:::::* Preferred regimen: [[Penicillin G]] 50,000-100,000 units/kg per day IV divided q12h for 10 days
:::* 1.2 '''Meningitis'''
::::* 1.2.1 '''Empiric therapy'''
:::::* Preferred regimen: [[Ampicillin]] 100-150 mg/kg IV q8h for 14-21 days {{and}} [[Gentamicin]] 4 mg/kg IV q24h for 14-21 days-for infants born at ≥ 35 weeks gestation; [[Gentamicin]] 3 mg/kg IV q24h for 14-21 days-for infants born at < 35 weeks gestation
::::* 1.2.2 '''Definitive therapy'''
:::::* Preferred regimen: [[Penicillin G]] 250,000-450,000 units/kg per day IV divided q8h for 14-21 days
:::::* Note: Cellulitis is the most frequent clinical manifestation of GBS-associated skin and soft tissue infections.
::* 2. '''Late onset group b streptococcus infections in neonates and young infants (age > 1 week and body weight ≥ 1 kg with normal renal function)'''<ref>{{cite web|title=group B Streptococcus infections|url=http://redbook.solutions.aap.org/book.aspx?bookid=1484}}</ref>
:::* 2.1 Bacteremia without a focus
::::* 2.1.1 '''Empiric therapy'''
:::::* Preferred regimen: [[Ampicillin]] IV for 10 days, [[Nafcillin]] IV for 10 days, ({{or}} [[Vancomycin]] IV for 10 days) {{and}} [[Gentamicin]] IV for 10 days ({{or}} [[Cefotaxime]] IV for 10 days)
::::* 2.1.2 '''Definitive therapy'''
:::::* Preferred regimen: [[Penicillin G]] 75,000-150,000 units/kg per day IV divided q8h for 10 days
:::* 2.2 '''Meningitis'''
::::* 2.2.1 '''Empiric therapy'''
:::::* Preferred regimen: [[Ampicillin]] IV for 14-21 days with or without [[Vancomycin]] IV for 14-21 day {{and}} [[Gentamicin]] IV for 14-21 days {{or}} [[Cefotaxime]] IV for 14-21 day
::::* 2.2.2 '''Definitive therapy'''
:::::* Preferred regimen: [[Penicillin G]] 450,000-500,000 units/kg per day IV divided q6h for 14-21 days
:::* 2.3 '''Cellulitis or adenitis'''
::::* 2.3.1 '''Empiric therapy'''
:::::* Preferred regimen: [[Nafcillin]] IV for 10-14 days ({{or}} [[Vancomycin IV for 10-14 days) {{and}} [[Gentamicin]] IV for 10-14 days ({{or}} [[Cefotaxime]] IV for 10-14 days)
::::* 2.3.2 '''Definitive therapy'''
:::::* Preferred regimen: [[Penicillin-G]] 75,000-150,000 units/kg per day IV divided q8h for 10-14 days 
:::* 2.4 '''Septic arthritis'''
::::* 2.4.1 '''Empiric therapy'''
:::::* Preferred regimen: [[Nafcillin]] IV for 14-21 days {{or}} [[Vancomycin]] IV for 14-21 days {{and}} [[Cefotaxime]] IV for 14-21 days 
::::* 2.4.2 '''Definitive therapy'''
:::::* Preferred regimen: [[Penicillin-G]] 75,000-150,000 units/kg per day IV divided q8h for 14-21 days 
:::* 2.5 Osteomyelitis
::::* 2.5.1 '''Empiric therapy'''
:::::* Preferred regimen: [[Nafcillin]] IV for 21-28 days {{or}} [[Vancomycin]] IV for 21-28 days {{and}} [[Cefotaxime]] IV for 21-28 days
::::* 2.5.2 '''Definitive therapy'''
:::::* Preferred regimen: [[Penicillin-G]] 75,000-150,000 units/kg per day IV divided q8h for 21-28 days
:::* 2.6 Urinary tract infection
::::* 2.6.1 '''Empiric therapy''' 
:::::* Preferred regimen: [[Ampicillin]] IV for 10 days, [[Nafcillin]] IV for 10 days, ({{or}} [[Vancomycin]] IV for 10 days) {{and}} [[Gentamicin]] IV for 10 days ({{or}} [[Cefotaxime]] IV for 10 days)
::::* 2.6.2 '''Definitive therapy'''
:::::* Preferred regimen: [[Penicillin-G]] 75,000-150,000 units/kg per day IV divided q8h for 10 days

:* '''Neonatal prophylaxis'''<ref name="pmid24446442">{{cite journal| author=Mukhopadhyay S, Dukhovny D, Mao W, Eichenwald EC, Puopolo KM| title=2010 perinatal GBS prevention guideline and resource utilization. | journal=Pediatrics | year= 2014 | volume= 133 | issue= 2 | pages= 196-203 | pmid=24446442 | doi=10.1542/peds.2013-1866 | pmc=PMC3904275 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24446442  }} </ref>
::* '''Group B streptococcus infection (maternal dose for neonatal prophylaxis)'''
:::* Preferred regimen: [[Penicillin-G]], [[Ampicillin]] 2 g IV initial dose, {{then}} 1 g q4h until delivery, [[Cefazolin]] ≥ 4h prior to delivery

====Bacteria – Gram-Positive Bacilli====  


{{PBI|Actinomycosis}}
*'''Actinomyces species including A. israeli'''<ref>{{cite book | last = Bennett | first = John | title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases | publisher = Elsevier/Saunders | location = Philadelphia, PA | year = 2015 | isbn = 978-1455748013 }}</ref>
:*Preferred regimen: [[Penicillin]] 3-4 million units IV q4h for 2-6 weeks {{then}} [[Penicillin V]] 2-4 g/day PO qid for 6-12 months
:*Alternative regimen (1): [[Erythromycin]] 500-1000 mg IV q6h {{or}} 500 mg PO qid
:*Alternative regimen (2): [[Tetracyclin]] 500 mg PO qid
:*Alternative regimen (3): [[Doxycycline]] 100 mg IV q12h {{or}} 100 mg PO bid
:*Alternative regimen (4): [[Clindamycin]] 900 mg IV q8h {{or}} 300-450 mg PO qd
:*Alternative regimen (5): [[Minocycline]] 100 mg IV q12h {{or}} 100 mg PO bid


{{PBI|Arcanobacterium haemolyticum}}
:* Arcanobacterium haemolyticum treatment
::* Preferred regimen: [[Erythromycin]] Base: 333 mg PO q8h; estolate/stearate/base: 250-500 mg q6h PO
::* Alternative regimen: [[Benzathine Penicillin G]] 1.2 MU IM q3-4 weeks
::: Note: Arcanobacterium haemolyticum is sensitivity to most drugs but resistent to [[Trimethoprim]]-[[Sulfamethoxazole]]


==Anthracis==
{{PBI|Bacillus anthracis}}

:*  '''Bacillus anthracis treatment'''

::* 1. '''Treatment for cutaneous anthrax, without systemic involvement'''<ref name="pmid24447897">{{cite journal| author=Hendricks KA, Wright ME, Shadomy SV, Bradley JS, Morrow MG, Pavia AT et al.| title=Centers for disease control and prevention expert panel meetings on prevention and treatment of anthrax in adults. | journal=Emerg Infect Dis | year= 2014 | volume= 20 | issue= 2 | pages=  | pmid=24447897 | doi=10.3201/eid2002.130687 | pmc=PMC3901462 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24447897  }} </ref>

:::* Preferred regimen (regardless of penicillin susceptibility or if susceptibility is unknown) (1): [[Ciprofloxacin]] 500 mg PO bid for 7-10 days

:::* Preferred regimen (regardless of penicillin susceptibility or if susceptibility is unknown) (2): [[Doxycycline]] 100 mg PO bid for 7-10 days

:::* Preferred regimen (regardless of penicillin susceptibility or if susceptibility is unknown) (3): [[Levofloxacin]] 750 mg PO qd for 7-10 days

:::* Preferred regimen (regardless of penicillin susceptibility or if susceptibility is unknown) (4): [[Moxifloxacin]] 400 mg PO qd for 7-10 days

:::* Alternative regimen (1): [[Clindamycin]] 600 mg PO tid for 7-10 days

:::* Alternative regimen (2): [[Amoxicillin]] 1 g PO tid (for penicillin-susceptible strains) for 7-10 days

:::* Alternative regimen (3): [[Penicillin VK]] 500 mg PO qid (for penicillin-susceptible strains) for 7-10 days

:::* Note: Duration of treatment is 60 days for bioterrorism-related cases and 7-10 days for naturally acquired cases.

::* 2. '''Treatment for systemic anthrax including anthrax meningitis, inhalational anthrax, injectional anthrax, and gastrointestinal anthrax; and cutaneous anthrax with systemic involvement, extensive edema, or lesions of the head or neck'''<ref name="pmid24447897">{{cite journal| author=Hendricks KA, Wright ME, Shadomy SV, Bradley JS, Morrow MG, Pavia AT et al.| title=Centers for disease control and prevention expert panel meetings on prevention and treatment of anthrax in adults. | journal=Emerg Infect Dis | year= 2014 | volume= 20 | issue= 2 | pages=  | pmid=24447897 | doi=10.3201/eid2002.130687 | pmc=PMC3901462 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24447897  }} </ref>

:::* 2.1 '''Systemic anthrax with possible/confirmed meningitis'''

::::* 2.1.1 '''Bactericidal agent''' (fluoroquinolone)

:::::* Preferred regimen (1): [[Ciprofloxacin]] 400 mg IV q8h for 2-3 weeks

:::::* Preferred regimen (2): [[Levofloxacin]] 750 mg IV q24h for 2-3 weeks

:::::* Preferred regimen (3): [[Moxifloxacin]] 400 mg IV q24h for 2-3 weeks {{and}}

::::* 2.1.2 '''Bactericidal agent (ß-lactam) for all strains, regardless of penicillin susceptibility or if susceptibility is unknown'''

:::::* Preferred regimen (1): [[Meropenem]] 2 g IV q8h for 2-3 weeks

:::::* Preferred regimen (2): [[Imipenem]] 1 g IV q6h for 2-3 weeks

:::::* Preferred regimen (3): [[Doripenem]] 500 mg IV q8h for 2-3 weeks

:::::* Preferred regimen (4): [[Penicillin G]] 4 MU IV q4h (for penicillin-susceptible strains) for 2-3 weeks

:::::* Preferred regimen (5): [[Ampicillin]] 3 g IV q6h (for penicillin-susceptible strains) for 2-3 weeks {{and}}

::::* 2.1.3 '''Protein synthesis inhibitor'''

:::::* Preferred regimen (1): [[Linezolid]] 600 mg IV q12h for 2-3 weeks

:::::* Preferred regimen (2): [[Clindamycin]] 900 mg IV q8h for 2-3 weeks

:::::* Preferred regimen (3): [[Rifampin]] 600 mg IV q12h for 2-3 weeks

:::::* Preferred regimen (4): [[Chloramphenicol]] 1 g IV q6-8h for 2-3 weeks

:::::* Note (1): Patients exposed to aerosolized spores will require prophylaxis to complete an antimicrobial drug course of 60 days from onset of illness.

:::::* Note (2): Increased risk for seizures associated with [[Imipenem]]/[[Cilastatin]] treatment.

:::::* Note (3): [[Linezolid]] should be used with caution in patients with thrombocytopenia because it might exacerbate it. [[Linezolid]] use for > 14 days has additional hematopoietic toxicity.

:::::* Note (4): [[Rifampin]] is not a protein synthesis inhibitor. However, it may be used in combination with other antimicrobial drugs on the basis of its in vitro synergy.

:::* 2.2 '''Systemic anthrax when meningitis has been excluded'''

::::* 2.2.1 '''Bactericidal agent'''

:::::* Preferred regimen (1): [[Ciprofloxacin]] 400 mg IV q8h for 2 weeks

:::::* Preferred regimen (2): [[Levofloxacin]] 750 mg IV q24h for 2 weeks

:::::* Preferred regimen (3): [[Moxifloxacin]] 400 mg q24h for 2 weeks

:::::* Preferred regimen (4): [[Meropenem]] 2 g IV q8h for 2 weeks

:::::* Preferred regimen (5): [[Imipenem]] 1 g IV q6h for 2 weeks

:::::* Preferred regimen (6): [[Doripenem]] 500 mg IV q8h for 2 weeks

:::::* Preferred regimen (7): [[Vancomycin]] 20 mg/kg IV q8h (maintain serum trough concentrations of 15-20 µg/mL) for 2 weeks

:::::* Preferred regimen (8): [[Penicillin G]] 4 MU IV q4h (penicillin-susceptible strains) for 2 weeks

:::::* Preferred regimen (9): [[Ampicillin]] 3 g IV q6h (penicillin-susceptible strains) for 2 weeks {{and}}

::::* 2.2.2 '''Protein synthesis inhibitor'''

:::::* Preferred regimen (1): [[Clindamycin]] 900 mg IV q8h for 2 weeks

:::::* Preferred regimen (2): [[Linezolid]] 600 mg IV q12h for 2 weeks

:::::* Preferred regimen (3): [[Doxycycline]] 200 mg IV initially, then 100 mg IV q12h for 2 weeks

:::::* Preferred regimen (4): [[Rifampin]] 600 mg IV q12h for 2 weeks

:::::* Note: Patients exposed to aerosolized spores will require prophylaxis to complete an antimicrobial drug course of 60 days from onset of illness.

::* 3. '''Specific considerations'''

:::* 3.1 '''Treatment of anthrax for pregnant Women'''

::::* 3.1.1 '''Intravenous antimicrobial treatment for systemic anthrax with possible/confirmed meningitis''' <ref name="pmid24457117">{{cite journal| author=Meaney-Delman D, Zotti ME, Creanga AA, Misegades LK, Wako E, Treadwell TA et al.| title=Special considerations for prophylaxis for and treatment of anthrax in pregnant and postpartum women. | journal=Emerg Infect Dis | year= 2014 | volume= 20 | issue= 2 | pages=  | pmid=24457117 | doi=10.3201/eid2002.130611 | pmc=PMC3901460 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24457117  }} </ref>

:::::* 3.1.1.1 ''' A Bactericidal Agent (Fluoroquinolone)'''

::::::* Preferred regimen (1): [[Ciprofloxacin]] 400 mg IV q8h for 2–3 weeks {{or}}

::::::* Preferred regimen (2): [[Levofloxacin]] 750 mg IV q24h for 2–3 weeks{{or}}

:::::* 3.1.1.2 ''' A Bactericidal Agent (ß-lactam)'''

::::::* 3.1.1.2.1 '''For all strains, regardless of penicillin susceptibility or if susceptibility is unknown'''

:::::::* Preferred regimen: [[Meropenem]] 2 g q8h for 2–3 weeks

::::::* 3.1.1.2.2 '''Alternatives for penicillin-susceptible strains'''

:::::::* Alternative regimen (1): [[Ampicillin]] 3 g IV q6h for 2–3 weeks

:::::::* Alternative regimen (2): [[Penicillin G]] 4 MU IV q4h for 2–3 weeks {{or}}

:::::* 3.1.1.3 ''' A Protein Synthesis Inhibitor'''

::::::* Preferred regimen (1): [[Clindamycin]] 900 IV mg q8h for 2–3 weeks

::::::* Preferred regimen (2): [[Rifampin]] 600 IV mg q12h for 2–3 weeks

::::::* Note: At least one antibiotic with transplacental passage is recommended.

::::* 3.1.2 '''Intravenous antimicrobial treatment for systemic anthrax when meningitis has been excluded'''

:::::* 3.1.2.1 ''' A Bactericidal Antimicrobial'''

::::::* Preferred regimen (1): [[Ciprofloxacin]] 400 mg IV q8h for 2 weeks

::::::* Preferred regimen (2): [[Levofloxacin]] 750 mg IV q24h for 2 weeks {{or}}

:::::* 3.1.2.2 ''' A Bactericidal Agent (ß-lactam)'''

::::::* 3.1.2.2.1 '''For all strains, regardless of penicillin susceptibility or if susceptibility is unknown'''

:::::::* Preferred regimen: [[Meropenem]] 2 g q8h for 2 weeks  {{or}}

::::::* 3.1.2.2.2 '''Alternatives for penicillin-susceptible strains'''

:::::::* Alternative regimen (1): [[Ampicillin]] 3 g IV q6h for 2 weeks

:::::::* Alternative regimen (2): [[Penicillin G]] 4 MU IV q4h for 2 weeks {{or}}

:::::* 3.1.2.3 ''' A Protein Synthesis Inhibitor'''

::::::* Preferred regimen (1): [[Clindamycin]] 900 IV mg q8h for 2 weeks

::::::* Preferred regimen (2): [[Rifampin]] 600 IV mg q12h for 2 weeks

::::* 3.1.3 '''Oral antimicrobial treatment for cutaneous anthrax without systemic involvement'''

:::::* 3.1.3.1 '''For all strains, regardless of penicillin susceptibility or if susceptibility is unknown'''

::::::* Preferred regimen: [[Ciprofloxacin]] 400 mg IV q8h

::::::* Note: Duration of treatment is 60 days

:::* 3.2 '''Treatment for anthrax in childern''' <ref name="pmid24777226">{{cite journal| author=Bradley JS, Peacock G, Krug SE, Bower WA, Cohn AC, Meaney-Delman D et al.| title=Pediatric anthrax clinical management. | journal=Pediatrics | year= 2014 | volume= 133 | issue= 5 | pages= e1411-36 | pmid=24777226 | doi=10.1542/peds.2014-0563 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24777226  }} </ref>

::::* 3.2.1 '''Treatment of cutaneous anthrax without systemic involvement (for children 1 month of age and older)'''

:::::* 3.2.1.1 '''For all strains, regardless of penicillin susceptibility or if susceptibility is unknown'''

::::::* Preferred regimen (1): [[Ciprofloxacin]] 30 mg/kg/day PO bid (not to exceed 500 mg/dose) for 7-10 days

::::::* Preferred regimen (2):

:::::::* If patients body weight is < 45 kg: [[Doxycycline]] 4.4 mg/kg/day PO bid (not to exceed  100 mg/dose) for 7-10 days

:::::::* If patients body weight is = 45 kg: [[Doxycycline]] 100 mg/dose PO bid for 7-10 days

::::::* Preferred regimen (3): [[Clindamycin]] 30 mg/kg/day PO tid (not to exceed  600 mg/dose) for 7-10 days

::::::* Preferred regimen (4):

:::::::* If patients body weight is < 50 kg: [[Levofloxacin]] 16 mg/kg/day PO bid (not to exceed  250 mg/dose) for 7-10 days

:::::::* If patients body weight is > 50 kg: [[Levofloxacin]] 500 mg PO qd for 7-10 days

:::::* 3.2.1.2 '''Alternatives for penicillin-susceptible strains'''

::::::* Alternative regimen (1):[[Amoxicillin]] 75 mg/kg/day PO tid (not to exceed 1 g/dose) for 7-10 days

::::::* Alternative regimen (2): [[Penicillin VK]] 50-75 mg/kg/day PO tid or qid for 7-10 days

::::* 3.2.2 ''' Combination therapy for systemic anthrax when meningitis can be ruled out (for children 1 month of age and older)'''

:::::* 3.2.2.1 '''A bactericidal antimicrobial'''

::::::* 3.2.2.1.1 '''For all strains, regardless of penicillin susceptibility or if susceptibility is unknown'''

:::::::* Preferred regimen (1): [[Ciprofloxacin]] 30 mg/kg/day IV divided q8h (not to exceed 400 mg/dose) for 14 days

:::::::* Preferred regimen (2): [[Meropenem]] 60 mg/kg/day IV divided q8h (not to exceed 2 g/dose) for 14 days

:::::::* Preferred regimen (3):

::::::::* If patients body weight is < 50 kg: [[Levofloxacin]] 20 mg/kg/day IV divided q12h (not to exceed 250 mg/dose) for 14 days

::::::::* If patients body weight is > 50 kg: [[Levofloxacin]] 500 mg IV q24h for 14 days

:::::::* Preferred regimen (4): [[Imipenem]]/[[Cilastatin]] 100 mg/kg/day IV divided q6h (not to exceed 1 g/dose) for 14 days

:::::::* Preferred regimen (5): [[Vancomycin]] 60 mg/kg/day IV divided q8h (follow serum concentrations) for 14 days

::::::* 3.2.2.1.2 '''Alternatives for penicillin-susceptible strains'''

:::::::* Alternative regimen (1): [[Penicillin G]] 400 000 U/kg/day IV divided q4h (not to exceed 4 MU/dose) for 14 days

:::::::* Alternative regimen (2): [[Ampicillin]] 200 mg/kg/day IV divided q6h (not to exceed 3 g/dose) for 14 days {{and}}

:::::* 3.2.2.2 '''A Protein Synthesis Inhibitor'''

::::::* Preferred regimen (1): [[Clindamycin]], 40 mg/kg/day IV divided q8h (not to exceed 900 mg/dose) for 14 days

::::::* Preferred regimen (2):  (non-CNS infection dose)

:::::::* If patient is < 12 y old: [[Linezolid]] 30 mg/kg/day IV divided q8h for 14 days

:::::::* If patient is = 12 y old: [[Linezolid]] 30 mg/kg/day IV divided q12h (not to exceed 600 mg/dose) for 14 days

::::::* Preferred regimen (3):

:::::::* If patients body weight is < 45 kg: [[Doxycycline]] 4.4 mg/kg/day IV loading dose (not to exceed 200 mg) {{then}} [[Doxycycline]] 4.4 mg/kg/day IV divided q12h  (not to exceed 100 mg/dose) for 14 days

:::::::* If patients body weight is =45 kg: [[Doxycycline]] 200 mg IV loading dose {{then}} [[Doxycycline]] 100 mg IV given q12h for 14 days

::::::* Preferred regimen (4): [[Rifampin]] 20 mg/kg/day IV divided q12h (not to exceed 300 mg/dose) for 14 days

::::::* Note: Duration of therapy for 14 days or longer until clinical criteria for stability are met. Will require prophylaxis to complete an antimicrobial course of up to 60 days from onset of illness.

::::* 3.2.3 '''Triple therapy for systemic anthrax (anthrax meningitis or disseminated infection and meningitis cannot be ruled out) for Children 1 Month of Age and Older'''

:::::* 3.2.3.1 '''A bactericidal antimicrobial''' (fluoroquinolone)

::::::* Preferred regimen (1): [[Ciprofloxacin]] 30 mg/kg/day IV divided q8h (not to exceed 400 mg/dose) for 2–3 wks

::::::* Preferred regimen (2):

:::::::* If patients body weight is < 50 kg: [[Levofloxacin]] 16 mg/kg/day IV divided q12h (not to exceed 250 mg/dose) for 2–3 wks

:::::::* If patients body weight is > 50 kg: [[Levofloxacin]] 500 mg IV q24h for 2–3 wks

::::::* Preferred regimen (3):

:::::::* If patients age is 3 months to < 2 years: [[Moxifloxacin]]  12 mg/kg/day IV, divided q12h (not to exceed 200 mg/dose) for 2–3 wks

:::::::* If patients age is 2-5 years: [[Moxifloxacin]] 10 mg/kg/day IV divided q1h (not to exceed 200 mg/dose) for 2–3 wks

:::::::* If patients age is 6–11 years: [[Moxifloxacin]] 8 mg/kg/day IV divided q12h (not to exceed 200 mg/dose) for 2–3 wks

:::::::* If patients age is 12–17 years, = 45 kg body weight: [[Moxifloxacin]] 400 mg IV q24h for 2–3 wks

:::::::* If patients age is 12–17 years, < 45 kg body weight: [[Moxifloxacin]] 8 mg/kg/day IV divided q12h (not to exceed 200 mg/dose) for 2–3 wks {{and}}

:::::* 3.2.3.2 '''A bactericidal antimicrobial (ß-lactam or glycopeptide)'''

::::::* 3.2.3.2.1 '''For all strains, regardless of penicillin susceptibility testing or if susceptibility is unknown''':

:::::::* Preferred regimen (1): [[Meropenem]] 120 mg/kg/day IV divided q8h (not to exceed 2 g/dose) for 2–3 wks

:::::::* Preferred regimen (2): [[Imipenem]]/[[Cilastatin]] 100 mg/kg/day IV divided q6h (not to exceed 1 g/dose) for 2–3 wks

:::::::* Preferred regimen (3): [[Doripenem]] 120 mg/kg/day IV divided q8h (not to exceed 1 g/dose) for 2–3 wks

:::::::* Preferred regimen (4): [[Vancomycin]] 60 mg/kg/day IV divided q8h for 2–3 wks

::::::* 3.2.3.2.2 '''Alternatives for penicillin-susceptible strains'''

:::::::* Alternative regimen (1): [[Penicillin G]] 400 000 U/kg/day IV divided q4h (not to exceed 4 MU/dose) for 2–3 wks

:::::::* Alternative regimen (2): [[Ampicillin]] 400 mg/kg/day IV divided q6h (not to exceed 3 g/dose) for 2–3 wks {{and}}

::::::* 3.2.3.3 '''A Protein Synthesis Inhibitor'''

:::::::* Preferred regimen (1):

::::::::* If patients age is < 12 y old: [[Linezolid]] 30 mg/kg/day IV divided q8h for 2–3 wk

::::::::* If patients age is = 12 y old: [[Linezolid]] 30 mg/kg/day,IV divided q12h (not to exceed 600 mg/dose) for 2–3 wk

:::::::* Preferred regimen (2): [[Clindamycin]] 40 mg/kg/day IV divided q8h (not to exceed 900 mg/dose)  for 2–3 wk

:::::::* Preferred regimen (3): [[Rifampin]] 20 mg/kg/day IV divided q12h (not to exceed 300 mg/dose) for 2–3 wk

:::::::* Preferred regimen (4): [[Chloramphenicol]] 100 mg/kg/day IV divided q6h for 2–3 wk

::::::: Note (1): Duration of therapy for 2–3 wk or greater, until clinical criteria for stability are met.Will require prophylaxis to complete an antimicrobial course of up to 60 days from onset of illness.

::::::: Note (2):  A 400-mg dose of [[Ciprofloxacin]] IV, provides an equivalent exposure to that of a 500-mg ciprofloxacin oral tablet.

::::* 3.2.4 '''Oral follow-up combination therapy for severe anthrax (for Children 1 Month of Age and Older)'''

:::::* 3.2.4.1 '''A bactericidal antimicrobial'''

::::::* 3.2.4.1.1 '''For all strains, regardless of penicillin susceptibility or if susceptibility is unknown'''

:::::::* Preferred regimen (1): [[Ciprofloxacin]] 30 mg/kg/day PO bid (not to exceed 500 mg/dose)

:::::::* Preferred regimen (2):

::::::::* If patients body weight is < 50 kg: [[Levofloxacin]] 16 mg/kg/day PO bid (not to exceed 250 mg/dose)

::::::::* If patients body weight is = 50 kg: [[Levofloxacin]] 500 mg PO qd

::::::* 3.2.4.1.2 '''Alternatives for penicillin-susceptible strains'''

:::::::* Alternative regimen (1): [[Amoxicillin]] 75 mg/kg/day PO tid (not to exceed 1 g/dose)

:::::::* Alternative regimen (2): [[Penicillin VK]] 50–75 mg/kg/day PO tid or qds {{and}}

:::::* 3.2.4.2 '''A protein synthesis inhibitor''':

::::::* Preferred regimen (1):[[Clindamycin]] 30 mg/kg/day PO tid (not to exceed 600 mg/dose)

::::::* Preferred regimen (2):

:::::::* If the patients body weight is < 45 kg: [[Doxycycline]] 4.4 mg/kg/day PO bid (not exceed 100 mg/dose)

:::::::* If the patients body weight is = 45 kg: [[Doxycycline]] 100 mg PO bid

::::::* Preferred regimen (3): (non-CNS infection dose):

:::::::* If the patients age is < 12 yrs old: [[Linezolid]] 30 mg/kg/day PO tid

:::::::* If the patients age is = 12 yrs old: [[Linezolid]] 30 mg/kg/day PO bid (not to exceed 600 mg/dose)

:::::::* Note: Duration of therapy to complete a treatment course of 14 days or greater. May require prophylaxis to complete an antimicrobial course of up to 60 days from onset of illness.

::::* 3.2.5 ''' Dosing in preterm and term neonates 32 to 44 Weeks postmenstrual Age (Gestational Age Plus Chronologic Age)'''

:::::* 3.2.5.1 '''Triple therapy for severe anthrax(anthrax meningitis or disseminated infection and meningitis cannot be ruled out)'''

::::::* 3.2.5.1.1 '''Bactericidal antimicrobial (fluoroquinolone) therapy'''

:::::::*  3.2.5.1.1.1 '''For 32–34 weeks gestational age '''

::::::::* '''For 0–1 week of age'''

:::::::::* Preferred regimen (1): [[Ciprofloxacin]] 20 mg/kg/day IV divided q12h for 2–3 weeks

:::::::::* Preferred regimen (2): [[Moxifloxacin]] 5 mg/kg/day IV q24h for 2–3 weeks

::::::::* '''For 1–4 weeks of age'''

:::::::::* Preferred regimen (1): [[Ciprofloxacin]] 20 mg/kg/day IV divided q12h for 2–3 weeks

:::::::::* Preferred regimen (2): [[Moxifloxacin]] 5 mg/kg/day IV q24h for 2–3 weeks

:::::::*  3.2.5.1.1.2 '''For 34–37 week gestational age '''

::::::::* '''For 0–1 wk of age'''

:::::::::* Preferred regimen (1): [[Ciprofloxacin]] 20 mg/kg/day IV divided q12h for 2–3 weeks

:::::::::* Preferred regimen (2):[[Moxifloxacin]] 5 mg/kg/day IV q24h for 2–3 weeks

::::::::* '''For 1–4 wk of age'''

:::::::::* Preferred regimen (1): [[Ciprofloxacin]] 20 mg/kg/day IV divided q12h for 2–3 weeks

:::::::::* Preferred regimen (2): [[Moxifloxacin]] 5 mg/kg/day IV q24h for 2–3 weeks

:::::::*  3.2.5.1.1.3 '''Term newborn infant'''

::::::::* '''For 0–1 week of age'''

:::::::::* Preferred regimen (1): [[Ciprofloxacin]] 30 mg/kg/day IV divided q12h for 2–3 weeks

:::::::::* Preferred regimen (2): [[Moxifloxacin]] 10 mg/kg/day IV q24h for 2–3 weeks

::::::::* '''For 1–4 weeks of age'''

:::::::::* Preferred regimen (1): [[Ciprofloxacin]] 30 mg/kg/day IV divided q12h for 2–3 weeks

:::::::::* Preferred regimen (2): [[Moxifloxacin]] 10 mg/kg/day IV q24h for 2–3 weeks {{and}}

::::::* 3.2.5.1.2 '''A bactericidal antimicrobial (ß-lactam)'''

:::::::* 3.2.5.1.2.1 '''For all strains, regardless of penicillin susceptibility or if susceptibility is unknown''':

::::::::* 3.2.5.1.2.1.1 '''For 32–34 weeks gestational age'''

:::::::::* For 0–1 week of Age :

::::::::::* Preferred regimen (1): [[Meropenem]] 60 mg/kg/day  IV divided q8h for 2–3 weeks

::::::::::* Preferred regimen (2): [[Imipenem]] 50 mg/kg/day  IV divided q12h for 2–3 weeks

::::::::::* Preferred regimen (3): [[Doripenem]] 20 mg/kg/day  IV divided q12h for 2–3 weeks

:::::::::* For 1–4 wk of Age :

::::::::::* Preferred regimen (1): [[Meropenem]] 90 mg/kg/day  IV divided q8h for 2–3 weeks

::::::::::* Preferred regimen (2): [[Imipenem]] 75 mg/kg/day  IV divided q8h for 2–3 weeks

::::::::::* Preferred regimen (3): [[Doripenem]] 30 mg/kg/day  IV divided q8h for 2–3 weeks

::::::::* 3.2.5.1.2.1.2 '''For 34–37 week gestational age'''

:::::::::* For 0–1 week of Age :

::::::::::* Preferred regimen (1): [[Meropenem]] 60 mg/kg/day IV divided q8h for 2–3 weeks

::::::::::* Preferred regimen (2): [[Imipenem]] 50 mg/kg/day IV divided q12h for 2–3 weeks

::::::::::* Preferred regimen (3): [[Doripenem]]  20 mg/kg/day IV divided q12h for 2–3 weeks

:::::::::* For 1–4 week of Age :

::::::::::* Preferred regimen (1): [[Meropenem]] 90 mg/kg/day IV divided q8h for 2–3 weeks

::::::::::* Preferred regimen (2): [[Imipenem]] 75 mg/kg/day IV divided q8h for 2–3 weeks

::::::::::* Preferred regimen (3): [[Doripenem]] 30 mg/kg/day IV divided q8h for 2–3 weeks

::::::::* 3.2.5.1.2.1.3 '''Term newborn infant'''

:::::::::* '''For < 1 week of age''' 

::::::::::* Preferred regimen (1): [[Meropenem]] 60 mg/kg/day IV divided q8h for 2–3 weeks

::::::::::* Preferred regimen (2): [[Imipenem]] 50 mg/kg/day IV divided q12h for 2–3 weeks

::::::::::* Preferred regimen (3): [[Doripenem]] 20 mg/kg/day IV divided q12h for 2–3 weeks

:::::::::* '''For 1–4 week of age'''

::::::::::* Preferred regimen (1): [[Meropenem]] 90 mg/kg/day IV divided q8h for 2–3 weeks

::::::::::* Preferred regimen (2): [[Imipenem]] 75 mg/kg/day IV divided q8h for 2–3 weeks

::::::::::* Preferred regimen (3): [[Doripenem]] 30 mg/kg/day IV divided q8h for 2–3 weeks

:::::::* 3.2.5.1.2.2 ''' Alternatives for penicillin-susceptible strains'''

::::::::* 3.2.5.1.2.2.1 '''For 32–34 weeks gestational age'''

:::::::::* '''For 0–1 week of age'''

::::::::::* Alternative regimen (1): [[Penicillin G]] 200000 Units/kg/day IV divided q12h for 2–3 weeks

::::::::::* Alternative regimen (2): [[Ampicillin]] 100 mg/kg/day IV divided q12h for 2–3 weeks

:::::::::* '''For 1–4 week of age''' :

::::::::::* Alternative regimen (1): [[Penicillin G]] 300000 Units/kg/day IV divided q12h for 2–3 weeks

::::::::::* Alternative regimen (2): [[Ampicillin]] 150 mg/kg/day divided IV q12h for 2–3 weeks

::::::::* 3.2.5.1.2.2.2 '''For 34–37 week gestational age'''

:::::::::* '''For < 1 week of age''' 

::::::::::* Alternative regimen (1): [[Penicillin G]] 300000 Units/kg/day IV divided q12h for 2–3 weeks

::::::::::* Alternative regimen (2): [[Ampicillin]] 150 mg/kg/day IV divided q12h for 2–3 weeks

:::::::::* '''For 1–4 week of age''' 

::::::::::* Alternative regimen (1): [[Penicillin G]] 400000 Units/kg/day IV divided q12h for 2–3 weeks

::::::::::* Alternative regimen (2): [[Ampicillin]] 200 mg/kg/day IV divided q12h for 2–3 weeks

::::::::* 3.2.5.1.2.2.3 '''Term newborn infant'''

:::::::::* '''For 0–1 week of age''' 

::::::::::* Alternative regimen (1): [[Penicillin G]] 300000 Units/kg/day IV divided q12h for 2–3 weeks

::::::::::* Alternative regimen (2): [[Ampicillin]] 150 mg/kg/day IV divided q12h for 2–3 weeks

:::::::::* '''For 1–4 week of age''' 

::::::::::* Alternative regimen (1): [[Penicillin G]] 400000 Units/kg/day IV divided q12h for 2–3 weeks

::::::::::* Alternative regimen (2): [[Ampicillin]] 200 mg/kg/day IV divided q12h for 2–3 weeks {{and}}

::::::* 3.2.5.1.3 '''A protein synthesis inhibitor'''

:::::::* 3.2.5.1.3.1 '''For 32–34 weeks gestational age'''

::::::::* '''For < 1 week of age'''

:::::::::* Preferred regimen (1): [[Linezolid]] 20 mg/kg/day IV divided q12h for 2–3 weeks

:::::::::* Preferred regimen (2): [[Clindamycin]] 10 mg/kg/day IV divided q12h for 2–3 weeks

:::::::::* Preferred regimen (3): [[Rifampin]] 10 mg/kg/day IV divided q12h for 2–3 weeks

:::::::::* Preferred regimen (4): [[Chloramphenicol]] 25 mg/kg/day IV q24h for 2–3 weeks

::::::::* '''For 1–4 week of age'''

:::::::::* Preferred regimen (1): [[Linezolid]] 30 mg/kg/day IV divided q8h for 2–3 weeks

:::::::::* Preferred regimen (2): [[Clindamycin]] 15 mg/kg/day IV divided q8h for 2–3 weeks

:::::::::* Preferred regimen (3): [[Rifampin]] 10 mg/kg/day IV divided q12h for 2–3 weeks

:::::::::* Preferred regimen (4): [[Chloramphenicol]] 50 mg/kg/day IV q12h for 2–3 weeks

:::::::* 3.2.5.1.3.2 '''For 34–37 week gestational age'''

::::::::* '''For < 1 week of age'''

:::::::::* Preferred regimen (1): [[Linezolid]] 30 mg/kg/day IV divided q8h for 2–3 weeks

:::::::::* Preferred regimen (2): [[Clindamycin]] 15 mg/kg/day IV divided q8h for 2–3 weeks

:::::::::* Preferred regimen (3): [[Rifampin]] 10 mg/kg/day IV divided q12h for 2–3 weeks

:::::::::* Preferred regimen (4): [[Chloramphenicol]] 25 mg/kg/day IV q24h for 2–3 weeks

::::::::* '''For 1–4 week of age'''

:::::::::* Preferred regimen (1): [[Linezolid]] 30 mg/kg/day IV divided q8h for 2–3 weeks

:::::::::* Preferred regimen (2): [[Clindamycin]] 20 mg/kg/day IV divided q6h for 2–3 weeks

:::::::::* Preferred regimen (3): [[Rifampin]] 10 mg/kg/day IV divided q12h for 2–3 weeks

:::::::::* Preferred regimen (4): [[Chloramphenicol]] 50 mg/kg/day IV q12h for 2–3 weeks

:::::::* 3.2.5.1.3.3 '''Term newborn infant'''

::::::::* '''For < 1 week of age'''

:::::::::* Preferred regimen (1): [[Linezolid]] 30 mg/kg/day IV divided q8h for 2–3 weeks

:::::::::* Preferred regimen (2): [[Clindamycin]] 15 mg/kg/day IV divided q8h for 2–3 weeks

:::::::::* Preferred regimen (3): [[Rifampin]] 10 mg/kg/day IV divided q12h for 2–3 weeks

:::::::::* Preferred regimen (4): [[Chloramphenicol]] 25 mg/kg/day IV q24h for 2–3 weeks

::::::::* '''For 1–4 week of age'''

:::::::::* Preferred regimen (1): [[Linezolid]] 30 mg/kg/day IV divided q8h for 2–3 weeks

:::::::::* Preferred regimen (2): [[Clindamycin]] 20 mg/kg/day IV divided q6h for 2–3 weeks

:::::::::* Preferred regimen (3): [[Rifampin]] 20 mg/kg/day IV divided q12h for 2–3 weeks

:::::::::* Preferred regimen (4): [[Chloramphenicol]] 50 mg/kg/day IV q12h for 2–3 weeks

:::::::::* Note :Duration of therapy for 2–3 weeks, until clinical criteria for stability are met. Will require prophylaxis to complete an antibiotic course of upto 60 days from onset of illness.

:::::* 3.2.5.2 '''Therapy for severe anthrax when meningitis can be ruled out'''

::::::* 3.2.5.2.1 '''A bactericidal antimicrobial'''

:::::::* 3.2.5.2.1.1 '''For all strains, regardless of penicillin susceptibility or if susceptibility is unknown'''

::::::::* 3.2.5.2.1.1.1 '''For 32–34 weeks gestational age'''

:::::::::* '''For < 1 week of age'''

::::::::::* Preferred regimen (1): [[Ciprofloxacin]] 20 mg/kg/day IV divided q12h for 2-3 weeks

::::::::::* Preferred regimen (2): [[Meropenem]] 40 mg/kg/day IV divided q8h for 2-3 weeks

::::::::::* Preferred regimen (3): [[Imipenem]] 40 mg/kg/day IV divided q12h for 2-3 weeks

:::::::::* '''For 1–4 week of age'''

::::::::::* Preferred regimen (1): [[Ciprofloxacin]] 20 mg/kg/day IV divided q12h for 2-3 weeks

::::::::::* Preferred regimen (2): [[Meropenem]] 60 mg/kg/day IV divided q8h for 2-3 weeks

::::::::::* Preferred regimen (3): [[Imipenem]] 50 mg/kg/day IV divided q12h for 2-3 weeks

::::::::* 3.2.5.2.1.1.2 '''For 34–37 week gestational age'''

:::::::::* '''For < 1 week of age'''

::::::::::* Preferred regimen (1): [[Ciprofloxacin]] 20 mg/kg/day IV divided q12h for 2-3 weeks

::::::::::* Preferred regimen (2): [[Meropenem]] 60 mg/kg/day IV divided q8h for 2-3 weeks

::::::::::* Preferred regimen (3): [[Imipenem]] 50 mg/kg/day IV divided q12h for 2-3 weeks

:::::::::* '''For 1–4 week of age'''

::::::::::* Preferred regimen (1): [[Ciprofloxacin]] 20 mg/kg/day IV divided q12h for 2-3 weeks

::::::::::* Preferred regimen (2): [[Meropenem]] 60 mg/kg/day IV divided q8h for 2-3 weeks

::::::::::* Preferred regimen (3): [[Imipenem]] 75 mg/kg/day IV divided q8h for 2-3 weeks

::::::::* 3.2.5.2.1.1.3 '''Term Newborn Infant'''

:::::::::* '''For < 1 week of age'''

::::::::::* Preferred regimen (1): [[Ciprofloxacin]] 30 mg/kg/day IV divided q12h for 2-3 weeks

::::::::::* Preferred regimen (2): [[Meropenem]] 60 mg/kg/day IV divided q8h for 2-3 weeks

::::::::::* Preferred regimen (3): [[Imipenem]] 50 mg/kg/day IV divided q12h for 2-3 weeks

:::::::::* '''For 1–4 week of age'''

::::::::::* Preferred regimen (1): [[Ciprofloxacin]] 30 mg/kg/day IV divided q12h for 2-3 weeks

::::::::::* Preferred regimen (2): [[Meropenem]] 60 mg/kg/day IV divided q8h for 2-3 weeks

::::::::::* Preferred regimen (3): [[Imipenem]] 75 mg/kg/day IV divided q8h for 2-3 weeks

:::::::::::* [[Vancomycin]] IV (dosing based on serum creatinine for infants of 32 wk gestational age). Follow vancomycin serum concentrations to modify dose.

::::::::::::* If  Serum creatinine < 0.7 then [[Vancomycin]] 15 mg/kg/dose IV q12h for 2-3 weeks

::::::::::::* If Serum creatinine 0.7 -0.9 then [[Vancomycin]] 20 mg/kg/dose IV q24h for 2-3 weeks

::::::::::::* If Serum creatinine 1–1.2 then [[Vancomycin]] 15 mg/kg/dose IV q24h for 2-3 weeks

::::::::::::* If Serum creatinine 1.3–1.6 then [[Vancomycin]] 10 mg/kg/dose IV q24h for 2-3 weeks

::::::::::::* If Serum creatinine > 1.6 then [[Vancomycin]] mg/kg/dose IV q48h for 2-3 weeks

::::::::::* Note: Begin treatment with a 20 mg/kg loading dose {{or}}

:::::::* 3.2.5.2.1.2 '''Alternatives for penicillin-susceptible strains'''

::::::::* 3.2.5.2.1.2.1 '''For 32–34 weeks gestational age'''

:::::::::* '''For < 1 week of age'''

::::::::::* Alternative regimen (1): [[Penicillin G]] 200000 U/kg/day IV divided q12h for 2-3 weeks

::::::::::* Alternative regimen (2): [[Ampicillin]] 100 mg/kg/day IV divided q12h for 2-3 weeks

:::::::::* '''For 1–4 week of age''' 

::::::::::* Alternative regimen (1): [[Penicillin G]] 300000 U/kg/day IV divided q8h for 2-3 weeks

::::::::::* Alternative regimen (2): [[Ampicillin]] 150 mg/kg/day IV divided q8h for 2-3 weeks

::::::::* 3.2.5.2.1.2.2 '''For 34–37 week gestational age'''

:::::::::* '''For < 1 week of age'''

::::::::::* Alternative regimen (1): [[Penicillin G]] 300000 U/kg/day IV divided q8h for 2-3 weeks

::::::::::* Alternative regimen (2): [[Ampicillin]] 150 mg/kg/day IV divided q8h for 2-3 weeks

:::::::::* '''For 1–4 week of age'''

::::::::::* Alternative regimen (1): [[Penicillin G]] 400000 U/kg/day IV divided q6h for 2-3 weeks
::::::::::* Alternative regimen (2): [[Ampicillin]] 200 mg/kg/day IV divided q6h for 2-3 weeks

::::::::* 3.2.5.2.1.2.3 '''Term newborn infant'''

:::::::::* '''For < 1 week of age'''

::::::::::* Alternative regimen (1): [[Penicillin G]] 300000 U/kg/day IV divided q8h for 2-3 weeks

::::::::::* Alternative regimen (2): [[Ampicillin]] 150 mg/kg/day IV divided q8h for 2-3 weeks

:::::::::* '''For 1–4 week of age'''

::::::::::* Alternative regimen (1): [[Penicillin G]] 400000 U/kg/day IV divided q6h for 2-3 weeks

::::::::::* Alternative regimen (2):[[Ampicillin]] 200 mg/kg/day IV divided q6h for 2-3 weeks

::::::* 3.2.5.2.2 '''A protein synthesis inhibitor'''

:::::::* 3.2.5.2.2.1 '''For 32–34 weeks gestational age'''

::::::::* '''For < 1 week of age'''

:::::::::* Preferred regimen (1): [[Clindamycin]] 10 mg/kg/day IV divided q12h for 2–3 wks

:::::::::* Preferred regimen (2): [[Linezolid]] 20 mg/kg/day IV divided q12h for 2–3 wks

:::::::::* Preferred regimen (3): [[Rifampin]] 10 mg/kg/day IV q24h for 2–3 wks

::::::::* '''For 1–4 week of age'''

:::::::::* Preferred regimen (1): [[Clindamycin]] 15 mg/kg/day IV divided q8h for 2–3 wks

:::::::::* Preferred regimen (2): [[Linezolid]] 30 mg/kg/day IV divided q8h for 2–3 wks

:::::::::* Preferred regimen (3): [[Rifampin]] 10 mg/kg/day IV q24h for 2–3 wks

:::::::* 3.2.5.2.2.2 '''For 34–37 week gestational age'''

::::::::* '''For < 1 week of age'''

:::::::::* Preferred regimen (1): [[Clindamycin]]  15 mg/kg/day IV divided q8h for 2–3 wks

:::::::::* Preferred regimen (2): [[Linezolid]] 30 mg/kg/day IV divided q8h for 2–3 wks

:::::::::* Preferred regimen (3): [[Rifampin]] 10 mg/kg/day IV q24h for 2–3 wks

::::::::* '''For 1–4 week of age'''

:::::::::* Preferred regimen (1): [[Clindamycin]] 20 mg/kg/day IV divided q6h for 2–3 wks

:::::::::* Preferred regimen (2): [[Linezolid]] 30 mg/kg/day IV divided q8h for 2–3 wks

:::::::::* Preferred regimen (3): [[Rifampin]] 10 mg/kg/day IV q24h for 2–3 wks

:::::::* 3.2.5.2.2.3 '''Term newborn infant'''

::::::::* For 0–1 week of age :

:::::::::* Preferred regimen (1): [[Clindamycin]] 15 mg/kg/day  IV divided q8h for 2–3 wks

:::::::::* Preferred regimen (2): [[Linezolid]] 30 mg/kg/day IV divided q8h for 2–3 wks

:::::::::* Preferred regimen (3): [[Doxycycline]] 4.4 mg/kg/day IV divided q12h, (loading dose 4.4 mg/kg) for 2–3 wks

:::::::::* Preferred regimen (4): [[Rifampin]] 10 mg/kg/day IV q24h for 2–3 wks

::::::::* For 1–4 week of age :

:::::::::* Preferred regimen (1): [[Clindamycin]] 20 mg/kg/day IV divided q6h for 2–3 wks

:::::::::* Preferred regimen (2): [[Linezolid]] 30 mg/kg/day IV divided q8h for 2–3 wks

:::::::::* Preferred regimen (3): [[Doxycycline]] 4.4 mg/kg/day IV divided q12h, (loading dose 4.4 mg/kg) for 2–3 wks

:::::::::* Preferred regimen (4): [[Rifampin]] 10 mg/kg/day IV q24h for 2–3 wks

:::::::::* Note: Duration of therapy for 2–3 wks, until clinical criteria for stability are met (see text). Will require prophylaxis to complete an antimicrobial course of upto 60 days from onset of illness

:::::* 3.2.5.3 '''Oral follow-up combination therapy for severe anthrax'''

::::::* 3.2.5.3.1 '''A bactericidal antimicrobial'''

:::::::* 3.2.5.3.1.1 '''For all strains, regardless of penicillin susceptibility or if susceptibility is unknown'''

::::::::* 3.2.5.3.1.1.1 '''For 32–34 weeks gestational age'''

:::::::::* '''For < 1 week of age'''

::::::::::* Preferred regimen: [[Ciprofloxacin]] 20 mg/kg/day PO bid

::::::::::* '''For 1–4 week of age'''

::::::::::* Preferred regimen: [[Ciprofloxacin]] 20 mg/kg/day PO bid

::::::::* 3.2.5.3.1.1.2 '''For 34–37 week gestational age'''

:::::::::*  '''For < 1 week of age'''

::::::::::* Preferred regimen: [[Ciprofloxacin]] 20 mg/kg/day PO bid

:::::::::* '''For 1–4 week of age'''

::::::::::* Preferred regimen: [[Ciprofloxacin]] 20 mg/kg/day PO bid

::::::::* 3.2.5.3.1.1.3 '''Term newborn infant'''

:::::::::* '''For < 1 week of age'''

::::::::::* Preferred regimen: [[Ciprofloxacin]] 30 mg/kg/day PO bid

:::::::::* '''For 1–4 week of age'''

::::::::::* Preferred regimen: [[Ciprofloxacin]] 30 mg/kg/day PO bid {{or}}

:::::::* 3.2.5.3.1.2 '''Alternatives for penicillin-susceptible strains'''

::::::::* 3.2.5.3.1.2.1 '''For 32–34 weeks gestational age'''

:::::::::* '''For < 1 week of age'''

::::::::::* Alternative regimen (1): [[Amoxicillin]] 50 mg/kg/day PO bid

::::::::::* Alternative regimen (2): Penicillin VK  50 mg/kg/day PO bid

:::::::::* '''For 1–4 week of age'''

::::::::::* Alternative regimen (1): [[Amoxicillin]] 75 mg/kg/day PO bid

::::::::::* Alternative  regimen (2): Penicillin VK 75 mg/kg/day PO bid

::::::::* 3.2.5.3.1.2.2 '''For 34–37 week gestational age'''

:::::::::* '''For < 1 week of age'''

::::::::::* Alternative regimen (1): [[Amoxicillin]] 50 mg/kg/day PO bid

::::::::::* Alternative regimen (2): Penicillin VK 50 mg/kg/day PO bid

::::::::* '''For 1–4 week of age''' 

:::::::::* Alternative regimen (1): [[Amoxicillin]] 75 mg/kg/day PO bid

:::::::::* Alternative regimen (2): Penicillin VK 75 mg/kg/day PO tid

::::::::* 3.2.5.3.1.2.3 '''Term newborn infant'''

:::::::::* '''For < 1 week of age''' 

::::::::::* Alternative regimen (1): [[Amoxicillin]] 75 mg/kg/day PO tid

::::::::::* Alternative regimen (2): Penicillin VK 75 mg/kg/day PO tid

:::::::::* '''For 1–4 week of age''' 

::::::::::* Alternative regimen (1): [[Amoxicillin]] 75 mg/kg/day PO tid
::::::::::* Alternative regimen (2): Penicillin VK 75 mg/kg/day PO tid or qid

::::::* 3.2.5.3.2 '''A protein synthesis inhibitor'''

:::::::* 3.2.5.3.2.1 '''For 32–34 weeks gestational age'''

::::::::* '''For < 1 week of age'''
:::::::::* Preferred regimen (1): [[Clindamycin]] 10 mg/kg/day PO bid

:::::::::* Preferred regimen (2): [[Linezolid]] 20 mg/kg/day PO bid

::::::::* '''For 1–4 week of age''' 

:::::::::* Preferred regimen (1): [[Clindamycin]] 15 mg/kg/day PO bid 

:::::::::* Preferred regimen (2): [[Linezolid]] 30 mg/kg/day PO bid

:::::::* 3.2.5.3.2.2 '''For 34–37 week gestational age'''

::::::::* '''For < 1 week of age''' 

:::::::::* Preferred regimen (1): [[Clindamycin]] 15 mg/kg/day PO tid

:::::::::* Preferred regimen (2): [[Linezolid]] 30 mg/kg/day PO tid

::::::::* '''For 1–4 week of age'''

:::::::::* Preferred regimen (1): [[Clindamycin]] 20 mg/kg/day PO qid

:::::::::* Preferred regimen (2): [[Linezolid]] 30 mg/kg/day PO tid

:::::::* 3.2.5.3.2.3 '''Term newborn infant'''

::::::::* '''For < 1 week of age'''

:::::::::* Preferred regimen (1): [[Clindamycin]] 15 mg/kg/day PO tid

:::::::::* Preferred regimen (2): [[Doxycycline]] 4.4 mg/kg/day PO bid (loading dose 4.4 mg/kg)  
:::::::::* Preferred regimen (3): [[Linezolid]] 30 mg/kg/day PO tid
::::::::* '''For 1–4 week of age'''
:::::::::* Preferred regimen (1): [[Clindamycin]] 20 mg/kg/day PO qid
:::::::::* Preferred regimen (2): [[Doxycycline]] 4.4 mg/kg/day PO bid (loading dose 4.4 mg/kg) 
:::::::::* Preferred regimen (3): [[Linezolid]] 30 mg/kg/day PO tid 

:::::::::* Note: Duration of therapy to complete a treatment course of 10–14 days or greater. May require prophylaxis to complete an antimicrobial course of upto 60 days from onset of illness.

:::::* 3.2.5.4 '''Treatment of cutaneous anthrax without systemic involvement'''

::::::* 3.2.5.4.1 '''For all strains, regardless of penicillin susceptibility or if susceptibility is unknown'''

:::::::* 3.2.5.4.1.1 '''For 32–34 weeks gestational age'''

::::::::* '''For < 1 week of age'''

:::::::::* Preferred regimen (1): [[Ciprofloxacin]] 20 mg/kg/day PO bid

:::::::::* Preferred regimen (2): [[Clindamycin]] 10 mg/kg/day PO bid

::::::::* '''For 1–4 week of age'''

:::::::::* Preferred regimen (1): [[Ciprofloxacin]] 20 mg/kg/day PO bid
:::::::::* Preferred regimen (2): [[Clindamycin]] 15 mg/kg/day PO tid

:::::::* 3.2.5.4.1.2 '''For 34–37 week gestational age'''

::::::::* '''For < 1 week of age'''

:::::::::* Preferred regimen (1): [[Ciprofloxacin]] 20 mg/kg/day PO bid

:::::::::* Preferred regimen (2): [[Clindamycin]] 15 mg/kg/day PO tid

::::::::* '''For 1–4 week of age'''

:::::::::* Preferred regimen (1): [[Ciprofloxacin]] 20 mg/kg/day PO bid

:::::::::* Preferred regimen (2): [[Clindamycin]] 20 mg/kg/day PO qid

:::::::* 3.2.5.4.1.3 '''Term newborn infant'''

::::::::* '''For < 1 week of age'''

:::::::::* Preferred regimen (1): [[Ciprofloxacin]] 30 mg/kg/day PO bid

:::::::::* Preferred regimen (2): [[Doxycycline]] 4.4 mg/kg/day PO bid (Loading dose 4.4 mg/kg)

:::::::::* Preferred regimen (3): [[Clindamycin]] 15 mg/kg/day PO tid

::::::::* '''For 1–4 week of age'''

:::::::::* Preferred regimen (1): [[Ciprofloxacin]] 30 mg/kg/day PO bid

:::::::::* Preferred regimen (2): [[Doxycycline]] 4.4 mg/kg/day PO bid (Loading dose 4.4 mg/kg) 

:::::::::* Preferred regimen (3): [[Clindamycin]] 20 mg/kg/day PO qid
 
::::::* 3.2.5.4.2 '''Alternatives for penicillin-susceptible strains'''

:::::::* 3.2.5.4.2.1 '''For 32–34 weeks gestational age'''

::::::::* '''For < 1 week of age'''

:::::::::* Alternative regimen (1): [[Amoxicillin]] 50 mg/kg/day PO bid
:::::::::* Alternative regimen (2): Penicillin Vk 50 mg/kg/day PO bid

::::::::* '''For 1–4 week of age'''

:::::::::* Alternative regimen (1): [[Amoxicillin]] 75 mg/kg/day PO tid

:::::::::* Alternative regimen (2): Penicillin Vk 75 mg/kg/day PO tid

:::::::* 3.2.5.4.2.2 '''For 34–37 week gestational age'''

::::::::* '''For < 1 week of age'''

:::::::::* Alternative regimen (1): [[Amoxicillin]] 50 mg/kg/day PO bid
:::::::::* Alternative regimen (2): Penicillin Vk 50 mg/kg/day PO bid

::::::::* '''For 1–4 week of age'''
:::::::::* Alternative regimen (1): [[Amoxicillin]] 75 mg/kg/day PO bid

:::::::::* Alternative regimen (2): Penicillin Vk 75 mg/kg/day PO bid

:::::::* 3.2.5.4.2.3 '''Term newborn infant'''

::::::::* '''For < 1 week of age'''

:::::::::* Alternative regimen (1): [[Amoxicillin]] 75 mg/kg/day PO tid
:::::::::* Alternative regimen (2): Penicillin Vk 75 mg/kg/day PO tid

::::::::* '''For 1–4 week of age'''
:::::::::* Alternative regimen (1): [[Amoxicillin]]  75 mg/kg/day PO tid

:::::::::* Alternative regimen (2): Penicillin Vk 75 mg/kg/day PO tid or qid
:::::::::* Note : Duration of therapy for naturally acquired infection is 7–10 days and for a biological weapon–related event,may require additional prophylaxis for inhaled spores to complete an antimicrobial course of up to 60 days from onset of illness.

:* '''Bacillus anthracis, postexposure prophylaxis'''

::* 1. '''For adults'''<ref name="pmid24447897">{{cite journal| author=Hendricks KA, Wright ME, Shadomy SV, Bradley JS, Morrow MG, Pavia AT et al.| title=Centers for disease control and prevention expert panel meetings on prevention and treatment of anthrax in adults. | journal=Emerg Infect Dis | year= 2014 | volume= 20 | issue= 2 | pages=  | pmid=24447897 | doi=10.3201/eid2002.130687 | pmc=PMC3901462 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24447897  }} </ref>

:::* 1.1 '''For all strains, regardless of penicillin susceptibility or if susceptibility is unknown'''

::::* Preferred regimen (1): [[Ciprofloxacin]] 500 mg IV q12h

::::* Preferred regimen (2): [[Doxycycline]] 100 mg IV q12h

::::* Preferred regimen (3): [[Levofloxacin]] 750 mg IV q24h

::::* Preferred regimen (4): [[Moxifloxacin]] 400 mg IV q24h

::::* Preferred regimen (5): [[Clindamycin]] 600 mg IV q8h

:::* 1.2 '''Alternatives for penicillin-susceptible strain'''

::::* Preferred regimen (1): [[Amoxicillin]] 1 g IV q8h

::::* Preferred regimen (2): Penicillin VK 500 mg IV q6h

::* 2. '''For children = 1 month'''<ref name="pmid24777226">{{cite journal| author=Bradley JS, Peacock G, Krug SE, Bower WA, Cohn AC, Meaney-Delman D et al.| title=Pediatric anthrax clinical management. | journal=Pediatrics | year= 2014 | volume= 133 | issue= 5 | pages= e1411-36 | pmid=24777226 | doi=10.1542/peds.2014-0563 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24777226  }} </ref>

:::* 2.1 '''For penicillin-resistant strains or prior to susceptibility testing'''

::::* Preferred regimen (1): [[Ciprofloxacin]] 30 mg/kg/day, PO, bid (not to exceed 500 mg/dose)

::::* Preferred regimen (2):

:::::* If patients body weight < 45 kg: [[Doxycycline]] 4.4 mg/kg/day, PO, bid (not to exceed 100 mg/dose)

:::::* If patients body weight > 45 kg: [[Doxycycline]] 100 mg/dose, PO, bid

::::* Preferred regimen (3): [[Clindamycin]] 30 mg/kg/day, PO, tid (not to exceed 900 mg/dose)

::::* Preferred regimen (4):

:::::* If patients body weight < 50 kg: [[Levofloxacin]] 16 mg/kg/day, PO, bid (not to exceed 250 mg/dose)

:::::* If patients body weight > 50 kg: [[Levofloxacin]] 500 mg, PO, qd

:::* 2.2 '''For penicillin-susceptible strains'''

::::* Preferred regimen (1): [[Amoxicillin]] 75 mg/kg/day, PO, tid (not to exceed 1 g/dose)

::::* Preferred regimen (2): [[Penicillin VK]] 50-75 mg/kg/day, PO, id or tid

::::* Note: '''Duration of Therapy is 60 days after exposure'''

::* 3. '''For children < 1 month'''

:::* 3.1 '''For all strains, regardless of penicillin susceptibility or if susceptibility is unknown'''

::::* 3.1.1 '''For 32–34 weeks gestational age'''

:::::* 3.1.1.1 '''For < 1 week of Age'''

::::::* Preferred regimen (1): [[Ciprofloxacin]] 20 mg/kg/day, PO, bid

::::::* Preferred regimen (2): [[Clindamycin]] 10 mg/kg/day, PO, bid

:::::* 3.1.1.2 '''For 1–4 week of age '''

::::::* Preferred regimen (1): [[Ciprofloxacin]] 20 mg/kg/day, PO,bid

::::::* Preferred regimen (2): [[Clindamycin]] 15 mg/kg/day, PO, tid

::::* 3.1.2 '''For 34–37 week gestational age'''

:::::* 3.1.2.1 '''For < 1 week of age'''

::::::* Preferred regimen (1): [[Ciprofloxacin]] 20 mg/kg/day, PO, bid

::::::* Preferred regimen (2): [[Clindamycin]] 15 mg/kg/day, PO, tid

:::::* 3.1.2.2 '''For 1–4 week of age'''

::::::* Preferred regimen (1): [[Ciprofloxacin]] 20 mg/kg/day, PO, bid

::::::* Preferred regimen (2): [[Clindamycin]] 20 mg/kg/day, PO, id

::::* 3.1.3 '''Term newborn infant'''

:::::* 3.1.3.1 '''For < 1 week of age '''

::::::* Preferred regimen (1): [[Ciprofloxacin]] 30 mg/kg/day, PO, bid

::::::* Preferred regimen (2): [[Doxycycline]] 4.4 mg/kg/day, PO, bid (Loading dose 4.4 mg/kg)

::::::* Preferred regimen (3): [[Clindamycin]] 15 mg/kg/day, PO, tid

:::::* 3.1.3.2 '''For 1–4 week of Age'''

::::::* Preferred regimen (1): [[Ciprofloxacin]] 30 mg/kg/day, PO, bid

::::::* Preferred regimen (2): [[Doxycycline]] 4.4 mg/kg/day, PO, bid (Loading dose 4.4 mg/kg)

::::::* Preferred regimen (3): [[Clindamycin]] 20 mg/kg/day, PO, qid

:::* 3.2 '''Alternatives for penicillin-susceptible strains'''

::::* 3.2.1 '''For 32–34 weeks gestational age'''

:::::* 3.2.1.1 '''For < 1 week of age'''

::::::* Alternative regimen (1): [[Amoxicillin]] 50 mg/kg/day, PO, bid

::::::* Alternative regimen (2): Penicillin Vk  50 mg/kg/day, PO, bid

:::::* 3.2.1.2 '''For 1–4 week of age'''

::::::* Alternative regimen (1): [[Amoxicillin]] 75 mg/kg/day, PO, tid

::::::* Alternative regimen (2): Penicillin Vk 75 mg/kg/day, PO, tid

::::* 3.2.2 '''For 34–37 week gestational age'''

:::::* 3.2.2.1 '''For < 1 week of age'''

::::::* Alternative regimen (1): [[Amoxicillin]] 50 mg/kg/day, PO, bid

::::::* Alternative regimen (2): Penicillin Vk 50 mg/kg/day, PO, bid

:::::* 3.2.2.2 '''For 1–4 week of age'''

::::::* Alternative regimen (1): [[Amoxicillin]] 75 mg/kg/day, PO, tid

::::::* Alternative regimen (2): Penicillin Vk  75 mg/kg/day, PO, tid

::::* 3.2.3 '''Term newborn infant'''

:::::* 3.2.3.1 '''For < 1 week of age'''

::::::* Alternative regimen (1): [[Amoxicillin]] 75 mg/kg/day, PO, tid

::::::* Alternative regimen (2): Penicillin Vk 75 mg/kg/day, PO, tid

:::::* 3.2.3.2 '''For 1–4 week of age'''

::::::* Alternative regimen (1): [[Amoxicillin]] 75 mg/kg/day, PO, tid

::::::* Alternative regimen (2): Penicillin Vk 75 mg/kg/day, PO, id or tid

::::::* Note: Duration of therapy is  60 days from exposure

----

{{PBI|Bacillus cereus}}
:* 1. '''Food poisoning'''<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
::* Preferred regimen: Food poisoning is usually self-limited and requires no antibiotic therapy.
:* 2. '''Bacteremia'''
::* Preferred regimen: [[Vancomycin]] 15 mg/kg IV q12h
::* Alternative regimen: [[Clindamycin]] 600 mg IV q8h
::* Note (1): Bacillus cereus is commonly resistant to beta-lactams.
::* Note (2): Pseudobacteremia is transient and usually results from contaminated blood cultures, gloves, or syringes.
:* 3. '''Meningitis or brain abscess'''
::* Preferred regimen: [[Vancomycin]] 15 mg/kg IV q12h
::* Alternative regimen: [[Clindamycin]] 600 mg IV q8h
::* Note: Blood culture isolates are mostly contaminates until proven otherwise, especially in intravenous drug user population.
:* 4. '''Endophthalmitis'''
::* Preferred regimen: [[Clindamycin]] 450 μg intravitreal {{and}} [[Gentamicin]] 400 μg intravitreal {{or}} [[Dexamethasone]] intravitreal {{and}} [[Vancomycin]] 15 mg/kg IV q12h
::* Alternative regimen: [[Clindamycin]] 600 mg IV q8h
::* Note: Ophthalmological consultation, culture ocular fluids, early vitrectomy, and intravitreal antibiotics are necessary.
:* 5. '''Endocarditis'''
::* Preferred regimen: [[Vancomycin]] 15 mg/kg IV q12h
::* Note: Most blood cultures in intravenous drug users are contaminates or represent transient bacteremia.
:* 6. ''' Soft tissue infection'''
::* Preferred regimen: [[Vancomycin]] 15 mg/kg IV q12h
::* Alternative regimen: [[Clindamycin]] 600 mg IV q8h
:* 7. '''Pneumonia'''
::* Preferred regimen: [[Vancomycin]] 15 mg/kg IV q12h
::* Alternative regimen: [[Clindamycin]] 600 mg IV q8h

----

{{PBI|Bacillus subtilis}}
:* Bacillus subtilis infection treatment<ref>{{cite book | last = Bennett | first = John | title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases | publisher = Elsevier/Saunders | location = Philadelphia, PA | year = 2015 | isbn = 978-1455748013 }}</ref><ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref><ref>{{Cite journal| issn = 0305-7453| volume = 49| issue = 6| pages = 1040–1042| last1 = Andrews| first1 = J. M.| last2 = Wise| first2 = R.| title = Susceptibility testing of Bacillus species| journal = The Journal of Antimicrobial Chemotherapy| date = 2002-06| pmid = 12039902}}</ref>
::* 1. Food poisoning
:::* Preferred regimen: supportive treatment
::* 2. Other infections
:::* Preferred regimen: [[Vancomycin]] {{or}} [[Clindamycin]]
:::* Alternative regimen: [[Ciprofloxacin]] {{or}} [[Imipenem]]
:::* Note: Distinguish clinically significant infection from contamination before administering antibiotics.

----


{{PBI|Clostridium botulinum}}
:*'''1. Antibiotics''' 
::* Antibiotics are not recommended in gastrointestinal botulism due to the risk of worsening of neurological symptoms caused by the lysis of the bacteria. For wound botulism antibiotics are indicated with surgical treatment as followed:
::* Preferred regimen: [[Metronidazole]] 500 mg IV q8h
::* Alternative regimen: [[Penicillin G]] 3 million units IV q4h
:*'''2. Antitoxin''' <ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
::* Preferred regimen: Trivalent antitoxin (A 7,500 IU, B 5,000 IU, and E 5,000 IU) 1 vial diluted 1:10, IV infusion over 30 min
::* Alternative regimen: Equine antitoxin
:*'''3. General Therapy'''
::* Preferred regimen: Mechanical ventilation; IV hydration; tube feedings


{{PBI|Clostridium perfringens}}
:* Clostridium perfringens <ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
:*'''Gas gangrene'''
:::* Preferred regimen: [[Penicillin G]] 3-4 million units IV q4h {{and}} ([[Clindamycin]] 900 mg IV q8h {{or}} [[Tetracycline]] 500 mg IV q6h)<ref name="pmid5109333">{{cite journal| author=Altemeier WA, Fullen WD| title=Prevention and treatment of gas gangrene. | journal=JAMA | year= 1971 | volume= 217 | issue= 6 | pages= 806-13 | pmid=5109333 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=5109333  }} </ref>


{{PBI|Clostridium tetani}}
:*1. '''General measures''' <ref name=World Health Organization>{{cite web | title = Current recommendations for treatment of tetanus during humanitarian emergencies| url =http://www.who.int/diseasecontrol_emergencies/publications/who_hse_gar_dce_2010.2/en/ }}</ref>
::*Preferred regimen: Patients should be placed in a quiet shaded area and protected from tactile and auditory stimulation as much as possible; All wounds should be cleaned and debrided as indicated
:*2. '''Immunotherapy'''
::*Preferred regimen: Human TIG 500 units IV/IM as soon as possible {{and}} Age-appropriate TT-containing vaccine, 0.5 cc IM at a separate site
::*Note: patients without a history of primary TT vaccination should receive a second dose 1–2 months after the first dose and a third dose 6–12 months later
:*3. '''Antibiotic treatment'''<ref>http://www.who.int/diseasecontrol_emergencies/who_hse_gar_dce_2010_en.pdf</ref>
::*Preferred regimen: [[Metronidazole]] 500 mg IV/PO q6h {{or}} [[Penicillin G]] 100,000–200,000 IU/kg/day IV, administered in 2–4 divided doses
::*Alternative regimen: [[Tetracyclines]] {{or}} [[Macrolides]] {{or}} [[Clindamycin]] {{or}} [[Cephalosporins]] {{or}} [[Chloramphenicol]]
:*4. '''Muscle spasm control'''
::*Preferred regimen: [[Diazepam]] 5 mg IV {{or}} [[Lorazepam]] 2 mg IV titrating to achieve spasm control without excessive sedation and hypoventilation
::*Alternative regimen (1): [[Magnesium]] sulphate 5 g (or 75mg/kg) IV loading dose, then 2–3 g per hour until spasm control is achieved {{withorwithout}} [[Benzodiazepines]]
::*Note: Monitor patellar reflex as areflexia (absence of patellar reflex) occurs at the upper end of the therapeutic range (4mmol/L). If areflexia develops, dose should be decreased
::*Alternative regimen (2): [[Baclofen]] {{or}} [[Dantrolene]] 1–2 mg/kg IV/PO q4h
::*Alternative regimen (3): [[Barbiturates]] 100–150 mg q1-4h by any route
::*Alternative regimen (4): [[Chlorpromazine]] 50–150 mg IM q4–8h
::*Pediatric regimen: [[Lorazepam]] 0.1–0.2 mg/kg IV q2–6h, titrating upward as needed; [[Barbiturates]] 6–10 mg/kg in children by any route; [[Chlorpromazine]] 4–12 mg IM every q4–8h
::*Note: As for [[Benzodiazepines]], large amounts may be required (up to 600 mg/day); oral preparations could be used but must be accompanied by careful monitoring to avoid respiratory depression or arrest
:* 5. '''Autonomic dysfunction control'''
::*Preferred regimen: [[Magnesium]] sulphate {{or}} [[Morphine]] {{or}} [[Esmolol]]
:* 6. '''Airway/respiratory control'''
::*Note: Drugs used to control spasm and provide sedation can result in respiratory depression. If spasm, including laryngeal spasm, is impeding or threatening adequate ventilation, mechanical ventilation is recommended when possible. Early tracheostomy is preferred as endotracheal tubes can provoke spasm and exacerbate airway compromise.


{{PBI|Clostridium difficile}}
:*1. '''Pseudomembranous colitis - mild to moderate'''<ref name="pmid25626036">{{cite journal| author=Bagdasarian N, Rao K, Malani PN| title=Diagnosis and treatment of Clostridium difficile in adults: a systematic review. | journal=JAMA | year= 2015 | volume= 313 | issue= 4 | pages= 398-408 | pmid=25626036 | doi=10.1001/jama.2014.17103 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25626036  }} </ref>
::*Preferred regimen:[[Metronidazole]] 500 mg PO tid for 10-14 days
::*Alternative regimen: [[Vancomycin]] 125 mg PO qid for 10-14 days
::*Note: If significant risk of recurrence: [[Vancomycin]] 125 mg PO qid for 10-14 days {{or}} [[Fidaxomicin]] 200 mg PO bid for 10 days
:*2. '''Pseudomembranous colitis - severe'''<ref name="pmid25626036">{{cite journal| author=Bagdasarian N, Rao K, Malani PN| title=Diagnosis and treatment of Clostridium difficile in adults: a systematic review. | journal=JAMA | year= 2015 | volume= 313 | issue= 4 | pages= 398-408 | pmid=25626036 | doi=10.1001/jama.2014.17103 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25626036  }} </ref>
::*Preferred regimen: [[Vancomycin]] 125 mg PO qid for 10-14 days
::*Note: If significant risk of recurrence: [[Vancomycin]] 125 mg PO qid for 10-14 days {{or}} [[Fidaxomicin]] 200 mg PO bid for 10 days
:*3. '''Pseudomembranous colitis - severe, complicated'''<ref name="pmid25626036">{{cite journal| author=Bagdasarian N, Rao K, Malani PN| title=Diagnosis and treatment of Clostridium difficile in adults: a systematic review. | journal=JAMA | year= 2015 | volume= 313 | issue= 4 | pages= 398-408 | pmid=25626036 | doi=10.1001/jama.2014.17103 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25626036  }} </ref>
::*Preferred regimen: [[Vancomycin]] 125-500 mg PO qid for 10-14 days {{and}} [[Vancomycin]] 500 mg diluted in 500 ml of saline as enema per rectum q6h {{and}} [[Metronidazole]] 500 mg IV q8h
::*Note: Consider urgent surgical consult
:*4. '''Recurrent pseudomembranous colitis'''<ref name="pmid25626036">{{cite journal| author=Bagdasarian N, Rao K, Malani PN| title=Diagnosis and treatment of Clostridium difficile in adults: a systematic review. | journal=JAMA | year= 2015 | volume= 313 | issue= 4 | pages= 398-408 | pmid=25626036 | doi=10.1001/jama.2014.17103 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25626036  }} </ref>
::*First recurrence treatment
:::*Preferred regimen: same as first episode or [Fidaxomicin]] 200 mg PO bid for 10 days
::*Second or more recurrence treatment
:::*Preferred regimen: [[Vancomycin]] 125 mg PO qid for 14 days {{then}} [[Vancomycin]] 125 mg PO tid for 7 days {{then}} [[Vancomycin]] 125 mg PO bid for 7 days {{then}} [[Vancomycin]] 125 mg PO qd for 7 days {{then}} [[Vancomycin]] 125 mg PO q48h for 7 days {{then}} [[Vancomycin]] 125 mg PO q72h for 7 days {{or}} [[Fidaxomicin]] 200 mg PO bid for 10 days
:::*Note: Consider expert consult for fecal microbiota transplantation

==Corynebacterium==
{{PBI|Corynebacterium diphtheriae}}
:* Diphtheria treatment <ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref> <ref>{{cite web | title = Diphtheria CDC| url =http://www.cdc.gov/vaccines/pubs/pinkbook/dip.html }}</ref>
::* 1. '''Antitoxin '''
:::* 1.1 '''Pharyngeal disease <48 hrs'''
::::* Preferred regimen: 20,000-40,000 U IV/IM 
:::* 1.2 '''Nasopharyngeal'''
::::* Preferred regimen: 40-60,000 U IV/IM

:::* 1.3 '''Extensive disease, or > 72 hrs'''
::::* Preferred regimen: 80-120,000 U IV/IM

:::* Note: IV administration for severe disease

::* 2. '''Antibiotics '''
:::* Preferred regimen: [[Erythromycin]] 40 mg/kg/day (Maximum, 2 gm/day) PO/IV for 14 days
:::* Alternative regimen: [[Procaine penicillin G]] 600,000 U/day IM qd for 14 days
:::* Note: Procaine penicillin G  300,000 U/day for those weighing 10 kg or less

::* 3. '''Preventive antibiotic use'''
:::* Note: For close contacts, especially household contacts, a diphtheria booster, appropriate for age, should be given
:::* Preferred regimen: [[Benzathine penicillin G ]]
::::* younger than 6 years old: 600,000 U IM
::::* 6 years old and older: 1,200,000 U IM
:::* Alternative regimen: [[Erythromycin]] 
::::* Adult: 1 g/day PO 7-10 days

::::* Pediatric: 40 mg/kg/day PO 7-10 days
:::* Note (1): If surveillance of contacts cannot be maintained, they should receive benzathine penicillin G
:::* Note (2): Maintain close surveillance and begin antitoxin at the first signs of illness

{{PBI|Corynebacterium jeikeium}}
:* Corynebacterium jeikeium<ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
::* Preferred regimen : [[Vancomycin]] 1 gm IV q12h 
::* Alternative regimen : [[Penicillin G]] {{and}} Anti pseudomonal aminoglycosides like [[Tobramycin]], [[Gentamicin]], [[Amikacin]]
{{PBI|Corynebacterium urealyticum}}
:* '''Corynebacterium urealyticum'''<ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
::* 1. '''Post renal transplant obstructive uropathy'''
:::* Preferred regimen (1): [[Vancomycin]] 1 gm IV q12h 
:::* Preferred regimen (2): [[Teicoplanin]] 6 mg/kg/day IV q24h

----

{{PBI|Coxiella burnetii}}
:* '''Q fever'''<ref>{{cite web | title =q fever | url = http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6203a1.htm   }}</ref>
::* 1. '''Acute Q fever'''
:::* 1.1 '''Adults'''
::::* Preferred Regimen: [[Doxycycline]] 100 mg PO bid for 14 days
:::* 1.2 '''Children'''
::::* 1.2.1 '''Children with age  ≥8 years'''
:::::* Preferred regimen: [[Doxycycline]] 2.2 mg/kg  PO bid for 14 days (maximum 100 mg per dose)
::::* 1.2.2  '''Children with age <8 years with high risk criteria'''
:::::* Preferred regimen: [[Doxycycline]] 2.2 mg/kg PO bid for 14 days (maximum: 100 mg per dose)
::::* 1.2.3  '''Children with age <8 years with mild or uncomplicated illness'''
:::::* Preferred regimen: [[Doxycycline]] 2.2 mg/kg  PO bid for 5 days (maximum 100 mg per dose). 
::::* 1.2.3  '''Children with age < 8 years with mild or uncomplicated illness,who remains febrile past 5 days of treatment'''
:::::* Preferred regimen: [[Trimethoprim/Sulfamethoxazole]] 4-20 mg/kg  PO bid for 14 days (maximum: 800 mg per dose)
:::* 1.3 '''Pregnant women'''
::::* Preferred regimen: [[Trimethoprim/Sulfamethoxazole]] 160 mg/800 mg  PO bid a day throughout pregnancy
::* 2. '''Chronic Q fever'''
:::* 2.1 '''Endocarditis or vascular infection'''
::::* Preferred regimen: [[Doxycycline]] 100 mg PO bid {{and}} [[Hydroxychloroquine]] 200 mg PO tid  for ≥18 months
::::* Note: childern and pregnant women- consultation  Recommended
:::* 2.2 '''Noncardiac organ disease'''
::::* Preferred regimen: [[Doxycycline]] 100 mg PO bid {{and}} [[Hydroxychloroquine]] 200 mg PO tid 
::::* Note: childern and pregnant women- consultation  Recommended
:::* 2.3 '''Postpartum with serologic profile for chronic Q fever'''
::::* Preferred regimen: [[Doxycycline]] 100 mg PO bid {{and}} [[Hydroxychloroquine]] 200 mg PO tid for 12 months
::::* Note (1): Women should only be treated postpartum if serologic titers remain elevated >12 months after delivery (immunoglobulin G phase I titer ≥1:1024). Women treated during pregnancy for acute Q fever should be monitored similarly to other patients who are at high risk for progression to chronic disease (e.g., serologic monitoring at 3, 6, 12, 18, and 24 months after delivery)
::::* Note (2): Post-Q fever fatigue syndrome- no current recommendation.

----
{{PBI|Ehrlichia}}
:* 1. '''[[Ehrlichiosis|Human Monocytic Ehrlichiosis]] or [[Human Granulocytic Anaplasmosis]] (adult)''' <ref name=CDC centers for the disease control and prevention>{{cite web | title =Ehrlichiosis CDC centers for the disease control and prevention| url= http://www.cdc.gov/ehrlichiosis/symptoms/index.html#treatment }}</ref> <ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
::* Preferred regimen: [[Doxycycline]] 100 mg PO/IV q12h for 7-14 days
::* Note: Patients should be treated for at least 3 days after the fever subsides and until there is evidence of clinical improvement
::* Alternative regimen (1): [[Chloramphenicol]] 500mg PO qid 

::* Alternative regimen (2): [[Rifampin]] 600 mg PO/IV qd for 7-10 days 
:* 2. '''[[Ehrlichiosis|Human Monocytic Ehrlichiosis]] or [[Human Granulocytic Anaplasmosis]] (pediatric)'''
::* 2.1 '''≥ 8 years old'''
:::* Preferred regimen: [[Doxycycline]] 2 mg/kg IV/PO q12h (Maximum, 200 mg/day) for 10 days
::* 2.2 '''< 8 years old without Lyme disease'''
:::* Preferred regimen: [[Doxycycline]] 2 mg/kg IV/PO q12h (Maximum, 200 mg/day) for 4-5 days (or 3 days after resolution of fever)
::* 2.3 '''co-infected with Lyme disease'''
:::* Preferred regimen: [[Doxycycline]] (see above) {{then}} [[Amoxicillin]] 50 mg/kg/day tid (Maximum, 500 mg/dose) {{or}} [[Cefuroxime]] 30 mg/kg/day bid (Maximum, 500 mg/dose) for 14 days

{{PBI|Erysipelothrix rhusiopathiae}}
:* Erysipelothrix rhusiopathiae <ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
::* 1. '''Erysipeloid of Rosenbach (localized cutaneous infection)'''
:::* Preferred regimen (1): [[Penicillin G benzathine]] 1.2 MU IV single dose
:::* Preferred regimen (2): [[Penicillin VK]] 250 mg PO qid for 5-7 days
:::* Preferred regimen (3): [[Procaine penicillin]] 0.6-1.2 MU IM qd for 5-7 days
:::* Alternative regimen (1): [[Erythromycin]] 250 mg PO qid for 5-7 days
:::* Alternative regimen (2): [[Doxycycline]] 100 mg PO bid for 5-7 days

::* 2. '''Diffuse cutaneous infection'''
:::* Preferred regimen: See localized infection

::* 3. '''Bacteremia or endocarditis'''
:::* Preferred regimen: [[Penicillin G benzathine]] 2-4 MU IV q4h for 4-6 weeks
:::* Alternative regimen (1): [[Ceftriaxone]] 2 g IV q24h for 4-6 weeks
:::* Alternative regimen (2): [[Imipenem]] 500 mg IV q6h for 4-6 weeks
:::* Alternative regimen (3): [[Ciprofloxacin]] 400 mg IV q12h for 4-6 weeks
:::* Alternative regimen (4): [[Daptomycin]] 6 mg/kg IV q24h for 4-6 weeks
:::* Note: Recommended duration of therapy for endocarditis is 4 to 6 weeks, although shorter courses consisting of 2 weeks of intravenous therapy followed by 2 to 4 weeks of oral therapy have been successful

{{PBI|Listeria monocytogenes}}
:* 1. '''Meningitis''' <ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
::* Preferred regimen: [[Ampicillin]] 2g IV q4-6h {{withorwithout}} [[Gentamicin]] 1.7 mg/kg IV q8h for more than 3 weeks

::* Alternative regimen: [[TMP-SMX]] 3-5 mg/kg (trimethoprim) IV q6h for more than 3 weeks
:* 2. '''Bacteremia'''
::* Preferred regimen: [[Ampicillin]] 2g IV q4-6h {{withorwithout}} [[Gentamicin]] 1.7 mg/kg IV q8h for 2 weeks
::* Alternative regimen: [[TMP-SMX]] 3-5 mg/kg (trimethoprim) q6h IV for 2 weeks

:* 3. '''Brain abscess or rhomboencephalitis'''
::* Preferred regimen: [[Ampicillin]] 2g IV q4-6h {{withorwithout}} [[Gentamicin]] 1.7 mg/kg IV q8h for 4-6 weeks 
::* Alternative regimen: [[TMP-SMX]] 3-5 mg/kg (trimethoprim) q6h IV for 4-6 weeks 

:* 4. '''Gastroenteritis'''
::* Preferred regimen (1): [[Amoxicillin]] 2g IV q4-6h 
::* Preferred regimen (2): [[TMP-SMX]] 3-5 mg/kg (trimethoprim) q6h IV for 7 days

{{PBI|Lactobacillus}}
:* 1. '''Endovascular Infection''' <ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
::* Preferred regiemn (1): [[Penicillin G]] 20 MU/day for 6 weeks 
::* Preferred regiemn (2): [[Gentamicin]] 1.3 mg/kg IV q8h (trough <1.5 mg/L) {{and}} [[Polychlorinated naphthalene]] 
:* 2. '''Odontogenic Infection'''
::* Preferred regiemn: [[Clindamycin]] 450 mg PO qid 
:* 3. '''Intrabdominal Abscess'''
::* Preferred regiemn: [[Clindamycin]] 450 mg PO qid

{{PBI|Leuconostoc}}
:* Leuconostoc <ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
::* Preferred regimen (1): [[Penicillin G]]

::* Preferred regimen (2): [[Ampicillin]]

::* Alternative regimen (1): [[Clindamycin]] 

::* Alternative regimen (2): [[Erythromycin]]  

::* Alternative regimen (3): [[Minocycline]]

{{PBI|Nocardia}}
:* 1. '''Sulfonamide-based therapies''' <ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
::* 1.1 '''Pulmonary'''
:::* Preferred regimen: [[TMP-SMX]] 10 mg/kg/day (TMP) IV q6-12h for 3-6 weeks {{then}} 2 DS PO bid for at least 5 months 
::* 1.2 '''Pulmonary alternatives'''
:::* Preferred regimen: [[Sulfisoxazole]] {{or}} [[Sulfadiazine]] {{or}} Trisulfapyrimidine 3-6 g/day PO bid-qid {{or}} [[TMP-SMX]] 2 DS bid up to 2 DS tid 
::* 1.3 '''CNS (AIDS, severe or disseminated disease)'''
:::* Preferred regimen: [[TMP-SMX]] 15 mg/kg/day (TMP) IV for 3-6 weeks {{then}} 3 DS PO bid for 6-12 months 
::* 1.4 '''CNS alternatives'''
:::* Preferred regimen: [[Imipenem]] 1000 mg IV q8h {{or}} [[Ceftriaxone]] 2 g IV q12h {{or}} [[Cefotaxime]] 2-3 g IV q6h {{and}} [[Amikacin]] 
::* 1.5 '''Severe disease, compromised host, multiple sites'''
:::* Preferred regimen: [[TMP-SMX]] 15 mg/kg/day (TMP) IV {{and}} [[Amikacin]] 7.5 mg/kg q12h {{or}} [[Sulfonamide]] 6-12 mg/day PO
::* 1.6 '''Sporotrichoid (cutaneous)'''
:::* Preferred regimen: [[TMP-SMX]] 1 DS bid for 4-6 months
::* Note (1): Immunocompetent medicine use for 6 months; Immunosuppressed medicine for 12 months
::* Note (2): Treat based on host, site of disease and in vitro activity; Sulfonamide usually preferred, must treat for 6-12 months; Preferred drugs for resistant strains are [[Amikacin]] and/or [[Imipenem]] 
::* Note (3): Seriously ill usually treated with IV [[Imipenem]] or [[Sulfonamide]] or [[Cefotaxime]] all potentially combined with [[Amikacin]]; less seriously ill treated with oral agents— especially [[TMP-SMX]] or [[Minocycline]] 

:* 2. '''Sulfonamide alternatives'''
::* 2.1 '''Severe'''
:::* Preferred regimen (1): (For AIDS) ([[Imipenem]] 1000 mg IV q8h {{or}} [[Meropenem]] 2 g q8h {{and}} [[Amikacin]] 7.5 mg/kg q12h IV 
:::* Preferred regimen (2): [[Cefotaxime]] 2-3 g q6-8h {{or}} [[Ceftriaxone]] 2 g/day IV {{withorwithout}} [[Amikacin]] 
::* 2.2 '''Mild'''
:::* Preferred regimen: [[Minocycline]] 100 mg bid for at least 6 months (initial treatment of local disease or maintenance) 
:::* Alternative regimen: [[Amoxicillin clavulanate]] 875/125 mg bid {{or}} [[Doxycycline]] {{or}} [[Erythromycin]] {{or}} [[Clarithromycin]] {{or}} [[Linezolid]] {{or}} [[Fluoroquinolone]] {{or}} combinations for at least 6 months

{{PBI|Propionibacterium acnes}}
:* Propiobacterium acnes <ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
::* 1. '''Systemic infection'''
:::* Preferred regimen: [[Penicillin G]] 2 MU IV q4h for 2-4 weeks
:::* Alternative regimen (1): [[Clindamycin]] 600 mg IV q8h for 2-4 weeks  

:::* Alternative regimen (2): [[Vancomycin]] 15 mg/kg IV q12h for 2-4 weeks

::* 2. '''Shoulder prosthesis infection'''
:::* Preferred regimen: [[Amoxicillin]] {{and}} [[Rifampin]] for 3-6 months

::* 3. '''Acne vulgaris'''
:::* Topical antibiotics: [[Erythromycin]] {{or}} [[Clindamycin]]
:::* Systemic antibiotics: [[Minocycline]] {{or}} [[Doxycycline]] {{or}} [[Trimethoprim-Sulfamethoxazole]]

{{PBI|Rhodococcus equi}}
:* Rhodococcus equi <ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
::* First line: 
:::* Preferred regimen: [[Vancomycin]] 1 g IV q12h (15 mg/kg q12 for >70 kg) {{or}} [[Imipenem]] 500 mg IV q6h {{and}} [[Rifampin]] 600 mg PO qd {{or}} [[Ciprofloxacin]] 750 mg PO bid {{or}} [[Erythromycin]] 500 mg PO qid for at least 4 weeks or until infiltrate disappears 
:::* Note: Should be administrated at least 8 weeks in immunocompromised patients
::* Oral/maintenance therapy (after infiltrate clears): 
:::* Preferred regimen (1): [[Ciprofloxacin]] 750 mg PO bid  

:::* Preferred regimen (2): [[Erythromycin]] 500 mg PO qid
::* Alternative regimen: [[Azithromycin]] {{or}} [[TMP-SMX]] {{or}} [[Chloramphenicol]] {{or}} [[Clindamycin]] 
::* Note: Avoid Penicillins/Cephalosporins due to development of resistance; Linezolid effective in vitro, but no clinical reports of use

{{PBI|Rickettsia prowazekii}}
{{PBI|Rickettsia rickettsii}}
:* 1. '''Adult''' <ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref> <ref>{{cite web | title = Rocky Mountain Spotted Fever (RMSF) CDC| url =http://www.cdc.gov/rmsf/symptoms/index.html#treatment }}</ref>
::* Preferred regimen: [[Doxycycline]] 100 mg q12h
::* Note: Patients should be treated for at least 3 days after the fever subsides and until there is evidence of clinical improvement. Standard duration of treatment is 7-14 days
::* Alternative regimen: [[Chloramphenicol]] 500 mg PO qid for 7 days or stop 3 days after defervescence

:* 2. '''Pediatric (under 45 kg (100 lbs))'''
::* Preferred regimen: [[Doxycycline]] 2.2 mg/kg bid
::* Note: The recommended dose and duration of medication needed to treat RMSF has not been shown to cause staining of permanent teeth, even when five courses are given before the age of eight. Healthcare providers should use doxycycline as the first-line treatment for suspected Rocky Mountain spotted fever in patients of all ages

{{PBI|Rickettsia typhi}}

====Bacteria – Gram-Negative Cocci and Coccobacilli====  
{{PBI|Aggregatibacter aphrophilus}}
:* 1. '''Endocarditis'''<ref>{{Cite web | title = Infective Endocarditis: | url = http://www.idsociety.org/uploadedFiles/IDSA/Guidelines-Patient_Care/PDF_Library/Endocarditis%20Management.pdf }}</ref>
::* 1.1 '''Adults'''
:::* Preferred regimen (1): [[Ceftriaxone]] 2 g/day TV/IM q24h for 4 weeks
:::* Preferred regimen (2): [[Ampicillin-sulbactam]] 12 g/day TV q6h for 4 weeks
:::* Preferred regimen (3): [[Ciprofloxacin]] 1000 mg PO q24h {{or}} 800 mg/day IV q12h for 4 weeks
::* 1.2 '''Pediatrics'''
:::* Preferred regimen (1): [[Ceftriaxone]] 100 mg/kg/day TV/IM q24h for 4 weeks
:::* Preferred regimen (2): [[Ampicillin-sulbactam]] 300 mg/kg/day TV q6h/q4h for 4 weeks
:::* Preferred regimen (3): [[Ciprofloxacin]] 20-30 mg/kg/day IV/PO bid for 4 weeks
:::* Note (1): Floroquinolone therapy recommended for patients unable to tolerate Cephalosporin and ampicillin thearpy
:::* Note (2): For patients < 18 years, Flourouinolones are generally not recommended
:::* Note (3): For patients with endocarditis involving the prosthetic cardiac valve or other prosthetic cardiac material should be treated for 6 weeks
:* 2. '''Abscess''' <ref>{{cite book | last = Bennett | first = John | title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases | publisher = Elsevier/Saunders | location = Philadelphia, PA | year = 2015 | isbn = 978-1455748013 }}</ref>
::* The small number of patients reported and the variety of antibiotics used, do not permit identification of the optimal therapeutic regimen for this organism


{{PBI|Bordetella pertussis}}

==Brucella==
{{PBI|Brucella}}
:* '''Brucellosis '''<ref>{{cite book | last = Corbel | first = Michael | title = Brucellosis in humans and animals | publisher = World Health Organization | location = Geneva | year = 2006 | isbn = 9241547138 }}</ref>,<ref>{{cite book | last = Bennett | first = John | title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases | publisher = Elsevier/Saunders | location = Philadelphia, PA | year = 2015 | isbn = 978-1455748013 }}</ref>
::* 1.'''Uncomplicated brucellosis in adults and children ≥8yrs of age'''
:::* Preferred regimen: [[Doxycycline]] 100 mg  PO bid for 6 weeks {{and}} [[Streptomycin]] 1 g/day IM  for  2-3 weeks  
:::* Alternative regimen (1): [[Doxycycline]] 100 mg/day PO for six weeks {{and}} [[Gentamicin]] 5mg/kg IM  for 7-days     
:::* Alternative regimen (2): [[Gentamicin]] 5mg/kg/day IV/ IM  for 7-10 days  {{and}} [[Rifampicin]] 600–900 mg/day PO for six weeks
::* 2. '''Complications of brucellosis'''
:::* 2.1 '''Spondylitis'''
::::* Preferred regimen:[[ Doxycycline]] for 3 months  {{and}} [[Streptomycin]] for 2 to 3 weeks.
:::* 2.2 '''Neurobrucellosis'''
::::* Preferred regimen: [[Ceftriaxone]] 2 mg IV q12h for 1 month {{and}} [[Doxycycline]] 100 mg PO bid for 4-5 month {{and}} [[Rifampicin]] 600–900 mg/day PO for  4-5 month 
:::* 2.3 '''Brucella endocarditis'''
::::* Preferred regimen: [[Doxycycline]] {{and}} an [[Aminoglycoside]] for at least 8 weeks, and therapy should be continued for several weeks after surgery when valve replacement is necessary
::::* Note: [[Rifampicin]] {{or}} [[Trimethoprim/sulfamethoxazole]] are used for their ability to penetrate cell membranes
::* 3. '''Pregnancy'''
:::* Preferred regimen: [[Rifampin]] 900 mg PO qd  for 6 weeks
:::* Note: Adding [[Trimethoprim-sulfamethoxazole]] can be considered, but this option should probably be avoided preceding the 13th week and after the 36th week of gestation because of concern about teratogenicity and kernicterus. 
::* 4.'''For children < 8 yrs of age'''
:::* Preferred regimen (1): [[TMP/SMZ]] 8/40 mg/ kg/day PO bid  for 6 weeks {{and}} [[Streptomycin]] 30 mg/kg/day IM q24h  for 3 weeks 
:::* Preferred regimen (2): [[Gentamicin]] 5 mg/kg/day IM/ IV q24h for 7-10 days
:::* Alternative regimen (1): [[TMP/SMZ]] {{and}} [[Rifampicin]] 15 mg/kg/day PO for 6 weeks 
:::* Alternative regimen (2): [[Rifampicin]] {{and}} an [[Aminoglycoside]]

{{PBI|Eikenella corrodens}}
:* 1. '''Human bite/soft tissue infections''' <ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
::* 1.1 '''Severe'''
:::* Preferred regimen: [[Ampicillin sulbactam]] 1.5-3 g IV q6h 
:::* Alternative regimen (1): [[Doxycycline]] 100 mg IV bid 

:::* Alternative regimen (2): [[Moxifloxacin]] 400 mg IV q24h 

:::* Alternative regimen (3): [[Levofloxacin]] 500 mg IV q24h 
::* 1.2 '''Mild'''
:::* Preferred regimen: [[Amoxicillin clavulanate]] 250-500 mg tid or 875/125 mg PO bid 
:::* Alternative regimen (1): [[Doxycycline]] 100 mg PO bid 

:::* Alternative regimen (2): [[Moxifloxacin]] 400 mg PO qd  

:::* Alternative regimen (3): [[Levofloxacin]] 500 mg PO qd
:* 2. '''Head and neck infections '''
::* 2.1 '''Severe'''
:::* Preferred regimen: [[Ampicillin sulbactam]] 1.5-3 g IV q6h 
:::* Alternative regimen (1): [[Doxycycline]] 100 mg IV bid 

:::* Alternative regimen (2): [[Moxifloxacin]] 400 mg IV q24h  

:::* Alternative regimen (3): [[Levofloxacin]] 500 mg IV q24h 
::* 2.2 '''Mild'''
:::* Preferred regimen: [[Amoxicillin clavulanate]] 250-500 mg tid or 875/125 mg PO bid 
:::* Alternative regimen (1): [[Doxycycline]] 100 mg PO bid  

:::* Alternative regimen (2): [[Moxifloxacin]] 400 mg PO qd  

:::* Alternative regimen (3): [[Levofloxacin]] 500 mg PO qd
:* 3. '''Endocarditis'''
::* Preferred regimen (1): [[Ceftriaxone]] 1 g IV q12h  

::* Preferred regimen (1): [[Cefotaxime]] 1-2 g IV q8h  

::* Preferred regimen (1): [[Cefepime]] 1-2g IV q8h

----

==Haemophilus ducreyi==
{{PBI|Haemophilus ducreyi}}
:* 1. '''Chancroid'''<ref>{{Cite journal| issn = 1545-8601| volume = 64| issue = RR-03| pages = 1–137| last1 = Workowski| first1 = Kimberly A.| last2 = Bolan| first2 = Gail A.| title = Sexually transmitted diseases treatment guidelines, 2015| journal = MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control| date = 2015-06-05| pmid = 26042815}}</ref>
::* Preferred Regimen (1): [[Azithromycin]] 1 g PO in a single dose 
::* Preferred Regimen (2): [[Ceftriaxone]] 250 mg IM in a single dose 
::* Preferred Regimen (3): [[Ciprofloxacin]] 500 mg PO bid for 3 days 
::* Preferred Regimen (4): [[Erythromycin]] base 500 mg PO tid for 7 days
::* Note: Patients should be tested for HIV infection at the time chancroid is diagnosed. If the initial test results were negative, a serologic test for syphilis and HIV infection should be performed 3 months after the diagnosis of chancroid.
::* 1.1 '''Follow-up'''
:::* Patients should be re-examined 3–7 days after initiation of therapy. If treatment is successful, ulcers usually improve symptomatically within 3 days and objectively within 7 days after therapy. If no clinical improvement is evident, the clinician must consider whether 1) the diagnosis is correct, 2) the patient is coinfected with another STD, 3) the patient is infected with HIV, 4) the treatment was not used as instructed, or 5) the H. ducreyi strain causing the infection is resistant to the prescribed antimicrobial. 
:::* Clinical resolution of fluctuant lymphadenopathy is slower than that of ulcers and might require needle aspiration or incision and drainage, despite otherwise successful therapy. Although needle aspiration of buboes is a simpler procedure, incision and drainage might be preferred because of reduced need for subsequent drainage procedures.
::* 1.2 '''Management of sex partners'''
:::* Regardless of whether symptoms of the disease are present, sex partners of patients who have chancroid should be examined and treated if they had sexual contact with the patient during the 10 days preceding the patient’s onset of symptoms.
::* 1.3 '''Pregnancy'''
:::* [[Ciprofloxacin]] presents a low risk to the fetus during pregnancy, with a potential for toxicity during breastfeeding. Alternative drugs should be used during pregnancy and lactation
::* 1.4 '''HIV Infection'''
:::* Persons with HIV infection who have chancroid should be monitored closely because they are more likely to experience treatment failure and to have ulcers that heal slowly. Persons with HIV infection might require repeated or longer courses of therapy, and treatment failures can occur with any regimen.

----

==Haemophilus influenzae==
{{PBI|Haemophilus influenzae}}
:* Haemophilus influenzae<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
::* 1. '''Non- life threatening infections'''<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
:::* 1.1 '''Adults'''
::::* Preferred regimen (1): [[Amoxicillin-clavulanate]] 500 mg PO tid or 875 mg PO bid
::::* Preferred regimen (2): [[Amoxicillin]] 500 mg PO tid 
::::* Preferred regimen (3): [[TMP-SMX]] DS PO bid
::::* Preferred regimen (4): [[Cefuroxime]] 250-500 mg PO bid
::::* Preferred regimen (5): [[Moxifloxacin]] 400 mg PO qd
::::* Preferred regimen (6): [[Levofloxacin]] 500 mg PO qd
::::* Preferred regimen (7): [[Azithromycin]] 500 mg PO single dose then 250 mg for 4 days 

::::* Preferred regimen (8): [[Clarithromycin]] 500 mg PO bid or XL 500 mg PO q24h
::::* Note: Treatment duration of otitis media is 10-14 days, acute exacerbation of chronic bronchitis is 5 days (quinolone - 14 days), sinusitis is 10-14 days.

::* 2. '''Meningitis'''<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
:::* [[Dexamethasone]] 0.15 mg/kg 15-20 mins before first dose of antibiotic and then q6h for 4 days
::::* 2.1 '''Adults'''
:::::* Preferred regimen (1): [[Ceftriaxone]] 2 g IV q12h (4 g maximum)
:::::* Preferred regimen (2): [[Cefotaxime]] 2 g IV q4-6h (12 g maximum)
:::::* Preferred regimen (3): [[Ampicillin]] 2 g IV q4h if sensitive
:::::* Alternative regimen: [[Ciprofloxacin]] 400 mg IV q8h {{or}} other [[Fluoroquinolones]]
::::* 2.2 '''Pediatric'''
:::::* 2.2.1 '''Neonates < 7 days'''
::::::* 2.2.1.1 Weight < 2 kg
:::::::* Preferred regimen: [[Cefotaxime]] 50 mg/kg IV q12h for 10-14 days
::::::* 2.2.1.2 Weight > 2 kg

:::::::* Preferred regimen (1): [[Cefotaxime]] 50 mg/kg IV q8h 

:::::::* Preferred regimen (2): [[Ceftriaxone]] 50 mg/kg IV q24h for 10-14 days
:::::* 2.2.2 '''Neonates >7 days'''
::::::* 2.2.2.1 Weight > 2 kg
:::::::* Preferred regimen (1): [[Cefotaxime]] 50 mg/kg IV q6-8h 
:::::::* Preferred regimen (2): [[Ceftriaxone]] 75 mg/kg IV q24h for 10-14 days
:::::* 2.2.3 '''Children'''
::::::* Preferred regimen (1): [[Cefotaxime]] 200 mg/kg/day IV q6h 
::::::* Preferred regimen (2): [[Ceftriaxone]] 100 mg/kg IV q12-24h for 10-14 days
::::* 2.3 '''Post-meningitis exposure prophylaxis'''<ref name="pmid6819447">{{cite journal| author=Centers for Disease Control (CDC)| title=Prevention of secondary cases of Haemophilus influenzae type b disease. | journal=MMWR Morb Mortal Wkly Rep | year= 1982 | volume= 31 | issue= 50 | pages= 672-4, 679-80 | pmid=6819447 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6819447  }} </ref> 
:::::* Preferred regimen (1): [[Rifampin]] 600 mg PO qd for 4 days 
::* 3. '''Severe infections'''<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
:::* 3.1 '''Adults'''
::::* Preferred regimen (1): [[Ceftriaxone]] 1-2 g IV q24 or q12h 
::::* Preferred regimen (2): [[Cefotaxime]] 2 g IV q6h
::::* Alternative regimen (1): [[Ciprofloxacin]] 400 mg IV q8h or other [[Fluoroquinolones]] 

::::* Alternative regimen (2): [[Ampicillin]] 2 g IV q6h if sensitive

----

==Neisseria gonorrhoeae==
{{PBI|Neisseria gonorrhoeae}}
:* '''Neisseria gonorrhoeae treatment'''<ref>{{Cite journal| issn = 1545-8601| volume = 64| issue = RR-03| pages = 1–137| last1 = Workowski| first1 = Kimberly A.| last2 = Bolan| first2 = Gail A.| title = Sexually transmitted diseases treatment guidelines, 2015| journal = MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control| date = 2015-06-05| pmid = 26042815}}</ref>
::* 1. '''Gonococcal infections in adolescents and adults'''
:::* 1.1 '''Uncomplicated gonococcal infections of the cervix, urethra, and rectum'''
::::* Preferred regimen: [[Ceftriaxone]] 250 mg IM in a single dose {{and}} [[Azithromycin]] 1 g PO in a single dose
::::* Alternative regimen: [[Cefixime]] 400 mg PO in a single dose {{and}} [[Azithromycin]] 1 g PO in a single dose (if ceftriaxone is not available)
:::* 1.2 '''Uncomplicated gonococcal infections of the pharynx'''
::::* Preferred regimen: [[Ceftriaxone]] 250 mg IM in a single dose {{and}} [[Azithromycin]] 1 g PO in a single dose
:::::* 1.2.1 '''Management of sex partners'''
::::::* Expedited partner therapy: [[Cefixime]] 400 mg PO in a single dose {{and}} [[Azithromycin]] 1 g PO in a single dose
::::::* Note (1): Recent sex partners (i.e., persons having sexual contact with the infected patient within the 60 days preceding onset of symptoms or gonorrhea diagnosis) should be referred for evaluation, testing, and presumptive dual treatment. 
::::::* Note (2): If the patient’s last potential sexual exposure was >60 days before onset of symptoms or diagnosis, the most recent sex partner should be treated. 
::::::* Note (3): To avoid reinfection, sex partners should be instructed to abstain from unprotected sexual intercourse for 7 days after they and their sexual partner(s) have completed treatment and after resolution of symptoms, if present.
:::::* 1.2.2  '''Allergy, intolerance, and adverse reactions'''
::::::* Preferred regimen (1): [[Gemifloxacin]] 320 mg PO in a single dose {{and}} [[Azithromycin]] 2 g PO in a single dose
::::::* Preferred regimen (2): [[Gentamicin]] 240 mg IM in a single dose {{and}} [[Azithromycin]] 2 g PO in a single dose
::::::* Note: Use of ceftriaxone or cefixime is contraindicated in persons with a history of an IgE-mediated penicillin allergy (e.g., anaphylaxis, Stevens Johnson syndrome, and toxic epidermal necrolysis).
:::::* 1.2.3 '''Pregnancy'''
::::::* Preferred regimen: [[Ceftriaxone]] 250 mg IM in a single dose {{and}} [[Azithromycin]] 1 g PO in a single dose
:::::* 1.2.4 '''Suspected cephalosporin treatment failure'''
::::::* Preferred regimen: [[Ceftriaxone]] 250 mg IM in a single dose {{and}} [[Azithromycin]] 1 g PO in a single dose
::::::* Alternative regimen (1): [[Gemifloxacin]] 320 mg PO  single dose  {{and}} [[Azithromycin]] 2 g PO  single dose (when isolates have elevated cephalosporin MICs)
::::::* Alternative regimen (2): [[Gentamicin]] 240 mg IM  single dose {{and}} [[Azithromycin]] 2 g PO single dose (when isolates have elevated cephalosporin MICs)
::::::* Alternative regimen (3): [[Ceftriaxone]] 250 mg IM as a single dose {{and}} [[Azithromycin]] 2 g PO as a single dose (failure after treatment with cefixime and azithromycin)
::::::* Note: Treatment failure should be considered in: (1) persons whose symptoms do not resolve within 3–5 days after appropriate treatment and report no sexual contact during the post-treatment follow-up period; (2) persons with a positive test-of-cure (i.e., positive culture ≥ 72 hours or positive NAAT ≥ 7 days after receiving recommended treatment) when no sexual contact is reported during the post-treatment follow-up period; (3) persons who have a positive culture on test-of-cure (if obtained) if there is evidence of decreased susceptibility to cephalosporins on antimicrobial susceptibility testing, regardless of whether sexual contact is reported during the post-treatment follow-up period.
:::* 1.3 '''Gonococcal conjunctivitis'''
::::* Preferred regimen: [[Ceftriaxone]] 250 mg IM in a single dose {{and}} [[Azithromycin]] 1 g PO in a single dose
::::: Note: Consider one-time lavage of the infected eye with saline solution.
:::::* 1.3.1 '''Management of sex partners'''
::::::* Patients should be instructed to refer their sex partners for evaluation and treatment. 
:::* 1.4 '''Disseminated gonococcal infection'''  
:::::* 1.4.1 '''Arthritis and arthritis-dermatitis syndrome '''
::::::* Preferred regimen: [[Ceftriaxone]] 1 g IM/IV q24h for 7 days {{and}} [[Azithromycin]] 1 g PO in a single dose
::::::* Alternative regimen (1): [[Cefotaxime]] 1 g IV q8h for 7 days
::::::* Alternative regimen (2): [[Ceftizoxime]] 1 g IV q8h  for 7 days {{and}} [[Azithromycin]] 1 g PO in a single dose
:::::* 1.4.2 '''Gonococcal meningitis and endocarditis'''
::::::* Preferred regimen: [[Ceftriaxone]] 1-2 g IV  q 12-24 h  for 10-14 days {{and}} [[Azithromycin]] 1 g PO in a single dose
::* 2. '''Gonococcal infections among neonates'''
:::* 2.1 '''Ophthalmia neonatorum caused by N. gonorrhoeae'''
::::* Preferred regimen: [[Ceftriaxone]] 25-50 mg/kg IM/IV in a single dose, not to exceed 125 mg
:::::* 2.1.1 '''Management of mothers and their sex partners'''
::::::* Mothers of infants with ophthalmia neonatorum caused by N. gonorrhoeae should be evaluated, tested, and presumptively treated for gonorrhea, along with their sex partner(s).
:::* 2.2 '''Disseminated gonococcal infection and gonococcal scalp abscesses in neonates'''
::::* Preferred regimen (1): [[Ceftriaxone]] 25-50 mg/kg/day IM/IV q24h for 7 days 
::::* Preferred regimen (2): [[Cefotaxime]] 25 mg/kg IM/IV  q12h for 7 days.
::::* Note (1): The duration of treatment is 10-14 days if meningitis is documented.
::::* Note (2): Ceftriaxone should be administered cautiously to hyperbilirubinemic infants, especially those born prematurely.
:::::* 2.2.1 '''Management of mothers and their sex partners'''
::::::* Mothers of infants who have DGI or scalp abscesses caused by N. gonorrhoeae should be evaluated, tested, and presumptively treated for gonorrhea, along with their sex partner(s).
:::* 2.3 '''Neonates born to mothers who have gonococcal infection'''
::::* Preferred regimen: [[Ceftriaxone]] 25-50 mg/kg IM/IV in a single dose, not to exceed 125 mg
:::::* 2.3.1 '''Management of mothers and their sex partners'''
::::::* Mothers who have gonorrhea and their sex partners should be evaluated, tested, and presumptively treated for gonorrhea.
::* 3. '''Gonococcal infections among infants and children'''
:::* 3.1 '''Infants and children who weigh ≤ 45 kg and who have uncomplicated gonococcal vulvovaginitis, cervicitis, urethritis, pharyngitis, or proctitis'''
::::* Preferred regimen: [[Ceftriaxone]] 25-50 mg/kg IM/IV in a single dose, not to exceed 125 mg
:::* 3.2 '''Children who weigh > 45 kg and who have uncomplicated gonococcal vulvovaginitis, cervicitis, urethritis, pharyngitis, or proctitis'''
::::* Preferred regimen: [[Ceftriaxone]] 250 mg IM in a single dose {{and}} [[Azithromycin]] 1g PO in a single dose
::::* Alternative regimen: [[Cefixime]] 400 mg PO  single dose {{and}} [[Azithromycin]] 1 g PO single dose.(If ceftriaxone is not available)  
:::* 3.3 '''Children who weigh ≤ 45 kg and who have bacteremia or arthritis'''
::::* Preferred regimen: [[Ceftriaxone]] 50 mg/kg (maximum dose: 1 g) IM/IV q24h for 7 days
:::* 3.4 '''Children who weigh > 45 kg and who have bacteremia or arthritis'''
::::* Preferred regimen: [[Ceftriaxone]] 1 g IM/IV q24h for 7 days

==Neisseria meningitidis==
{{PBI|Neisseria meningitidis}}
:* 1. '''Meningococcal meningitis or meningococcemia, treatment'''<ref name="pmid15494903">{{cite journal| author=Tunkel AR, Hartman BJ, Kaplan SL, Kaufman BA, Roos KL, Scheld WM et al.| title=Practice guidelines for the management of bacterial meningitis. | journal=Clin Infect Dis | year= 2004 | volume= 39 | issue= 9 | pages= 1267-84 | pmid=15494903 | doi=10.1086/425368 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15494903  }} </ref><ref name="pmid23141618">{{cite journal| author=van de Beek D, Brouwer MC, Thwaites GE, Tunkel AR| title=Advances in treatment of bacterial meningitis. | journal=Lancet | year= 2012 | volume= 380 | issue= 9854 | pages= 1693-702 | pmid=23141618 | doi=10.1016/S0140-6736(12)61186-6 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23141618  }} </ref>
::* 1.1 '''Adults'''
:::* 1.1.1 '''Penicillin MIC < 0.1 mcg/mL'''
::::* Preferred regimen (1): [[Penicillin G]] 4 MU IV q4h for 7 days
::::* Preferred regimen (2): [[Ampicillin]] 2 g IV q4h for 7 days
::::* Alternative regimen (1): [[Ceftriaxone]] 4 g/day IV q12-24h for 7 days
::::* Alternative regimen (2): [[Cefotaxime]] 8-12 g/day IV q4-6h for 7 days
::::* Alternative regimen (3): [[Chloramphenicol]] 4-6 g/day IV q6h for 7 days
:::* 1.1.2 '''Penicillin MIC 0.1-1.0 mcg/mL'''
::::* Preferred regimen (1): [[Ceftriaxone]] 4 g/day IV q12-24h for 7 days
::::* Preferred regimen (2): [[Cefotaxime]] 8-12 g/day IV q4-6h for 7 days
::::* Alternative regimen (1): [[Cefepime]] 2 g IV q8h for 7 days
::::* Alternative regimen (2): [[Chloramphenicol]] 4-6 g/day IV q6h for 7 days
::::* Alternative regimen (3): [[Moxifloxacin]] 400 mg IV q24h for 7 days
::::* Alternative regimen (4): [[Meropenem]] 2 g IV q8h for 7 days
::* 1.2 '''Neonates (birth-7 days old)'''
:::* 1.2.1 '''Penicillin MIC < 0.1 mcg/mL'''
::::* Preferred regimen (1): [[Penicillin G]] 0.15 MU/kg/day IV q8-12h for 7 days
::::* Preferred regimen (2): [[Ampicillin]] 150 mg/kg/day IV q8h for 7 days
::::* Alternative regimen (1): [[Cefotaxime]] 100-150 mg/kg/day IV q8-12h for 7 days
::::* Alternative regimen (2): [[Chloramphenicol]] 25 mg/kg/day IV q24h for 7 days
:::* 1.2.2 '''Penicillin MIC 0.1-1.0 mcg/mL'''
::::* Preferred regimen: [[Cefotaxime]] 100-150 mg/kg/day IV q8-12h for 7 days
::::* Alternative regimen: [[Chloramphenicol]] 25 mg/kg/day IV q24h for 7 days
::* 1.3 '''Neonates (8-28 days old)'''
:::* 1.3.1 '''Penicillin MIC < 0.1 mcg/mL'''
::::* Preferred regimen (1): [[Penicillin G]] 0.2 MU/kg/day IV q6-8h for 7 days  
::::* Preferred regimen (2): [[Ampicillin]] 200 mg/kg/day IV q6-8h for 7 days
::::* Alternative regimen (1): [[Cefotaxime]] 150-200 mg/kg/day IV q6-8h  for 7 days
::::* Alternative regimen (2): [[Chloramphenicol]] 50 mg/kg/day IV q12-24h for 7 days
:::* 1.3.2 '''Penicillin MIC 0.1-1.0 mcg/mL'''
::::* Preferred regimen : [[Cefotaxime]] 150-200 mg/kg/day IV q6-8h  for 7 days
::::* Alternative regimen : [[Chloramphenicol]] 50 mg/kg/day IV q12-24h for 7 days
::* 1.4 '''Infants and children'''
:::* 1.4.1 '''Penicillin MIC < 0.1 mcg/mL'''
::::* Preferred regimen (1): [[Penicillin G]] 0.3 MU/kg/day IV q4-6h for 7 days
::::* Preferred regimen (2): [[Ampicillin]] 300 mg/kg/day IV q6h for 7 days
::::* Alternative regimen (1): [[Ceftriaxone]] 80-100 mg/kg/day IV q12-24h for 7 days
::::* Alternative regimen (2): [[Cefotaxime]] 225-300 mg/kg/day IV q6-8h for 7 days
::::* Alternative regimen (3): [[Chloramphenicol]] 75-100 mg/kg/day IV q6h for 7 days
:::* 1.4.2 '''Penicillin MIC 0.1-1.0 mcg/mL'''
::::* Preferred regimen (1): [[Ceftriaxone]] 80-100 mg/kg/day IV q12-24h for 7 days
::::* Preferred regimen (2): [[Cefotaxime]] 225-300 mg/kg/day IV q6-8h for 7 days
::::* Alternative regimen (1): [[Cefepime]] 150 mg/kg/day IV q8h for 7 days
::::* Alternative regimen (2): [[Chloramphenicol]] 75-100 mg/kg/day q6h for 7 days
::::* Alternative regimen (3): [[Meropenem]] 120 mg/kg/day IV q8h for 7 days
::* Note (1): Dexamethasone has not been shown to be beneficial in meningococcal meningitis and should be discontinued once this diagnosis is established.<ref name="pmid12432041">{{cite journal| author=de Gans J, van de Beek D, European Dexamethasone in Adulthood Bacterial Meningitis Study Investigators| title=Dexamethasone in adults with bacterial meningitis. | journal=N Engl J Med | year= 2002 | volume= 347 | issue= 20 | pages= 1549-56 | pmid=12432041 | doi=10.1056/NEJMoa021334 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12432041  }}  [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12725615 Review in: ACP J Club. 2003 May-Jun;138(3):60] </ref><ref name="pmid20824838">{{cite journal| author=Brouwer MC, McIntyre P, de Gans J, Prasad K, van de Beek D| title=Corticosteroids for acute bacterial meningitis. | journal=Cochrane Database Syst Rev | year= 2010 | volume=  | issue= 9 | pages= CD004405 | pmid=20824838 | doi=10.1002/14651858.CD004405.pub3 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20824838  }} </ref>
::* Note (2): Clinical data are limited on the use of fluoroquinolones for therapy for meningococcal meningitis but may be considered in patients not responding to standard therapy or when disease is caused by resistant organisms.
:* 2. '''Meningococcal meningitis, prophylaxis for household and close contacts'''<ref name="pmid15917737">{{cite journal| author=Bilukha OO, Rosenstein N, National Center for Infectious Diseases, Centers for Disease Control and Prevention (CDC)| title=Prevention and control of meningococcal disease. Recommendations of the Advisory Committee on Immunization Practices (ACIP). | journal=MMWR Recomm Rep | year= 2005 | volume= 54 | issue= RR-7 | pages= 1-21 | pmid=15917737 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15917737  }} </ref>
::* 2.1 '''Adults'''
:::* Preferred regimen (1): [[Rifampin]] 600 mg PO bid for 2 days
:::* Preferred regimen (2): [[Ciprofloxacin]] 500 mg PO single dose
:::* Preferred regimen (3): [[Ceftriaxone]] 250 mg IM single dose
::* 2.2 '''Children < 15 years'''
:::* Preferred regimen: [[Ceftriaxone]] 12 mg IM single dose
::* 2.3 '''Children ≥ 1 month'''
:::* Preferred regimen: [[Rifampin]]  10 mg /kg  PO bid for 2 days
::* 2.4 '''Children < 1 month'''
:::* Preferred regimen: [[Rifampin]] 5 mg/kg PO bid for 2 days

----

{{PBI|Moraxella catarrhalis}}
:* ''Moraxella catarrhalis'' <ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>

::* Preferred regimen(1): [[TMP-SMX]] 1DS PO bid 
::* Preferred regimen(2): [[Erythromycin]] 500 mg PO qid
::* Preferred regimen(3): [[Clarithromycin]] 500 mg PO bid or XL 1 g PO qd 
::* Preferred regimen(4): [[Azithromycin]] 500 mg PO single dose {{then}} 250 mg PO qd
::* Preferred regimen(5): [[Doxycycline]] 100 mg PO/IV bid/q12h
::* Preferred regimen(6): [[Cefprozil]] 200-500 mg PO bid 

::* Preferred regimen(7): [[Cefpodoxime]] 200-400 mg PO bid  

::* Preferred regimen(8): [[Cefuroxime]] 250-500 mg PO bid  

::* Preferred regimen(9): [[Cefdinir]] 300 mg PO bid
::* Preferred regimen(10): [[Moxifloxacin]] 400 mg IV/PO qd 

::* Preferred regimen(11): [[Levofloxacin]] 500 mg IV/PO qd
::* Preferred regimen(12): [[Amoxicillin clavulanate]] 875/125 mg PO bid or XL 2000/125 PO bid


{{PBI|Pasteurella multocida}}
:* ''Pasteurella multocida'' <ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
::* Preferred regimen (1): [[Amoxicillin clavulanate]] 500 mg PO tid or 875 mg PO bid with food 
::* Note: Its also a preferred empirical coverage of animal bite wounds
::* Preferred regimen (2): [[Ampicillin sulbactam]] 3 g IV q6h 
::* Preferred regimen (3): [[Ciprofloxacin]] 500 mg PO bid or 400 mg IV q12h 
::* Preferred regimen (4): [[Levofloxacin]] 500 mg PO qd or IV q24h 
::* Alternative regimen (1): [[Doxycycline]] 100 mg PO bid 
::* Alternative regimen (2): [[TMP-SMX]] DS PO bid (for beta-lactam allergic patients )
::* Alternative regimen (3): [[Penicillin]] 500 mg PO qid or 4 MU IV q4h (use only if isolate known to be susceptible)

====Bacteria – Spirochetes====  
{{PBI|Borrelia burgdorferi}}
:* Lyme disease <ref>{{cite journal |vauthors=Wormser GP, Dattwyler RJ, Shapiro ED, Halperin JJ, Steere AC, Klempner MS, Krause PJ, Bakken JS, Strle F, Stanek G, Bockenstedt L, Fish D, Dumler JS, Nadelman RB |title=The clinical assessment, treatment, and prevention of lyme disease, human granulocytic anaplasmosis, and babesiosis: clinical practice guidelines by the Infectious Diseases Society of America |journal=Clin. Infect. Dis. |volume=43 |issue=9 |pages=1089–134 |year=2006 |pmid=17029130 |doi=10.1086/508667 |url=}}</ref>
::* 1. '''Early Lyme Disease'''
:::* 1.1 '''Erythema migrans'''
::::* 1.1.1 '''Adult'''
:::::* Preferred regimen (1): [[Doxycycline]] 100 mg PO bid for 10-21 days   
:::::* Preferred regimen (2): [[Amoxicillin]] 500 mg PO tid for 14-21 days
:::::* Preferred regimen (3): [[Cefuroxime axetil]] 500 mg bid for 14-21 days
:::::* Alternatie regimen (1): [[Azithromycin]] 500 mg PO qd for 7–10 days  
:::::* Alternatie regimen (2): [[Clarithromycin]] 500 mg PO bid for 14–21 days (if the patient is not pregnant)

:::::* Alternatie regimen (3): [[Erythromycin]] 500 mg PO qid for 14–21 days

::::* 1.1.2 '''Pediatric'''

:::::* 1.1.2.1 '''children <8 years of age''' 
::::::* Preferred regimen (1): [[Amoxicillin]] 50 mg/kg/day PO q8h (Maximum of 500 mg per dose)  

::::::* Preferred regimen (2): [[Cefuroxime axetil]] 30 mg/kg/day PO q12h（Maximum, 500 mg per dose)
::::* 1.1.2.2 '''children ≥8 years of age'''

::::::* Preferred regimen (1): [[Doxycycline]] 4 mg/kg/day PO q12h（Maximum, 100 mg per dose）
::::::* Preferred regimen (2): [[Azithromycin]] 10 mg/kg PO qd (Maximum, 500 mg qd)

::::::* Preferred regimen (3): [[Clarithromycin]] 7.5 mg/kg PO bid (Maximum, 500 mg per dose)  

::::::* Preferred regimen (4): [[Erythromycin]] 12.5 mg/kg PO qid (Maximum, 500 mg per dose)

:::* 1.2 '''When erythema migrans cannot be reliably distinguished from community-acquired bacterial cellulitis'''
::::* Preferred regimen: [[Amoxicillin-Clavulanate]] 500 mg PO tid 
::::* Pediatric regimen: [[Amoxicillin-Clavulanate]] 50 mg/kg/day q8h (Maximum, 500 mg per dose)

:::* 1.3 '''Lyme meningitis and other manifestations of early neurologic Lyme disease'''
::::* 1.3.1 '''Adult'''
:::::* Preferred regimen: [[Ceftriaxone]] 2 g IV q24h for 10–28 days 
:::::* Alternative regimen (1): [[Cefotaxime]] 2 g IV q8h 
:::::* Alternative regimen (2): [[Penicillin G]] 18–24 MU q4h (for patients with normal renal function)
:::::* Alternative regimen (3): [[Doxycycline]] 200–400 mg/day PO bid for 10–28 days
::::* 1.3.2 '''Pediatric'''
:::::* Preferred regimen (1): [[Ceftriaxone]] 50–75 mg/kg IV single dose (Maximum, 2 g)
:::::* Preferred regimen (2): [[Cefotaxime]] 150–200 mg/kg/day IV q6-8h (Maximum, 6 g per day) 
:::::* Alternative regimen (1): [[Penicillin G]] 200,000–400,000 units/kg/day IV  q4h (for normal renal function) (maximum, 18–24 MU per day)
:::::* Alternative regimen (2): [[Doxycycline]] 4–8 mg/kg/day PO bid (maximum, 100–200 mg per dose) (≥8 years old) 

:::* 1.4 '''Lyme carditis'''
::::* Preferred regimen: [[Ceftriaxone]] 2 g IV q24h for 10–28 days
::::* Note: patients with advanced heart block, a temporary pacemaker may be required; expert consultation with a cardiologist is recommended; Use of the pacemaker may be discontinued when the advanced heart block has resolved; An oral antibiotic treatment regimen should be used for completion of therapy and for outpatients, as is used for patients with erythema migrans without carditis (see above)

:::* 1.5 '''Borrelial lymphocytoma'''
::::* Preferred regimen: The same regimens used to treat patients with erythema migrans (see above) 

::* 2. '''Late Lyme Disease'''
:::* 2.1 '''Lyme arthritis'''
::::* Preferred regimen (1): [[Doxycycline]] 100 mg PO bid 

::::* Preferred regimen (2): [[Amoxicillin]] 500 mg PO tid
::::* Alternative regimen: [[Cefuroxime axetil]] 500 mg PO bid for 28 days
::::* Pediatric regimen: [[Amoxicillin]] 50 mg/kg/day tid (Maximum, 500 mg per dose); [[Cefuroxime axetil]] 30 mg/kg/day bid (Maximum,500 mg per dose); (≥8 years of age) [[Doxycycline]] 4 mg/kg/day bid (Maximum, 100 mg per dose)
::::* Note: For patients who have persistent or recurrent joint swelling after a recommended course of oral antibiotic therapy, we recommend re-treatment with another 4-week course of oral antibiotics or with a 2–4 weeks course of [[Ceftriaxone]] IV

:::* 2.2 '''patients with arthritis and objective evidence of neurologic disease'''
::::* Preferred regimen: [[Ceftriaxone]] IV for 2–4 weeks
::::* Alternative regimen (1): [[Cefotaxime]] IV

::::* Alternative regimen (1): [[Penicillin G]] IV
::::* Pediatric regime: [[Ceftriaxone]]; [[Cefotaxime]]; [[Penicillin G]] IV

:::* 2.3 '''Late neurologic Lyme disease'''
::::* Preferred regimen: [[Ceftriaxone]] IV for 2 to 4 weeks
::::* Alternative regimen (1): [[Cefotaxime]] IV

::::* Alternative regimen (2): [[Penicillin G]] IV
::::* Pediatric regimen: [[Ceftriaxone]]; [[Cefotaxime]]; [[Penicillin G]]

:::* 2.4 '''Acrodermatitis chronica atrophicans'''
::::* Preferred regimen (1): [[Doxycycline]] 100 mg PO bid for 21 days 
::::* Preferred regimen (2): [[Amoxicillin]] 500 mg PO tid for 21 days 
::::* Preferred regimen (3): [[Cefuroxime axetil]] 500 mg PO bid for 21 days 

::* 3. '''Post–Lyme Disease Syndromes'''
::::* Preferred regimen: Further antibiotic therapy for Lyme disease should not be given unless there are objective findings of active disease (including physical findings, abnormalities on cerebrospinal or synovial fluid analysis, or changes on formal neuropsychologic testing)

{{PBI|Borrelia recurrentis}}
:* 1. '''Tick-Borne Relapsing Fever''' <ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
::* Preferred regimen: [[Doxycycline]] 100 mg PO bid for 5-10 days
::* Alternative regimen: [[Erythromycin]] 500 mg PO qid for 5-10 days
::* Note: If meningitis/encephalitis present, use [[Ceftriaxone]] 2 g IV q12h for 14 days
:* 2. '''Louse-Borne Relapsing Fever'''
::* Preferred regimen: [[Tetracycline]] 500 mg PO single dose
::* Alternative regimen: [[Erythromycin]] 500 mg PO single dose

{{PBI|Leptospira}}
:* 1. '''Severe''' <ref>{{cite book | last = LastName | first = FirstName | title = Human leptospirosis guidance for diagnosis, surveillance and control | publisher = World Health Organization | location = Geneva | year = 2003 | isbn = 9241545895 }}</ref> <ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
::* Preferred regimen: [[Penicillin]] 1.5 MU IV q6h for 5-7 days
:* 2. '''Less severe'''
::* Preferred regimen (1): [[Amoxycillin]] 

::* Preferred regimen (2): [[Ampicillin]] 

::* Preferred regimen (3): [[Doxycycline]] 100 mg IV/PO q12h/bid for 5-7 days 

::* Preferred regimen (4): [[Erythromycin]]  

::* Preferred regimen (5): [[Ceftriaxone]] 1 g IV q24h for 5-7 days 

::* Preferred regimen (6): [[Cefotaxime]] 

::* Preferred regimen (7): [[Quinolone]] PO

{{PBI|Treponema pallidum}}
:* 1. '''Syphilis Among non-HIV-Infected Persons''' <ref name="pmid26042815">{{cite journal |vauthors=Workowski KA, Bolan GA |title=Sexually transmitted diseases treatment guidelines, 2015 |journal=[[MMWR. Recommendations and Reports : Morbidity and Mortality Weekly Report. Recommendations and Reports / Centers for Disease Control]] |volume=64 |issue=RR-03 |pages=1–137 |year=2015 |pmid=26042815 |doi= |url=http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6403a1.htm |issn=}}</ref>
::* 1.1 '''Primary and Secondary Syphilis'''
:::* Preferred regimen: [[Benzathine penicillin G]] 2.4 MU IM single dose
:::* Pediatric regimen: [[Benzathine penicillin G]] 50,000 U/kg (Maximum, 2.4 MU) IM single dose 
::* 1.2 '''Latent Syphilis'''
:::* 1.2.1 '''Early Latent Syphilis'''
::::* Preferred regimen: [[Benzathine penicillin G]] 2.4 MU IM in a single dose
::::* Pediatric regimen: [[Benzathine penicillin G]] 50,000 U/kg (Maximum, 2.4 MU) IM single dose 
:::* 1.2.2 '''Late Latent Syphilis or Latent Syphilis of Unknown Duration'''
::::* Preferred regimen: [[Benzathine penicillin G]] 7.2 MU total, administered as 3 doses of 2.4 MU IM each at 1 week intervals
::::* Pediatric regimen: [[Benzathine penicillin G]] 50,000 U/kg IM (Maximum, 2.4 MU), administered as 3 doses at 1 week intervals (total 150,000 U/kg up to the adult total dose of 7.2 MU)
::* 1.3 '''Tertiary Syphilis'''
:::* Preferred regimen: [[Benzathine penicillin G]] 7.2 MU total, administered as 3 doses of 2.4 MU IM each at 1 week intervals
::* 1.4 '''Neurosyphilis and ocular syphilis'''
:::* Preferred regimen: [[Aqueous crystalline penicillin G]] 18-24 MU per day, administered as 3-4 MU IV q4h or continuous infusion, for 10-14 days
:::* Alternative regimen: [[Procaine penicillin]] 2.4 MU IM q24h {{and}} [[Probenecid]] 500 mg PO qid for 10-14 days

:* 2. '''Syphilis Among HIV-Infected Persons'''
::* 2.1 '''Primary and Secondary Syphilis Among HIV-Infected Persons'''
:::* Preferred regimen: [[Benzathine penicillin G]] 2.4 MU IM single dose
::* 2.2 '''Latent Syphilis Among HIV-Infected Persons'''
:::* 2.2.1 '''early latent'''
::::* Preferred regimen: [[Benzathine penicillin G]] 2.4 MU IM single dose
:::* 2.2.2 '''late latent'''
::::* Preferred regimen: [[Benzathine penicillin G]] 2.4 MU once a week for 3 weeks
::* 2.3 '''Neurosyphilis Among HIV-Infected Persons'''
:::* Preferred regimen: [[Aqueous crystalline penicillin G]] 18-24 MU per day, administered as 3-4 MU IV q4h or continuous infusion, for 10-14 days
:::* Alternative regimen: [[Procaine penicillin]] 2.4 MU IM q24h {{and}} [[Probenecid]] 500 mg PO qid  for 10-14 days

:* 3. '''Syphilis During Pregnancy'''
::* Pregnant women should be treated with the [[penicillin]] regimen appropriate for their stage of infection

:* 4. '''Congenital Syphilis in neonates'''
::* 4.1 '''condition1''': Infants with proven or highly probable disease and (1) an abnormal physical examination that is consistent with congenital syphilis;（2）a serum quantitative nontreponemal serologic titer that is fourfold higher than the mother's titer; or（3）a positive darkfield test of body fluid(s).
:::* Preferred regimen (1): [[Aqueous crystalline penicillin G]] 100,000-150,000 U/kg/day, administered as 50,000 U/kg/dose IV q12h during the first 7 days of life and q8h thereafter for a total of 10 days  

:::* Preferred regimen (2): [[Procaine penicillin G]] 50,000 U/kg/dose IM q24h for 10 days
:::* Note: If more than 1 day of therapy is missed, the entire course should be restarted. Data are insufficient regarding the use of other antimicrobial agents (e.g., ampicillin). When possible, a full 10-day course of penicillin is preferred, even if ampicillin was initially provided for possible sepsis. The use of agents other than penicillin requires close serologic follow-up to assess adequacy of therapy. In all other situations, the maternal history of infection with T. pallidum and treatment for syphilis must be considered when evaluating and treating the infant.

::* 4.2 '''condition2''': Infants who have a normal physical examination and a serum quantitive nontreponemal serologic titer the same or less than fourfold the maternal titer and the (1) mother was not treated, inadequately treated, or has no documentation of having received treatment; (2) mother was treated with erythromycin or another nonpenicillin regimen; or (3) mother received treatment <4 weeks before delivery.
:::* Preferred regimen (1): [[Aqueous crystalline penicillin G]] 100,000-150,000 U/kg/day, administered as 50,000 U/kg/dose IV q12h during the first 7 days of life and q8h thereafter for a total of 10 days  

:::* Preferred regimen (2): [[Procaine penicillin G]] 50,000 U/kg/dose IM q24h for 10 days  

:::* Preferred regimen (3): [[Benzathine penicillin G]] 50,000 U/kg/dose IM single dose
:::* Note: If the mother has untreated early syphilis at delivery, 10 days of parenteral therapy can be considered

::* 4.3 '''condition3''': Infants who have a normal physical examination and a serum quantitative nontreponemal serologic titer the same or less than fourfold the maternal titer and the (1) mother was treated during pregnancy, treatment was appropriate for the stage of infection, and treatment was administered >4 weeks before delivery and (2) mother has no evidence of reinfection or relapse.
:::* Preferred regimen: [[Benzathine penicillin G]] 50,000 U/kg/dose IM single dose

::* 4.4 '''condition4''': Infants who have a normal physical examination and a serum quantitative nontreponemal serologic titer the same or less than fourfold the maternal titer and the (1) mother's treatment was adequate before pregnancy; and (2) mother's nontreponemal serologic titer remained low and stable before and during pregnancy and at delivery (VDRL <1:2; RPR <1:4).
:::* No treatment is required
:::* [[Benzathine penicillin G]] 50,000 U/kg IM single dose might be considered, particularly if follow-up is uncertain.

:* 5. '''Congenital Syphilis in infants and children'''
:::* Preferred regimen: [[Aqueous crystalline penicillin G]] 50,000 U/kg q4–6h for 10 days

====Bacteria – Gram-Negative Bacilli====  
{{PBI|Achromobacter xylosoxidans}}

==Acinetobacter baumannii==
{{PBI|Acinetobacter baumannii}}
:* Acinetobacter baumannii<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
::* Preferred regimen (1): [[Imipenem]] 0.5-1 g IV q6h
::* Preferred regimen (2): [[Ampicillin/sulbactam]] 3 g IV q4h 
::* Preferred regimen (3): [[Cefepime]] 1-2 g IV q8h
::* Preferred regimen (4): [[Colistin]] 2.5 mg/kg IV q12h
::* Preferred regimen (5): [[Tigecycline]] 100 mg IV single dose {{then}} 50 mg IV q12h 
::* Preferred regimen (6): [[Amikacin]] 7.5 mg/kg IV q12h or 15 mg/kg IV q24h
::* Preferred regimen (7) (pan-resistant isolates): [[Colistin]] 5 mg/kg/day IV q12h {{withorwithout}} [[Imipenem]] 
::* Preferred regimen (8) (pan-resistant isolates): [[Ampicillin-sulbactam]] 3 g IV q4h 
::* Alternative regimen (1): [[Ceftriaxone]] 1-2 g IV qd
::* Alternative regimen (2): [[Cefotaxime]] 2-3 g IV q6-8h
::* Alternative regimen (3): [[Ciprofloxacin]] 400 mg IV q8-12h or 750 mg PO bid
::* Alternative regimen (4): [[TMP-SMX]] 15-20 mg (TMP)/kg/day IV q6-8h or 2 DS PO bid

==Aeromonas hydrophila==
{{PBI|Aeromonas hydrophila}}
:* Aeromonas hydrophila <ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
::*1. '''Diarrhea'''
:::* Preferred regimen (if not self-limiting, or if severe): [[Ciprofloxacin]] 500 mg PO bid. 
:::* Alternate regimen: [[TMP-SMX]] 1 DS PO bid 
:::* Note: High resistance to sulfa agents described in Taiwan and Spain
::*2. '''Skin and soft tissue infection''' 
:::*2.1 '''Mild infection'''
::::* Preferred regimen (1): [[Ciprofloxacin]] 500 mg PO bid 
::::* Preferred regimen (2): [[Levofloxacin]] 500 mg qd
:::*2.2 '''Severe infection or sepsis'''
::::* Preferred regimen (1): [[Ciprofloxacin]] 400 mg IV q8h 
::::* Preferred regimen (2): [[Levofloxacin]] 750 mg IV q24h 
::::*Note (1): For suspicion of water-based injury,empiric coverage for Vibrio doxycycline 100 mg bid, although flouroquinolones may also cover and vancomycin 15 mg/kg IV q12h with or without clindamycin or linezolid for inhibition of gram-positive toxin production
::::* Note (2): Alternatives to fluoroquinolones for Aeromonas coverage include carbapenems (ertapenem, doripenem, imipenem or meropenem), ceftriaxone, cefepime and aztreonam
::*3. '''Prevention'''
:::*Preferred regimen: Frequent recommendations include using a [[Cephalosporin]] (e.g.,cefuroxime,ceftriaxone or cefixime) {{or}} a [[Fluoroquinolone]] (e.g.,ciprofloxacin or levofloxacin) during treatment with medicinal leeches 
:::*Note (1): Duration of antibiotic use is 3-5 days, some recommend continuing until wound or eschar resolves
:::*Note (2): Aeromonas isolates from leeches have been described as uniformly susceptible to fluoroquinolones

==Bartonella==
{{PBI|Bartonella}}
:* Bartonella<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
::* 1. '''Bartonella quintana'''
:::* 1.1 '''Acute or chronic infections without endocarditis'''<ref name="pmid12821469">{{cite journal| author=Foucault C, Raoult D, Brouqui P| title=Randomized open trial of gentamicin and doxycycline for eradication of Bartonella quintana from blood in patients with chronic bacteremia. | journal=Antimicrob Agents Chemother | year= 2003 | volume= 47 | issue= 7 | pages= 2204-7 | pmid=12821469 | doi= | pmc=PMC161867 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12821469  }} </ref>
::::* Preferred regimen: [[Doxycycline]] 200 mg PO qd or 100 mg bid for 4 weeks {{and}} [[Gentamicin]] 3 mg/kg IV qd for the first 2 weeks
:::* 1.2 '''Endocarditis'''<ref name="pmid15956145">{{cite journal| author=Baddour LM, Wilson WR, Bayer AS, Fowler VG, Bolger AF, Levison ME et al.| title=Infective endocarditis: diagnosis, antimicrobial therapy, and management of complications: a statement for healthcare professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association: endorsed by the Infectious Diseases Society of America. | journal=Circulation | year= 2005 | volume= 111 | issue= 23 | pages= e394-434 | pmid=15956145 | doi=10.1161/CIRCULATIONAHA.105.165564 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15956145  }} </ref>
::::* Preferred regimen: [[Gentamicin]] 3 mg/kg/day IV q8h for 14 days {{and}} [[Ceftriaxone]] 2 g IV q24h for 6 weeks {{withorwithout}} [[Doxycycline]] 100 mg PO bid for 6 weeks
::* 2. '''Bartonella elizabethae'''
:::* 2.1 '''Endocarditis'''<ref name="pmid15956145">{{cite journal| author=Baddour LM, Wilson WR, Bayer AS, Fowler VG, Bolger AF, Levison ME et al.| title=Infective endocarditis: diagnosis, antimicrobial therapy, and management of complications: a statement for healthcare professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association: endorsed by the Infectious Diseases Society of America. | journal=Circulation | year= 2005 | volume= 111 | issue= 23 | pages= e394-434 | pmid=15956145 | doi=10.1161/CIRCULATIONAHA.105.165564 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15956145  }} </ref>
::::* Preferred regimen: [[Gentamicin]] 3 mg/kg/day IV q8h for 14 days {{and}}  [[Ceftriaxone]] 2 g IV q24h for 6 weeks {{withorwithout}} [[Doxycycline]] 100 mg PO bid for 6 weeks
::* 3. '''Bartonella bacilliformis'''
:::* 3.1 '''Oroya fever'''
::::* Preferred regimen: [[Ciprofloxacin]] 500 mg PO bid for 14 days
::::* Note: If severe disease, add [[Ceftriaxone]] 1 g IV qd for 14 days
:::* 3.2 '''Verruga peruana'''<ref>Bradley JS, Jackson MA, Committee on Infectious Diseases, American Academy of Pediatrics. The use of systemic and topical fluoroquinolones. Pediatrics 2011; 128:e1034.</ref>
::::* Preferred regimen: [[Azithromycin]] 500 mg PO qd for 7 days
::::* Alternative regimen (1): [[Rifampin]] 600 mg PO qd for 14-21 days
::::* Alternative regimen (2): [[Ciprofloxacin]] 500 mg bid for 7-10 days
::* 4. '''Bartonella henselae'''<ref name="pmid15155180">{{cite journal| author=Rolain JM, Brouqui P, Koehler JE, Maguina C, Dolan MJ, Raoult D| title=Recommendations for treatment of human infections caused by Bartonella species. | journal=Antimicrob Agents Chemother | year= 2004 | volume= 48 | issue= 6 | pages= 1921-33 | pmid=15155180 | doi=10.1128/AAC.48.6.1921-1933.2004 | pmc=PMC415619 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15155180  }} </ref>
:::* 4.1 '''Cat scratch disease'''
::::* No treatment recommended for typical cat scratch disease, consider treatment if there is an extensive lymphadenopathy
::::* 4.1.1 '''If extensive lymphadenopathy'''
:::::* Preferred regimen (1) (pediatrics): [[Azithromycin]] 500 mg PO on day 1 {{then}} 250 mg PO qd on days 2 to 5 
:::::* Preferred regimen (2) (adults): [[Azithromycin]] 1 g PO at day 1 {{then}} 500 mg PO for 4 days 
:::* 4.2 '''Endocarditis'''
::::* Preferred regimen: [[Gentamicin]] 3 mg/kg/day IV q8h for 14 days {{and}}  [[Ceftriaxone]] 2 g/day IV for 6weeks {{withorwithout}} [[Doxycycline]] 100 mg PO bid for 6 weeks
:::* 4.3 '''Retinitis'''
::::* Preferred regimen: [[Doxycycline]] 100 mg bid {{and}}  [[Rifampin]] 300 mg bid PO for 4-6 weeks
:::* 4.4 '''Bacillary angiomatosis'''<ref name="pmid9494835">{{cite journal| author=Spach DH, Koehler JE| title=Bartonella-associated infections. | journal=Infect Dis Clin North Am | year= 1998 | volume= 12 | issue= 1 | pages= 137-55 | pmid=9494835 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9494835  }} </ref>
::::* Preferred regimen (1): [[Erythromycin]] 500 mg PO qid for 2 months at least
::::* Preferred regimen (2): [[Doxycycline]] 100 mg PO bid for 2 months at least
:::* 4.5 '''Bacillary Pelliosis'''<ref name="pmid9494835">{{cite journal| author=Spach DH, Koehler JE| title=Bartonella-associated infections. | journal=Infect Dis Clin North Am | year= 1998 | volume= 12 | issue= 1 | pages= 137-55 | pmid=9494835 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9494835  }} </ref>
::::* Preferred regimen (1): [[Erythromycin]] 500 mg PO qid  for 4 months at least
::::* Preferred regimen (2): [[Doxycycline]] 100 mg PO bid for 4 months at least

----

==Bordetella pertussis==
{{PBI|Bordetella pertussis}}
:*Bordetella pertussis<ref>{{Cite web | title = Recommended Antimicrobial Agents for the Treatment and Postexposure Prophylaxis of Pertussis 2005 CDC Guidelines
 | url = http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5414a1.htm#tab4}}</ref> 
::* 1. '''Whooping cough'''
:::* 1.1 '''Adults'''
::::* Preferred regimen (1): [[Azithromycin]] 500 mg PO single dose on day 1 {{then}} 250 mg PO qd on 2-5 days
::::* Preferred regimen (2): [[Erythromycin]] 2 g/day PO qid for 14 days
::::* Preferred regimen (3): [[Clarithromycin]] 1 g PO bid for 7 days.
::::* Alternative regimen (intolerant of macrolides): [[Trimethoprim]] 320 mg/day {{and}} [[Sulfamethoxazole]] 1600 mg/day PO bid for 14 days
:::* 1.2 '''Infants <6 months of age'''
::::* 1.2.1 '''Infants <1 month'''
:::::* Preferred regimen (1): [[Azithromycin]] 10 mg/kg PO qd for 5 days
:::::* Preferred regimen (2) (if azithromycin unavailable): [[Erythromycin]] 40-50 mg/kg/day PO q6h for 14 days
:::::* Note: TMP-SMX contraindicated for infants aged < 2 months
::::* 1.2.2 '''Infants of 1-5 months of age'''
:::::* Preferred regimen (1): [[Azithromycin]] 10 mg/kg PO qd for 5 days 
:::::* Preferred regimen (2): [[Erythromycin]] 40-50 mg/kg/day PO qid for 14 days 
:::::* Preferred regimen (3): [[Clarithromycin]] 15 mg/kg PO bid for 7 days
:::::* Alternative regimen: For infants aged ≥ 2 months [[TMP]] 8 mg/kg q24h {{and}} [[Sulfamethoxazole|SMX]] 40 mg/kg/day PO bid for 14 days
:::* 1.3 '''Infants ≥6 months of age-children'''
:::::* Preferred regimen(1): [[Azithromycin]] 10 mg/kg single dose {{then}} 5 mg/kg (500 mg Maximum) qd for 2-5 days 
:::::* Preferred regimen(2): [[Erythromycin]] 40-50 mg/kg PO (2 g daily Maximum) qid for 14 days 
:::::* Preferred regimen(3): [[Clarithromycin]] 15 mg/kg PO (1 g daily Maximum) bid for 7 days
:::::* Preferred regimen(4): [[TMP]] 8 mg/kg/day {{and}} [[Sulfamethoxazole|SMX]] 40 mg/kg/day bid for 14 days
::* 2. '''Post exposure prophylaxis'''<ref>{{Cite web | title = Recommended Antimicrobial Agents for the Treatment and Post exposure Prophylaxis of Pertussis 2005 CDC Guidelines
 | url = http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5414a1.htm#tab4}}</ref>
:::* Preferred regimen: The antibiotic regimens for post exposure prophylaxis are similar to the regimens used for the treatment of pertussis
:::* Note (1):  Post exposure prophylaxis to an asymptomatic contacts within 21 days of onset of cough in the index patient can potentially prevent symptomatic infection
:::* Note (2): Close contacts include persons who have direct contact with respiratory, oral or nasal secretions from a symptomatic patient (eg: cough, sneeze, sharing food, eating utensils, mouth to mouth resuscitation, or performing a medical examination of the mouth, nose, throat.
:::* Note (3): Some close contacts are at high risk for acquiring severe disease following exposure to pertussis. These contacts include infants aged < 1 year , persons with some immunodeficiency conditions, or other underlying medical conditions such as chronic lung disease, respiratory insufficiency and cystic fibrosis.
----

==Burkholderia cepacia==
{{PBI|Burkholderia cepacia}}
:* Burkholderia cepacia complex<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
::* Preferred regimen (1): [[Ceftazidime]] 2 g IV q8h 
::* Preferred regimen (2): [[Imipenem]] 1 g IV q6h 
::* Preferred regimen (3): [[Meropenem]] 1-2 g IV q8h 
::* Preferred regimen (4): [[Minocycline]] 100 mg IV/PO bid

==Burkholderia pseudomallei==
{{PBI|Burkholderia pseudomallei}}
:* Burkholderia pseudomallei
::* 1. '''Melioidosis'''<ref name="pmid22970946">{{vcite2 journal |vauthors=Wiersinga WJ, Currie BJ, Peacock SJ |title=Melioidosis |journal=N. Engl. J. Med. |volume=367 |issue=11 |pages=1035–44 |year=2012 |pmid=22970946 |doi=10.1056/NEJMra1204699 |url= |issn=}}</ref>
:::* 1.1 '''Intial intensive therapy''' (Minimum of 10-14 days)
::::* Preferred regimen (1): [[Ceftazidime]] 50 mg/kg upto 2 g q6h  
::::* Preferred regimen (2): [[Meropenem]] 25 mg/kg upto 1 g q8h
::::* Preferred regimen (3): [[Imipenem]] 25 mg/kg upto 1 g q6h
::::* Note: Any one of the three may be combined with [[TMP-SMX]] 6/30 mg/kg upto 320/1600 mg/kg q12h (recommended for neurologic, bone, joint, cutaneous and prostatic melioidosis)
:::* 1.2 '''Eradication therapy''' (Minimum of 3 months)
::::* Preferred regimen: [[TMP-SMX]] 6/30 mg/kg upto 320/1600 mg/kg q12h

----

==Campylobacter fetus==
{{PBI|Campylobacter fetus}}
:* Campylobacter fetus<ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
::* 1. '''Gastroenteritis'''
:::* Preferred regimen: [[Gentamicin]] 5 mg/kg IV q24h
:::* Alternative regimen (1): [[Ampicillin]] 100 mg/kg IV  q6h 

:::* Alternative regimen (2): [[Imipenem]] 500 mg IV q6h 
{{PBI|Campylobacter jejuni}}
:* Campylobacter jejuni
::* 1. '''Gastroenteritis'''<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
:::* Most patients donot require antibiotics and symptoms last < 1 week
:::* 1.1 '''Indications for the treatment'''
::::* Highfevers
::::* Bloodystools
::::* Prolonged illness > 1 week
::::* Pregnancy
::::* HIV and other immunosuppressed states
:::* 1.2 '''Treatment regimen''' <ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
::::* Preferred regimen (1):[[Erythromycin|Erythromycin stearate]] 500 mg PO bid for 5 days 
::::* Preferred regimen (2): [[Ciprofloxacin]] 500 mg PO bid for 3–5 days 
::::* Alternative regimen (1): [[TMP-SMX]] DS PO bid for 3–5 days
::::* Note (1): Campylobacter resistance to TMP-SMX common in tropics 
::::* Note (2): Extraintestinal infections should be treated for longer duration (e.g.,2-4 weeks)
----

==Capnocytophaga canimorsus==
{{PBI|Capnocytophaga canimorsus}}
:* Capnocytophaga canimorsus<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
::* 1. '''Severe cellulitis/sepsis or endocarditis'''
:::* Preferred regimen (1) (Beta-lactam/beta-lactamase inhibitor): [[Ampicillin]]/[[sulbactam]] 3 g IV q6h 
:::* Preferred regimen (2) (Non-beta-lactamase producing): [[Penicillin G]] 2-4 MU IV q24h
:::* Alternative regimen (1): [[Ceftriaxone]] 1-2 g IV q24h 
:::* Alternative regimen (2): [[Meropenem]] 1 g IV q8h
:::* Alternative regimen (3) (complicated infections or immunocompromise): [[Clindamycin]] 600 mg IV q8h may be combined with above agents
:::* Note (1): Resistance to aztreonam described, and variable susceptibility reported to TMP-SMX and aminoglycosides
:::* Note (2): For endocarditis, alternatives to penicillins not well established, treated for duration of 6 weeks 
:::* Note (3): For non-endocarditis infections, duration not well established, but most authorities recommend at least 14-21 days of therapy
::* 2. '''Mild cellulitis/dog or cat bites'''
:::* Preferred regimen (1): [[Amoxicillin/clavulanate]] 500 mg PO q8h or 875 mg PO bid 
:::* Preferred regimen (2): [[Amoxicillin]] 500 mg PO q8h
:::* Alternative regimen (1): [[Clindamycin]] 300 mg PO q6h 
:::* Alternative regimen (2): [[Doxycycline]] 100 mg PO bid 
:::* Alternative regimen (3): [[Clarithromycin]] 500 mg PO bid 
:::* Alternative regimen (4): [[Moxifloxacin]] 400 mg PO qd
::* 3. '''Meningitis or brain abscess'''
:::* Preferred regimen (1): [[Ceftriaxone]] 2 g IV q12h {{and}} [[Ampicillin]] 2 g IV q4h
:::* Preferred regimen (2) (if beta-lactamase producing or polymicrobial brain abscess): [[Imipenem]]/[[Cilastin]] 1000 mg q6-8h {{and}} [[Clindamycin]] 600 mg IV q8h
::* 4. '''Prevention'''
:::* Although no firm data supports this recommendation, many clinicians do give prophylaxis for dog and cat bites in asplenic patients with [[Amoxicillin/clavulanate]] for 7-10 days.

----

==Citrobacter freundii==
{{PBI|Citrobacter freundii}}
:* Citrobacter freundii<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
::* Preferred regimen (1): [[Meropenem]] 1-2 g IV q8h 
::* Preferred regimen (2): [[Imipenem]] 1 g IV q6h 
::* Preferred regimen (3): [[Doripenem]] 500 mg IV q8h
::* Preferred regimen (4): [[Cefepime]] 1-2 g IV q8h 
::* Preferred regimen (5): [[Ciprofloxacin]] 400 mg IV q12h or 500 mg PO bid for UTI
::* Preferred regimen (6): [[Gentamicin]] 5 mg/kg IV q24h
::* Alternate regimen (1): [[Piperacillin-tazobactam]] 3.375 mg IV q6h  
::* Alternate regimen (2): [[Aztreonam]] 1-2 g IV q6h 
::* Alternate regimen (3): [[TMP-SMX]] 5 mg/kg q6h IV or DS PO bid for UTI
::* Note: Usually carbenicillin sensitive, cephalothin resistant

==Citrobacter koseri==
{{PBI|Citrobacter koseri}}
:* Citrobacter koseri<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
::* Preferred regimen (1): [[Ceftriaxone]] 1-2 g IV q12-24h 
::* Preferred regimen (2): [[Cefotaxime]] 1-2 g IV q6h 
::* Preferred regimen (3): [[Cefepime]] 1-2 IV q8h
::* Alternate regimen (1): [[Ciprofloxacin]] 400 mg IV q12h or 500 mg PO q12h for UTI
::* Alternate regimen (2): [[Imipenem]] 1 g IV q6h 
::* Alternate regimen (3): [[Doripenem]] 500 mg IV q8h 
::* Alternate regimen (4): [[Meropenem]] 1-2 g IV q8h 
::* Alternate regimen (5): [[Aztreonam]] 1-2 g IV q6h
::* Alternate regimen (6): [[TMP-SMX]] 5 mg/kg IV q6h  or DS PO bid for UTI
::* Note: Usually Ampicillin resistant, but may be sensitive to first generation cephalosporins

----

{{PBI|Elizabethkingia meningoseptica}}
:* 1. '''Bacteremia'''<ref>{{Cite journal| doi = 10.1007/s10096-011-1223-0| issn = 1435-4373| volume = 30| issue = 10| pages = 1271–1278| last1 = Hsu| first1 = M.-S.| last2 = Liao| first2 = C.-H.| last3 = Huang| first3 = Y.-T.| last4 = Liu| first4 = C.-Y.| last5 = Yang| first5 = C.-J.| last6 = Kao| first6 = K.-L.| last7 = Hsueh| first7 = P.-R.| title = Clinical features, antimicrobial susceptibilities, and outcomes of Elizabethkingia meningoseptica (Chryseobacterium meningosepticum) bacteremia at a medical center in Taiwan, 1999-2006| journal = European Journal of Clinical Microbiology & Infectious Diseases: Official Publication of the European Society of Clinical Microbiology| date = 2011-10| pmid = 21461847}}</ref><ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
::* Preferred regimen (1): [[Levofloxacin]] 750 mg IV/PO q24h
::* Preferred regimen (2): [[TMP-SMX]] 8–10 mg/kg/day IV divided q6–8h
::* Alternative regimen (1): [[Ciprofloxacin]] 400 mg IV q12h
::* Alternative regimen (2): [[TMP-SMX]] 8–10 mg/kg/day IV divided q6–8h

----

==Enterobacter==
{{PBI|Enterobacter}}
:* '''Enterobacter species including <i>E. aerogenes</i> and <i>E. cloacae</i>'''<ref>{{Cite journal| issn = 0893-8512| volume = 10| issue = 2| pages = 220–241| last1 = Sanders| first1 = W. E.| last2 = Sanders| first2 = C. C.| title = Enterobacter spp.: pathogens poised to flourish at the turn of the century| journal = Clinical Microbiology Reviews| date = 1997-04| pmid = 9105752| pmc = PMC172917}}</ref><ref>{{Cite journal| doi = 10.1128/CMR.00036-08| issn = 1098-6618| volume = 22| issue = 1| pages = 161–182| last = Jacoby| first = George A.| title = AmpC beta-lactamases| journal = Clinical Microbiology Reviews| date = 2009-01| pmid = 19136439| pmc = PMC2620637}}</ref><ref>{{Cite journal| doi = 10.1128/CMR.18.4.657-686.2005| issn = 0893-8512| volume = 18| issue = 4| pages = 657–686| last1 = Paterson| first1 = David L.| last2 = Bonomo| first2 = Robert A.| title = Extended-spectrum beta-lactamases: a clinical update| journal = Clinical Microbiology Reviews| date = 2005-10| pmid = 16223952| pmc = PMC1265908}}</ref><ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref><ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
::* 1. '''Empiric antimicrobial therapy pending <i>in vitro</i> susceptibility'''
:::* 1.1 '''Non–life-threatening infections or MDR-GNB prevalence &lt; 20%'''
::::* Preferred regimen: [[Piperacillin-Tazobactam]] 3.375 g IV q6h {{withorwithout}} [[Aminoglycosides]]
::::* Alternative regimen: [[Ciprofloxacin]] 400 mg IV q8–12h
:::* 1.2 '''Life-threatening infections or MDR-GNB prevalence &gt; 20%'''
::::* Preferred regimen: [[Meropenem]] 0.5–1 g IV q8h
::::* Alternative regimen (1): [[Colistin]] {{and}} [[Meropenem]] 0.5–1 g IV q8h
::::* Alternative regimen (2): [[Colistin]] {{and}} [[Imipenem]] 500 mg IV q6h
::::* Alternative regimen (3): [[Colistin]] {{and}} [[Doripenem]] 500 mg IV q8h
::::* Alternative regimen (4): [[Colistin]] {{and}} [[Ertapenem]] 1 g IV q24h
::::* Alternative regimen (5): [[Colistin]] {{and}} [[Fosfomycin]] 6 g IV q6h
::* 2. '''<i>In vitro</i> susceptibility available'''
:::* 2.1 '''Susceptible to all tested agents'''
::::* Preferred regimen: [[Piperacillin-Tazobactam]] 3.375 g IV q6h
::::* Alternative regimen (1): [[Ciprofloxacin]] 400 mg IV q8–12h
::::* Alternative regimen (2): [[Cefepime]] 2 g IV q8h (if MIC ≤ 1 μg/mL)
:::* 2.2 '''Extended spectrum beta-lactamase (ESBL)-producing Enterobacter spp.'''
::::* Preferred regimen: [[Meropenem]] 0.5–1 g IV q8h
::::* Alternative regimen (1): [[Imipenem]] 500 mg IV q6h
::::* Alternative regimen (2): [[Doripenem]] 500 mg IV q8h
::::* Alternative regimen (3): [[Ertapenem]] 1 g IV q24h
::::* Alternative regimen (4): [[Cefepime]] 2 g IV q8h (if MIC ≤ 1 μg/mL)
:::* 2.3 '''Resistant to all tested agents'''
::::* Preferred regimen: [[Colistin]] {{and}} [[Meropenem]] 0.5–1 g IV q8h
::::* Alternative regimen (1): [[Colistin]] {{and}} [[Imipenem]] 500 mg IV q6h
::::* Alternative regimen (2): [[Colistin]] {{and}} [[Doripenem]] 500 mg IV q8h
::::* Alternative regimen (3): [[Colistin]] {{and}} [[Ertapenem]] 1 g IV q24h
::::* Alternative regimen (4): [[Colistin]] {{and}} [[Minocycline]] 100 mg IV q12h


----

==Escherichia coli==
{{PBI|Escherichia coli}}
:* Escherichia coli<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
::* 1. '''Meningitits'''
:::* Preferred regimen (1): [[Ceftriaxone]] 4 g IV q12–24h 
:::* Preferred regimen (2): [[Cefotaxime]] 8–12 g/day IV q4–6h
:::* Alternative regimen (1): [[Aztreonam]] 6–8 g/day IV q6–8h 
:::* Alternative regimen (2): [[Gatifloxacin]] 400 mg/day IV q24h 
:::* Alternative regimen (3): [[Moxifloxacin]] 400 mg/day IV q24h 
:::* Alternative regimen (4): [[Meropenem]] 6 g/day IV q8h 
:::* Alternative regimen (5): [[Trimethoprim-Sulfamethoxazole]] 10–20 mg/kg/day IV q6–12h 
:::* Alternative regimen (6): [[Ampicillin]] 12 g/day IV q4h
::* 2. '''Uncomplicated urinary tract infection'''<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
:::* Preferred agents (IDSA/AUA Guidelines): [[TMP-SMX]] DS PO bid for 3 days
:::* Alternative regimen (1): [[Ciprofloxacin]] 250 mg PO bid 
:::* Alternative regimen (2): [[Ciprofloxacin]] 500 mg XR qd for 3 days 
:::* Alternative regimen (3): [[Levofloxacin]] 250 mg PO qd for 3 days.
:::* Alternative regimen (4): [[Nitrofurantoin]] 100 mg PO q6h 
:::* Alternative regimen (5): [[Nitrofurantoin]] macrocrystals 100 mg PO bid for 7 days
:::* Alternative regimen (6): [[Fosfomycin]] 3 g sachet PO single dose
:::* Note: For older patients, those with comorbidities (e.g., diabetes mellitus) use 7-10 days course.
::* 3. '''Pyelonephritis'''
:::* 3.1 '''Acute uncomplicated pyelonephritis'''<ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
::::* Preferred regimen (1): [[Ciprofloxacin]] 500 mg bid PO for 5-7 days 
::::* Preferred regimen (2): [[Ciprofloxacin]]-[[Erythromycin]] 1000 mg q24h 
::::* Preferred regimen (3): [[Levofloxacin]] 750 mg q24h 
::::* Preferred regimen (4): [[Ofloxacin]] 400 mg bid
::::* Preferred regimen (5): [[Moxifloxacin]] 400 mg q24h 
::::* Alternative regimen (1): [[Amoxicillin-Clavulanic acid]] 875/125 mg PO q12h or 500/125 mg PO tid or 1000 /125 mg PO bid 
::::* Alternative regimen (2): [[Cephalosporins|Oral Cephalosporins]] 
::::* Alternative regimen (3): [[TMP-SMX]] 2 mg/kg IV q6h PO for 14 days
:::* 3.2 '''Acute pyelonephritis (Hospitalized)'''<ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
::::* Preferred regimen (1): [[Ciprofloxacin]] 400 mg IV q12h 
::::* Preferred regimen (2): [[Ampicillin]] and [[Gentamicin]] 
::::* Preferred regimen (3): [[Piperacillin-Tazobactam]] 3.375 g IV q4-6h for 14 days 
::::* Alternative regimen (1): [[Ticarcillin-Clavulanate]] 3.1 g IV q6h 
::::* Alternative regimen (2): [[Ampicillin]]-[[Sulbactam]] 3 g IV q6h 
::::* Alternative regimen (3): [[Piperacillin-Tazobactam]] 3.375 g IV q4-6h 
::::* Alternative regimen (4): [[Ertapenem]] 1 g IV q24h 
::::* Alternative regimen (5): [[Doripenem]] 500 mg q8h for 14 days 
::* 4. '''Traveler’s diarrhea'''<ref>{{Cite web | title = The Practice of Travel Medicine: Guidelines by the Infectious Diseases Society of America   | url = http://www.idsociety.org/uploadedFiles/IDSA/Guidelines-Patient_Care/PDF_Library/Travel%20Medicine.pdf }} </ref>    
:::* 4.1 '''Prophylaxis'''

::::* Preferred regimen (1): [[Bismuth subsalicylate]]  two chewable tablets  qid

::::* Preferred regimen (2): [[Norfloxacin]] 400 mg PO qd

::::* Preferred regimen (3): [[Ciprofloxacin]] 500 mg PO qd

::::* Preferred regimen (4): [[Rifaximin]] 200 mg  PO qd or bid
:::* 4.2 '''Symptomatic treatment'''

::::* Preferred regimen (1): [[Bismuth subsalicylate]] 1 oz PO every 30 min for 8 doses

::::* Preferred regimen (2): [[Loperamide]] 4 mg PO then 2 mg after each loose stool not to exceed 16 mg daily

:::* 4.3 '''Antibiotic treatment'''

::::* Preferred regimen (1): [[Fluoroquinolones]], [[Norfloxacin]] 400 mg PO bid 

::::* Preferred regimen (2): [[Ciprofloxacin]] 500 mg PO bid

::::* Preferred regimen (3): [[Ofloxacin]] 200 mg PO bid

::::* Preferred regimen (4): [[Levofloxacin]] 500 mg PO qd

::::* Preferred regimen (5): [[Azithromycin]] 1000 mg PO single dose

::::* Preferred regimen (6): [[Rifaximin]] 200 mg PO tid

::*5. '''Malacoplakia'''<ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
:::* Preferred regimen (1): [[Bethanechol chloride]] {{and}} [[Ciprofloxacin]] 400 mg IV q12h
:::* Preferred regimen (2): [[Bethanechol chloride]] {{and}} [[TMP-SMX]] 2 mg/kg (TMP component IV q6h)       
::*6. '''Bacteremia/pneumonia'''<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
:::* Preferred regimen (1): [[Ceftriaxone]] 1-2 g IV q24h
:::* Preferred regimen (2): [[Ciprofloxacin]] 400 mg IV q12h or 500 mg PO q12h 
:::* Preferred regimen (3): [[Levofloxacin]] 500 mg PO/IV q24h 
:::* Preferred regimen (4): [[Moxifloxacin]] 400 mg IV/PO q24h 
:::* Preferred regimen (5): [[Ampicillin]] 2 g IV q6h (if sensitive)
:::* Preferred regimen (6): [[TMP-SMX]] 5-10 mg/kg/day for q6-8h IV (if sensitive) 
:::* Alternative regimen (1): [[Imipenem]], [[Meropenem]], [[Ertapenem]], [[Doripenem]]; [[Ceftazidime]], [[Cefepime]]; [[Cefazolin]] or [[Cefuroxime]] (if sensitive); [[Aztreonam]]; [[Ticarcillin]], [[Piperacillin]]; [[Piperacillin-Tazobactam]]
:::* Alternative regimen (2): [[Ampicillin-sulbactam]] 3 g IV q6h {{and}} ([[Gentamicin]] 1.5 mg/kg IV q8h or 5-7 mg/kg/day IV {{or}} [[Tobramycin]] 5 mg/kg/day IV) 
:::* Note (1): A 7- to 14-day course of antibiotic therapy is usually recommended.
:::* Note (2): The choice of antimicrobial agents should be based on susceptibility results.
:::* Note (3): Monotherapy with aminoglycosides is generally not recommended for bacteremia or pneumonia.
----

==Francisella tularensis==
{{PBI|Francisella tularensis}}
:* Francisella tularensis<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
::* 1. '''Tularemia'''
:::* Preferred regimen (1): [[Streptomycin]] 1 g IM bid 
:::* Preferred regimen (2): [[Gentamicin]] 5 mg/kg IV q24h for 10 days
:::* Preferred regimen (3) (pregnancy): [[Gentamicin]] 5 mg/kg IV q24h for 10 days
:::* Alternative regimen (1): [[Doxycycline]] 100 mg IV  bid 
:::* Alternative regimen (2): [[Chloramphenicol]] 1 g IV q6h 
:::* Alternative regimen (3): [[Ciprofloxacin]] 400 mg IV bid until stable {{then}} PO for 14-21 days (total)

----

==Helicobacter pylori==
{{PBI|Helicobacter pylori}}
:* 1. '''Peptic ulcer disease'''<ref name="pmid22491499">{{vcite2 journal |vauthors=Malfertheiner P, Megraud F, O'Morain CA, et al. |title=Management of Helicobacter pylori infection--the Maastricht IV/ Florence Consensus Report |journal=Gut |volume=61 |issue=5 |pages=646–64 |year=2012 |pmid=22491499 |doi=10.1136/gutjnl-2012-302084 |url= |issn=}}</ref>
::* In patients aged 55 years or younger with no alarm features, two management options may be considered:
::* 1.1 '''Indications for eradication therapy'''
:::* In moderate to high prevalence of H. pylori infection (≥ 10%): Test-and-treat strategy using a validated noninvasive test (urea breathing test or stool antigen test) 
:::* In low prevalence situations: Treatment indicated after the empiric trial of acid suppression with a proton pump inhibitor for 4–8 weeks
::* 1.2 '''Proton pump inhibitors (PPI)'''
:::* Preferred regimen (1): [[Lansoprazole]] 30 mg q12h 
:::* Preferred regimen (2): [[Omeprazole]] 20 mg q12h 
:::* Preferred regimen (3): [[Esomeprazole]] 40 mg q24h 
:::* Preferred regimen (4): [[Rabeprazole]] 20 mg q12h
::* 1.3 '''Regimens for Initial Treatment'''
:::* 1.3.1 '''Triple therapy''' 
::::* Preferred regimen (1): [[Proton pump inhibitor]] standard dose bid {{and}} [[Amoxicillin]] 1 g bid {{and}} [[Clarithromycin]] 500 mg bid  for 7-14 days
::::* Preferred regimen (2): [[Proton pump inhibitor]] standard dose bid {{and}} [[Amoxicillin]] 1 g bid {{and}} [[Metronidazole]] 500 mg bid for 7-14 days
::::* Preferred regimen (3) (Levofloxacin triple therapy): [[Proton pump inhibitor]] standard dose bid {{and}} [[Amoxicillin]] 1 g bid {{and}} [[Levofloxacin]] 500 mg bid for 10 days
::::* Preferred regimen (4) (Rifabutin triple therapy): [[Proton pump inhibitor]] standard dose bid {{and}} [[Amoxicillin]] 1 g bid {{and}} [[Rifabutin]] 150-300 mg/day for 10 days
:::* 1.3.2 '''Quadruple therapy'''
::::* Preferred regimen (1): [[Proton pump inhibitor]] standard dose bid {{and}} [[Metronidazole]] 250 mg q6h {{and}} [[Tetracycline]] 500 mg q6h {{and}} [[Bismuth]] (dose depends on preparation) for 10-14 days
::::* Preferred regimen (2) non-bismuth quadruple therapy (concomitant therapy): Proton pump inhibitor (standard dose twice daily) for 7–14 days {{and}} [[Clarithromycin]] 500 mg bid for 7–14 days {{and}} [[Amoxicillin]] 1 g bid for 10 days {{and}} [[Metronidazole]] 250 mg qid for 7–14 days 
:::* 1.3.3 '''Sequential therapy'''
::::* Preferred regimen: [[Proton pump inhibitor]] standard dose bid {{and}} [[Amoxicillin]] 1 g bid for 1-5 days followed by [[Proton pump inhibitor]] standard dose bid {{and}} [[Clarithromycin]] 500 mg bid {{and}} [[Tinidazole]] 500 mg bid for 6-10 days
:::* Note: Alternative triple therapies appropriate for patients with an allergy to Amoxicillin include (Proton pump inhibitor and Clarithromycin and Metronidazole) or (Proton pump inhibitor and Tetracycline and Metronidazole)
::* 1.5 '''Clarithromycin resistance'''
:::* 1.5.1 Clarithromycin resistance ≥ 20%
::::* Preferred regimen (1) (bismuth quadruple therapy): [[Proton pump inhibitor]] standard dose bid {{and}} [[Metronidazole]] 250 mg q6h {{and}} [[Tetracycline]] 500 mg q6h {{and}} [[Bismuth]] (dose depends on preparation) for 10-14 days
::::* Preferred regimen (2) (sequential therapy): [[Proton pump inhibitor]] standard dose bid {{and}} [[Amoxicillin]] 1 g bid for 1-5 days followed by [[Proton pump inhibitor]] standard dose bid {{and}} [[Clarithromycin]] 500 mg bid {{and}} [[Tinidazole]] 500 mg bid for 6-10 days
::::* Preferred regimen (3) non-bismuth quadruple therapy (concomitant therapy): Proton pump inhibitor (standard dose twice daily) for 7–14 days {{and}} [[Clarithromycin]] 500 mg bid for 7–14 days {{and}} [[Amoxicillin]] 1 g bid for 10 days {{and}} [[Metronidazole]] 250 mg qid for 7–14 days
::::* Alternative regimen: [[Proton pump inhibitor]] standard dose bid {{and}} [[Amoxicillin]] 1 g bid {{and}} [[Levofloxacin]] 500 mg bid for 10 days
:::* 1.5.2 Clarithromycin resistance < 20%
::::* Preferred regimen (1): [[Proton pump inhibitor]] standard dose bid for 7-14 days {{and}} [[Clarithromycin]] 500 mg bid for 7–14 days {{and}} [[Amoxicillin]]  1 g bid for 7–14 days {{or}} [[Metronidazole]] 250 mg qid for 7–14 days
::::* Preferred regimen (2): [[Proton pump inhibitor]] standard dose bid {{and}} [[Metronidazole]] 250 mg q6h {{and}} [[Tetracycline]] 500 mg q6h {{and}} [[Bismuth]] (dose depends on preparation) for 10-14 days 
::::* Alternative regimen (1):[[Proton pump inhibitor]] standard dose bid {{and}} [[Metronidazole]] 250 mg q6h {{and}} [[Tetracycline]] 500 mg q6h {{and}} [[Bismuth]] (dose depends on preparation) for 10-14 days
::::* Alternative regimen (2): [[Proton pump inhibitor]] standard dose bid for 10 days {{and}} [[Levofloxacin]] 500 mg bid for 10 days {{and}} [[Amoxicillin]] 1 g bid for 10 days


----

==Klebsiella granulomatis==
{{PBI|Klebsiella granulomatis}}
:* Klebsiella granulomatis (formly known as Calymmatobacterium granulomatis)
::*1. '''Granuloma inguinale (donovanosis)'''<ref>{{Cite journal| issn = 1545-8601| volume = 64| issue = RR-03| pages = 1–137| last1 = Workowski| first1 = Kimberly A.| last2 = Bolan| first2 = Gail A.| title = Sexually transmitted diseases treatment guidelines, 2015| journal = MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control| date = 2015-06-05| pmid = 26042815}}</ref>
:::* Preferred regimen: [[Azithromycin]] 1 g PO once a week or 500 mg qd for 3 weeks {{then}} until all lesions have completely healed
:::* Alternative regimen (1): [[Doxycycline]] 100 mg PO bid for 3 weeks {{then}} until all lesions have completely healed
:::* Alternative regimen (2): [[Ciprofloxacin]] 750 mg PO bid for at least 3 weeks {{then}} until all lesions have completely healed
:::* Alternative regimen (3): [[Erythromycin]] base 500 mg PO qid for at least 3 weeks {{then}} until all lesions have completely healed
:::* Alternative regimen (4): [[Trimethoprim-sulfamethoxazole]] DS (160 mg/800 mg) tablet PO bid for at least 3 weeks {{then}} until all lesions have completely healed

==Klebsiella pneumoniae==
{{PBI|Klebsiella pneumoniae}}
:* '''Klebsiella pneumoniae'''<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
::* 1. '''Severe, nosocomial infections'''
:::* 1.1 '''Non-ESBLs in pneumonia, sepsis, complicated UTI, or intra-abdominal infections'''
::::* Preferred regimen (1): [[Cefepime]] 2 g IV q8h 
::::* Preferred regimen (2): [[Ceftazidime]] 2 g IV q8h 
::::* Preferred regimen (3): [[Imipenem]] 500 mg IV q6h 
::::* Preferred regimen (4): [[Meropenem]] 1 g IV q8h 
::::* Preferred regimen (5): [[Piperacillin-tazobactam]] 4.5 g IV q6h {{and}} [[Aminoglycoside]] 
::::* Alternative regimen (1): [[Ceftriaxone]] 1 g IV q24h {{and}} [[Metronidazole]] 500 mg IV q6h or 1 g IV q12h
::::* Alternative regimen (2): [[Moxifloxacin]] 400 mg IV/PO q24h 
:::* 1.2 '''ESBLs in pneumonia, sepsis, complicated UTI, or intra-abdominal infections'''
::::* Preferred regimen (1): [[Imipenem]] 500 mg IV q6h 
::::* Preferred regimen (2): [[Meropenem]] 1 g IV q8h 
::::* Preferred regimen (3): [[Ertapenem]] 1 g IV q24h 
::::* Preferred regimen (4): [[Doripenem]] 500 mg IV q8h
::::* Note: In ESBLs, inconsistent activity is seen with aminoglycosides, fluoroquinolones, and piperacillin-tazobactam. Avoid cephalosporins.

==Klebsiella rhinoscleromatis==
{{PBI|Klebsiella rhinoscleromatis}}
:* 1. '''Rhinoscleroma'''<ref>{{Cite journal| doi = 10.1007/s00405-013-2649-z| issn = 1434-4726| volume = 271| issue = 7| pages = 1851–1856| last1 = Mukara| first1 = B. K.| last2 = Munyarugamba| first2 = P.| last3 = Dazert| first3 = S.| last4 = Löhler| first4 = J.| title = Rhinoscleroma: a case series report and review of the literature| journal = European archives of oto-rhino-laryngology: official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS): affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery| date = 2014-07| pmid = 23904142}}</ref><ref>{{Cite journal| doi = 10.1086/592966| issn = 1537-6591| volume = 47| issue = 11| pages = 1396–1402| last1 = de Pontual| first1 = Loïc| last2 = Ovetchkine| first2 = Philippe| last3 = Rodriguez| first3 = Diana| last4 = Grant| first4 = Audrey| last5 = Puel| first5 = Anne| last6 = Bustamante| first6 = Jacinta| last7 = Plancoulaine| first7 = Sabine| last8 = Yona| first8 = Laurent| last9 = Lienhart| first9 = Pierre-Yves| last10 = Dehesdin| first10 = Danièle| last11 = Huerre| first11 = Michel| last12 = Tournebize| first12 = Régis| last13 = Sansonetti| first13 = Philippe| last14 = Abel| first14 = Laurent| last15 = Casanova| first15 = Jean Laurent| title = Rhinoscleroma: a French national retrospective study of epidemiological and clinical features| journal = Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America| date = 2008-12-01| pmid = 18947330}}</ref><ref>{{Cite journal| doi = 10.3109/00016489.2010.539264| issn = 1651-2251| volume = 131| issue = 4| pages = 440–446| last1 = Gaafar| first1 = Hazem A.| last2 = Gaafar| first2 = Alaa H.| last3 = Nour| first3 = Yasser A.| title = Rhinoscleroma: an updated experience through the last 10 years| journal = Acta Oto-Laryngologica| date = 2011-04| pmid = 21198342}}</ref>
::* Preferred regimen (1): [[Ciprofloxacin]] 500–750 mg PO bid for 2–3 months 
::* Preferred regimen (2): [[Levofloxacin]] 750 mg PO qd for 2–3 months 
::* Preferred regimen (3): [[Trimethoprim-Sulfamethoxazole]] 1 DS tab PO bid for 3 months {{and}} [[Rifampicin]] 300 mg PO bid for 3 months
::* Alternative regimen: [[Tetracycline]] {{or}} [[Streptomycin]] {{or}} [[Doxycycline]]  {{or}} [[Ceftriaxone]] {{or}} [[Ofloxacin]]
::* Note (1): The optimal duration of antimicrobial therapy remains unclear. A 6-week to 6-month course of antibiotics until histology exams and cultures are negative may be required.
::* Note (2): Use of topical antiseptics such as Acriflavinium and Rifampin ointment has been reported with resolution of symptoms.<ref>{{Cite journal| doi = 10.1007/s00405-013-2649-z| issn = 1434-4726| volume = 271| issue = 7| pages = 1851–1856| last1 = Mukara| first1 = B. K.| last2 = Munyarugamba| first2 = P.| last3 = Dazert| first3 = S.| last4 = Löhler| first4 = J.| title = Rhinoscleroma: a case series report and review of the literature| journal = European archives of oto-rhino-laryngology: official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS): affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery| date = 2014-07| pmid = 23904142}}</ref>
----

==Legionella pneumophila==
{{PBI|Legionella pneumophila}}
:* 1.'''Atypical pneumonia (Legionnaires' disease )'''<ref>{{cite book | last = Bennett | first = John | title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases | publisher = Elsevier/Saunders | location = Philadelphia, PA | year = 2015 | isbn = 978-1455748013 }}</ref>
::* 1.1  '''Mild pneumonia inpatient or outpatient, non immunocompromised'''
:::* Preferred regimen (1): [[Azithromycin]] 500 mg PO qd for 3-5 days
:::* Preferred regimen (2): [[Levofloxacin]] 500 mg PO qd for 7-10 days
:::* Preferred regimen (3): [[Ciprofloxacin]] 500 mg PO bid for 7-10 days
:::* Preferred regimen (4): [[Moxifloxacin]] 400 mg PO qd for 7-10 days
:::* Preferred regimen (5): [[Clarithromycin]] 500 mg PO bid for 10-14 days
:::* Alternative regimen (1): [[Doxycycline]] 200 mg PO loading dose, then 100 mg PO bid for 10-14 days
:::* Alternative regimen (2): [[Erythromycin]] 500 mg PO qid for 10-14 days
:::* Note: Patients with mild disease may be treated entirely with oral therapy.
::* 1.2 '''Moderate to severe pneumonia or immunocompromised'''
:::* Preferred regimen (1): [[Azithromycin]] 500 mg PO/IV  q24h for 5-7 days
:::* Preferred regimen (2): [[Levofloxacin]] 500 mg PO/IV q24h for 7-10 days {{or}} 750 mg PO/IV q24h for 5-7 days
:::* Alternative regimen (1): [[Ciprofloxacin]] 750 mg PO bid for 14 days   
:::* Alternative regimen (2): [[Moxifloxacin]] 400 mg PO qd for 14 days 
:::* Alternative regimen (3): [[Erythromycin]] 750-1000 mg IV q6h for 3-7 days, then 500 mg PO qid for a total course of 21 days
:::* Alternative regimen (4): [[Clarithromycin]] 500 mg IV q12h for 3-7 days, and then 500 mg PO bid  for a total course of 21 days
:::* Note: Severely ill patients parenteral therapy is advised until improvement is seen and oral absorption is sufficient.
:*  2 '''Pontiac fever''' 
::*  Pontiac fever is febrile, self-limited form of Legionella infection which requires only symptomatic therapy, such as analgesics for headache. Antibiotics are not indicated.

==Moraxella catarrhalis==        
{{PBI|Moraxella catarrhalis}}
:* Moraxella catarrhalis<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
::* Preferred regimen (1): [[TMP-SMX]] 1DS PO bid              
::* Preferred regimen (2): [[Erythromycin]] 500 mg PO q6h      
::* Preferred regimen (3): [[Clarithromycin]] 500 mg bid or XL 1 g PO qd        
::* Preferred regimen (4): [[Azithromycin]] 500 mg single dose {{then}} 250 mg PO qd   
::* Preferred regimen (5): [[Doxycycline]] 100 mg PO/IV bid                              
::* Preferred regimen (6): Parenteral cephalosporins such as [[Cefuroxime]] {{or}} [[Cefotaxime]] {{or}} [[Ceftriaxone]] 
::* Preferred regimen (7): [[Cefprozil]] 200-500 mg PO bid
::* Preferred regimen (8): [[Cefpodoxime]] 200-400 mg PO bid
::* Preferred regimen (9): [[Cefuroxime]] 250-500 mg PO bid 
::* Preferred regimen (10): [[Cefdinir]] 300 mg bid 
::* Preferred regimen (11): [[Moxifloxacin]] 400 mg IV/PO qd  
::* Preferred regimen (12): [[Levofloxacin]] 500 mg IV/PO qd 
::* Preferred regimen (13): [[Amoxicillin-Clavulanate]] 875/125 mg PO bid or XL 2000/125 PO bid

==Morganella morganii==
{{PBI|Morganella morganii}}
:* Morganella morganii<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
::* Preferred regimen (1): [[Imipenem]] 500 mg IV q6h 
::* Preferred regimen (2): [[Meropenem]] 1.0 g IV q8h (adjust dose if necessary for renal function).
::* Note (1): [[Carbapenems]] are considered first line therapy due to inducible cephalosporinases, and presence of extended-spectrum beta-lactamases in some isolates 
::* Note (2): Duration of treatment for UTI (generally complicated) is 7 days and duration of treatment for bacteremia is 14 days
::* Note (3): [[Tigecycline]] is not reliably effective
::* Alternative Regimen (1): [[Cefepime]] 2.0 g IV q8-12h 
::* Alternative Regimen (2): [[Ciprofloxacin]] 500 mg PO/400 mg IV q12h 
::* Alternative Regimen (3): [[Piperacillin]] 3 g IV q6h 
::* Alternative Regimen (4): [[Ticarcillin]] 3 g IV q4h
::* Alternative Regimen (5): [[Gentamicin]] 
::* Alternative Regimen (6): [[Tobramycin]] 1 mg/kg IV q24h
::* Alternative Regimen (7): [[Amikacin]] 3 mg/kg IV q24h
::* Note: Aminoglycosides can be used alone for treatment of UTI

==Plesiomonas shigelloides==
{{PBI|Plesiomonas shigelloides}}
:* Plesiomonas shigelloides<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
::* 1. '''Immunocompetent hosts or severe Infection'''
:::* Preferred regimen: [[Ciprofloxacin]] 500 mg PO bid or 400 mg IV q12h
:::* Alternative regimen (1): [[Ofloxacin]] 300 mg PO bid 
:::* Alternative regimen (2): [[Norfloxacin]] 400 mg PO bid 
:::* Alternative regimen (3): [[TMP-SMX]] DS PO bid for 3 days
:::* Alternative regimen (4): [[Ceftriaxone]] 1-2 g IV qd in severe cases
::* 2. '''Immunocompromised hosts'''
:::* Preferred regimen: [[Ciprofloxacin]] 500 mg PO bid for 3 days
:::* Alternative regimen (1): [[Ofloxacin]] 300 mg PO bid 
:::* Alternative regimen (2): [[Norfloxacin]] 400 mg PO bid 
:::* Alternative regimen (3): [[TMP-SMX]] DS PO bid for 3 days if susceptible

==Proteus mirabilis==
{{PBI|Proteus mirabilis}}
:* Proteus mirabilis<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
::* Preferred regimen (1): [[Ampicillin]] 500 mg PO q6h or 2 g IV q6h
::* Preferred regimen (2): [[Cefuroxime]] 250 mg PO bid or 750 mg IV q8h
::* Preferred regimen (3): [[Ciprofloxacin]] 250-500 mg PO bid or 400 mg IV q12h
::* Preferred regimen (4): [[Levofloxacin]] 500 mg PO OD or 500 mg IV q24h
::* Note: Duration of treatment for uncomplicated UTI 3 days, pyelonephritis 7-14 days, complicated UTI 10-21 days and bacteremia is 7-14 days

==Indole positive Proteus species==
:* '''Indole positive Proteus species'''<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
::* Preferred regimen (1): [[Ceftriaxone]] 1 g IV q24h
::* Preferred regimen (2): [[Imipenem]] 500 mg IV q6h
::* Preferred regimen (3): [[Ciprofloxacin]] 400 mg IV q12h or 250-500 mg PO bid
::* Preferred regimen (4): [[Levofloxacin]] 500 mg IV/PO q24h

==Providencia==
{{PBI|Providencia}}
:* Providencia<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
::* 1. '''Complicated uti/bacteremia/acute prostatitis'''
:::* Preferred regimen (1): [[Ciprofloxacin]] 500-750 mg PO q12h or 400 mg IV q8-12h 
:::* Preferred regimen (2): [[Levofloxacin]] 500 mg IV/PO q24h 
:::* Preferred regimen (3): [[Piperacillin]]-[[Tazobactam]] 3.375 mg IV q6h 
:::* Preferred regimen (4): [[Ceftriaxone]] 1-2 g IV q24h (donot use if ESBL suspected or critically ill)
:::* Preferred regimen (5): [[Meropenem]] 1 g IV q8h (consider if critically ill or ESBL suspected)
:::* Preferred regimen (6): [[Amikacin]] 7.5 mg/kg IV q12h 
:::* Preferred regimen (7): [[Gentamicin]] 
:::* Preferred regimen (8): [[Tobramycin]] acceptable if susceptible but many species are resistant
:::* Note (1): Duration of treatment for (UTI) is 7 days common or 3-5 days after defervescence or control/elimination of complicating factors (e.g.,removal of foreign material catheter).
:::* Note (2): Duration of treatment for (bacteremia) is 10-14 days or 3-5 days after defervescence or control/elimination of complicating factors
:::* Note (3): Duration for acute prostatitis (2 weeks), shorter than chronic prostatitis (4-6 weeks)
:::* Alternative regimen: [[TMP-SMX]] DS PO q12h for 10-14 days or [[TMP]] 5-10 mg/kg/day IV q6h

==Pseudomonas aeruginosa==
{{PBI|Pseudomonas aeruginosa}}
:*Pseudomonas aeruginosa<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
::* Preferred regimen (1): [[Cefepime]] 2 g IV q8h 
::* Preferred regimen (2): [[Ceftazidime]] 2 g IV q8h 
::* Preferred regimen (3): [[Piperacillin]] 3-4 g IV q4h in (no benefit for pseudomonas from beta-lactamase inhibitor)
::* Preferred regimen (4): [[Ticarcillin]] 3-4 g IV q4h (no benefit for pseudomonas from beta-lactamase inhibitor)
::* Preferred regimen (5): [[Imipenem]] 500 mg—1 g IV q6h 
::* Preferred regimen (6): [[Meropenem]] 1 g IV q8h 
::* Preferred regimen (7): [[Doripenem]] 500 mg IV q8h 
::* Preferred regimen (8): [[Ciprofloxacin]] 400 mg IV q8h or 750 mg PO q12h (for less serious infections) 
::* Preferred regimen (9): [[Aztreonam]] 2 g IV q6-8h
::* Preferred regimen (10): [[Colistin]] 2.5 mg/kg IV q12h 
::* Preferred regimen (11): [[Polymyxin B]] 0.75-1.25 mg/kg IV q12h 
::* Preferred regimen (12): [[Gentamicin]] 
::* Preferred regimen (13): [[Tobramycin]] 1.7-2.0 mg/Kg IV q8h or 5-7 mg/kg IV 
::* Preferred regimen (14): [[Amikacin]] 2.5 mg/kg IV q12h
::* Note: Amikacin > Tobramycin > Gentamicin with respect to P.aeruginosa susceptibility percentages at most institutions.

==Salmonella==
{{PBI|Salmonella}}
:* 1. '''Salmonellosis in immunocompetent hosts'''<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
::* 1.1 '''Gastroenteritis'''
:::* Antimicrobial therapy is usually not recommended for uncomplicated diarrheal illness.
:::* 1.1.1 '''Indications for antimicrobial therapy'''
::::* severedisease,
::::* Age > 50 yrs
::::* Prosthesis
::::* Presence of valvular heart disease 
::::* Severe atherosclerosis
::::* Cancer
::::* Uremia
::::* Immunosuppression
:::* 1.1.2 Treatment regimens
::::* Preferred regimen (1): [[TMP-SMX]] DS PO bid for 5-7 days
::::* Preferred regimen (2): [[Ciprofloxacin]] 500 mg PO bid for 5-7 days
::::* Preferred regimen (3): [[Ceftriaxone]] 2 g IV q24h for 5-7 days
::* 1.2 '''Typhoid fever'''<ref>{{Cite web | title = TYPHOID FEVER | url = http://www.nejm.org/doi/pdf/10.1056/NEJMra020201}}</ref>
:::* 1.2.1 '''Uncomplicated typhoid'''
::::* Preferred regimen (1) (fully susceptible): [[Fluoroquinolone]] (e.g., [[Ofloxacin]] 15 mg/kg PO qd for 5–7 days) 
::::* Preferred regimen (2) (multi drug-resistant): [[Fluoroquinolone]] ([[Ofloxacin]] 15 mg/kg PO qd for 5–7 days)   
::::* Preferred regimen (3) (quinolone-resistant): [[Azithromycin]] 8–10 mg/kg  PO qd for 7 days 
::::* Preferred regimen (4) (quinolone-resistant): [[Fluoroquinolone]] 20 mg/kg PO qd for 10-14 days
::::* Alternative regimen (1) (fully susceptible): [[Chloramphenicol]] 50–75 mg/kg PO qd for 14-21 days
::::* Alternative regimen (2) (fully susceptible): [[Amoxicillin]] 75–100 mg/kg PO qd for 14 days
::::* Alternative regimen (3) (fully susceptible): [[Trimethoprim–Sulfamethoxazole]], 8 mg/kg ([[trimethoprim]])– 40 mg/kg ([[sulfamethoxazole]]) PO qd for 14 days
::::* Alternative regimen (4) (multi drug-resistant): [[Azithromycin]] 8–10 mg/kg PO for 7 days
::::* Alternative regimen (5) (multi drug-resistant): Third-generation cephalosporin, e.g., [[Cefixime]] 20 mg/kg PO qd for 7-14 days
::::* Alternative regimen (6) (quinolone-resistant): Third-generation cephalosporin, e.g., [[Cefixime]] 20 mg/kg PO qd for 7-14 days
:::* 1.2.2 '''Severe typhoid'''
::::* Preferred regimen (1) (fully susceptible): [[Fluoroquinolone]] (e.g., [[Ofloxacin]] 15 mg/kg IV qd for 10-14 days) 
::::* Preferred regimen (2) (multi drug-resistant): [[Fluoroquinolone]] ([[Ofloxacin]] 15 mg/kg IV qd for 10-14 days)   
::::* Preferred regimen (3) (quinolone-resistant): [[Ceftriaxone]] 60 mg/kg IV qd for 10-14 days 
::::* Preferred regimen (4) (quinolone-resistant): [[Cefotaxime]] 80 mg/kg IV qd for 10-14 days
::::* Alternative regimen (1) (fully susceptible): [[Chloramphenicol]] 100 mg/kg PO qd for 14-21 days
::::* Alternative regimen (2) (fully susceptible): [[Ampicillin]] 100 mg/kg PO qd for 14-21 days
::::* Alternative regimen (3) (fully susceptible): [[Trimethoprim–Sulfamethoxazole]], 8 mg/kg ([[trimethoprim]])– 40 mg/kg ([[sulfamethoxazole]]) IV qd for 10-14 days
::::* Alternative regimen (4) (multi drug-resistant): [[Ceftriaxone]] 60 mg/kg IV qd for 10-14 days 
::::* Alternative regimen (5) (multi drug-resistant): [[Cefotaxime]] 80 mg/kg IV qd for 10-14 days
::::* Alternative regimen (6) (quinolone-resistant): [[Fluoroquinolone]] 20 mg/kg IV qd for 10-14 days

::* 1.3 '''Non-typhoid (serious infection)'''<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
:::* Preferred regimen (1): [[Cephalosporin|3rd generation cephalosporin]] ([[Ceftriaxone]]/[[Cefotaxime]]) 
:::* Preferred regimen (2): [[Fluoroquinolone]] ([[Ciprofloxacin]], [[Levofloxacin]])
::* 1.4 '''Bacteremia'''<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
:::* Preferred regimen (1): [[Ceftriaxone]] 2 g IV q24h 

:::* Preferred regimen (2): [[Cefotaxime]] 2 g IV q6-8h for 7-14 days 

:::* Preferred regimen (3): [[Ciprofloxacin]] 400 mg IV q12h for 7-14 days
::* 1.5 '''Vascular prosthesis infection'''<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
:::* Preferred regimen (1): [[Ceftriaxone]]

:::* Preferred regimen (2): [[Cefotaxime]] 

:::* Preferred regimen (3): [[Ciprofloxacin]] 400 mg IV q12h for 6 weeks
::* 1.6 '''Osteomyelitis'''<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
:::* Preferred regimen (1): [[Ceftriaxone]] 2 g IV q24h 

:::* Preferred regimen (2): [[Cefotaxime]] 2 g IV q6-8h 

:::* Preferred regimen (3): [[Ciprofloxacin]] 750 mg PO bid for ≥ 4 weeks
::* 1.7 '''Arthritis'''<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
:::* Preferred regimen (1): [[Ceftriaxone]] 2 g IV q24h

:::* Preferred regimen (2): [[Cefotaxime]] 2 g IV q6-8h for 6 weeks
::* 1.8 '''Endocarditis'''<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
:::* Preferred regimen (1): [[Ceftriaxone]] 2 g IV q24h 

:::* Preferred regimen (2): [[Cefotaxime]] 2 g IV q6-8h for 6 weeks
::* 1.9 '''UTI'''<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
:::*Preferred regimen (1): [[Ceftriaxone]]

:::*Preferred regimen (2): [[Cefotaxime]] 

:::*Preferred regimen (3): [[Ciprofloxacin]] IV for 1-2 weeks {{then}} ([[Ciprofloxacin|oral Ciprofloxacin]] {{or}} [[TMP-SMX]] for 6 weeks)
::* 1.10 '''Carrier state'''<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
:::* Preferred regimen (1): [[Ciprofloxacin]] 500 mg PO bid for 4-6 weeks 
:::* Preferred regimen (2): [[TMP-SMX]] 1DS bid PO for 6 weeks
:::* Preferred regimen (3): [[Amoxicillin]] 500 mg PO for 6 weeks

::* 2. '''Salmonellosis in immunocompromised hosts'''
:::* 2.1 '''HIV and salmonellosis'''<ref>{{Cite web | title = Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents | url = https://aidsinfo.nih.gov/contentfiles/lvguidelines/AdultOITablesOnly.pdf}}</ref>
::::* 2.1.1 Gastroenteritis
:::::* Preferred regimen: [[Ciprofloxacin]] 500-750 mg PO bid or 400 mg IV q12h, if susceptible 
:::::* Alternative regimen (1): [[Levofloxacin]] 750 mg PO/IV q24h 
:::::* Alternative regimen (2): [[Moxifloxacin]] 400 mg PO/IV q24h 
:::::* Alternative regimen (3): [[TMP]] 160 mg {{and}} [[sulfamethoxazole|SMX]] 800 mg PO/IV q12h 
:::::* Alternative regimen (4): [[Ceftriaxone]] 1 g IV q24h  
:::::* Alternative regimen (5): [[Cefotaxime]] 1 g IV q8h 
:::::* Duration of treatment for gastroenteritis without bacteremia
::::::* If CD4 count ≥ 200 cells/μL: Duration of treatment is 7–14 days 
::::::* If CD4 count < 200 cells/μL: Duration of treatment is 2–6 weeks
:::::* Duration of treatment for gastroenteritis with bacteremia
::::::* If CD4 count ≥ 200/μL: Duration of treatment is 14 days; longer duration if bacteremia persists or if the infection is complicated (e.g., if metastatic foci of infection are present) 
::::::* If CD4 count < 200 cells/μL: Duration of treatment is 2–6 weeks 
:::::* Note (1): Secondary prophylaxis should be considered for
::::::* Patients with recurrent Salmonella gastroenteritis with or without bacteremia 
::::::* Patients with CD4 < 200 cells/μL with severe diarrhea

==Serratia marcescens==
{{PBI|Serratia marcescens}}
:* Serratia marcescens<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
::* 1. '''Bacteremia, pneumonia or serious infections'''
:::* Preferred regimen (1): [[Cefepime]] 1-2 g IV q8h
:::* Preferred regimen (2): [[Imipenem]] 0.5-1.0 g IV q6h
:::* Preferred regimen (3): [[Ciprofloxacin]] 400 mg IV q8h
:::* Alternative regimen (1): [[Aztreonam]]
:::* Alternative regimen (2): [[Gentamicin]] 
:::* Alternative regimen (3): [[Amikacin]] 
:::* Alternative regimen (4): [[Piperacillin-tazobactam]] also often effective
:::* Note: Duration depends on clinical response, usually 7-14 days
::* 2. '''Endocarditis'''
:::* Note: Choice dictated by sensitivities, 4 to 6 week duration of parenteral therapy.
::* 3. '''Osteomyelitis'''
:::* Note (1): Choice dictated by sensitivity profile, treat for 6-12 weeks depending upon response. 
:::* Note (2): Use IV treatment until stable/clinically improved (10-14 days Minimum) then may convert to oral therapy if appropriate.
::* 4. '''UTI'''
:::* Preferred regimen (1): [[Ciprofloxacin]] 250 mg PO bid or 400 mg IV q12h 
:::* Preferred regimen (2): [[Levofloxacin]] 250 mg PO qd or 500mg IV q24h
:::* Note: Fluoroquinolones often sensitive but in seriously ill patient consider empiric coverage with two drugs (e.g.,beta-lactam and aminoglycoside or fluoroquinolones and carbapenem) until susceptibilities known.

==Shigella==
{{PBI|Shigella}}
:* 1. '''Shigellosis''' <ref>{{Cite web | title = Guidelines for the control of shigellosis, including epidemics due to Shigella dysenteriae type 1
 | url = http://apps.who.int/iris/bitstream/10665/43252/1/924159330X.pdf?ua=1&ua=1}}</ref>
::* 1.1 '''Adults'''  
:::* Preferred regimen (1): [[Ciprofloxacin]] 500 mg PO bid for 3 days
:::* Alternative regimen (1): [[Pivmecillinam]] 100 mg PO qid for 5 days
:::* Alternative regimen (2): [[Azithromycin]] 1-1.5 g PO qd for 1 to 5 days
::* 1.2 '''Pediatrics'''  
:::* Preferred regimen (1): [[Ciprofloxacin]] 15 mg/kg PO bid for 3 days
:::* Alternative regimen (1): [[Pivmecillinam]] 20 mg/kg PO qid for 5 days  
:::* Alternative regimen (2): [[Ceftriaxone]] 50-100 mg/kg IM qd for 2 to 5 days 
:::* Alternative regimen (3): [[Azithromycin]] 6-20 mg/kg PO qd for 1 to 5 days

==Stenotrophomonas maltophilia==
{{PBI|Stenotrophomonas maltophilia}}
:*Stenotrophomonas maltophilia<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
::* Preferred treatment: [[TMP-SMX]] 15-20 mg/kg/day (TMP component) IV/PO q8h
::* Alternative treatment (1): [[Ceftazidime]] 2 g IV q8h 
::* Alternative treatment (2): [[Ticarcillin-clavulanate]] 3.1 g IV q4h  
::* Alternative treatment (3): [[Tigecycline]] 100 mg IV single dose {{then}} 50 mg IV q12h
::* Alternative treatment (4): [[Ciprofloxacin]] 500-750 mg PO /400 mg IV q12h 
::* Alternative treatment (5): [[Moxifloxacin]] 400 mg PO/IV 
::* Alternative treatment (6): [[Levofloxacin]] 750 mg PO/IV .
::* Alternative treatment (7) (Multiply-resistantance): [[Colistin]] 2.5 mg/kg q12h IV
::* Note: Treatment duration uncertain, but usually ≥ 14 days
{{PBI|Vibrio cholerae}}
:* 1. '''WHO''' <ref>{{cite web | title = WHO. Cholera Outbreak: Assessing the Outbreak Response and Improving Preparedness.| url =http://www.who.int/cholera/publications/final%20outbreak%20booklet%20260105-OMS.pdf }}</ref> <ref>{{cite web | title = Prevention and control of cholera outbreaks: WHO policy and recommendations| url =http://www.who.int/cholera/prevention_control/recommendations/en/index4.html}}</ref>
:::* Note: Antibiotic treatment for cholera patients with severe dehydration only
:::* Adults
::::* Preferred regimen: [[Doxycycline]] 300 mg po single dose
::::* Alternative regimen: [[Tetracycline]] 12.5 mg/kg PO qid for 3 days
:::* Pediatric
::::* Under 12 years old
:::::* Preferred regimen: [[Erythromycin]] 12.5 mg/kg PO qid for 3 days
::::* Over 12 years old
:::::* Preferred regimen: [[Doxycycline]] 300 mg po single dose
:::::* Alternative regimen: [[Tetracycline]] 12.5 mg/kg PO qid for 3 days

:* 2. '''Pan American Health Organization''' <ref>{{cite web | title = PAHO. Recommendations for clinical management of cholera| url =file:///Users/censhanshan/Desktop/cholera_clin_management_ENG_rev_JUN%201.pdf }}</ref>
:::* Note: Antibiotic treatment for cholera patients with moderate or severe dehydration
:::* 2.1 '''Adult'''
::::* Preferred regimen: [[Doxycycline]] 300 mg po single dose 
::::* Alternative regimen (1): [[Ciprofloxacin]] 1 g PO single dose  
::::* Alternative regimen (2): [[Azithromycin]] 1 g PO single dose
:::* 2.2 '''Pediatric'''
::::* 2.2.1 '''Children over 3 year, who can swallow tablets'''
:::::* Preferred regimen (1): [[Erythromycin]] 12.5 mg/kg/ PO qid for 3 days 
:::::* Preferred regimen (2): [[Azithromycin]] 20 mg/kg PO in a single dose
:::::* Alternative regimen (1): [[Ciprofloxacin]] suspension or tablets 20 mg/kg PO single dose 
:::::* Alternative regimen (2): [[Doxycycline]] suspension or tablets 2-4 mg/kg PO single dose
:::::* Note: Although doxycycline has been associated with a low risk of yellowing of the teeth in children, its benefits outweigh its risks
::::* 2.2.2 '''Children under 3 year, or infants who cannot swallow tablets'''
:::::* Preferred regimen (1): [[Erythromycin]] suspension 12.5 mg/kg/ PO qid for 3 days 
:::::* Preferred regimen (2): [[Azithromycin]] suspension 20 mg/kg PO single dose
:::::* Alternative regimen (1): [[Ciprofloxacin]] suspension 20 mg/kg PO single dose 
:::::* Alternative regimen (2): [[Doxycycline]] syrup 2-4 mg/kg PO single dose
:::* 2.3 '''Pregnancy'''
::::* Preferred regimen (!): [[Erythromycin]] 500 mg/ PO qid for 3 days  
::::* Preferred regimen (2): [[Azithromycin]] 1 g PO single dose


{{PBI|Vibrio parahaemolyticus}}
:* [[Vibrio parahaemolyticus]] <ref>{{cite web | title = Vibrio parahaemolyticus CDC| url =http://www.cdc.gov/vibrio/vibriop.html }}</ref>
::* 1. '''Mild to Moderate '''
:::* Treatment is not necessary in most cases of V. parahaemolyticus infection
:::* There is no evidence that antibiotic treatment decreases the severity or the length of the illness
:::* Patients should drink plenty of liquids to replace fluids lost through diarrhea

::* 2. '''Severe or prolonged illnesses'''
:::* Preferred regimen: [[Tetracycline]] {{or}} [[Ciprofloxacin]]


{{PBI|Vibrio vulnificus}}
:* [[Vibrio vulnificus]] <ref>{{cite web | title = Vibrio vulnificus CDC| url =http://www.cdc.gov/vibrio/vibriov.html }}</ref>
::* Note: If V. vulnificus is suspected, treatment should be initiated immediately because antibiotics improve survival
::* Preferred regimen: [[Doxycycline]] 100 mg PO/IV bid for 7-14 days {{and}} [[Ceftazidime]] 1-2 g IV/IM q8h
::* Note: A single agent regimen with a fluoroquinolone such as [[Levofloxacin]], [[Ciprofloxacin]] or [[Gatifloxacin]], has been reported to be at least as effective in an animal model as combination drug regimens with [[Doxycycline]] and a [[Cephalosporin]]
::* Pediatric regimen: [[Doxycycline]] {{and}} [[Fluoroquinolones]]; [[trimethoprim-sulfamethoxazole]] {{and}} an [[Aminoglycoside]]
----

====Bacteria – Atypical Organisms====

==Chlamydophila pneumoniae==
{{PBI|Chlamydophila pneumoniae}}
:* 1. '''Atypical pneumonia''' <ref>{{cite book | last = Bennett | first = John | title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases | publisher = Elsevier/Saunders | location = Philadelphia, PA | year = 2015 | isbn = 978-1455748013 }}</ref>
::* 1.1 ''' Adult'''
:::* Preferred regimen (1): [[Doxycycline]] 100 mg PO bid for 14-21 days
:::* Preferred regimen (2): [[Tetracycline]] 250  mg PO qid for 14-21 days
:::* Preferred regimen (3): [[Azithromycin]] 500 mg PO as a single dose, followed by 250 mg PO qd for 4 days
:::* Preferred regimen (4): [[Clarithromycin]] 500 mg  PO bid for 10 days
:::* Preferred regimen (5): [[Levofloxacin]] 500 mg IV {{or}} PO qd for 7 to 14 days
:::* Preferred regimen (6): [[Moxifloxacin]] 400 mg PO qd for 10 days. 
::* 1.2 '''Pediatric'''
:::* Preferred regimen (1): [[ Erythromycin]] suspension PO 50 mg/kg/day for 10 to 14 days
:::* Preferred regimen (2): [[ Clarithromycin]] suspension PO 15 mg/kg/day for 10 days
:::* Preferred regimen (3): [[Azithromycin ]]suspension PO 10 mg/kg once on the first day, followed by 5 mg/kg qd daily for 4 days
:* 2. '''Upper respiratory tract infection'''<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
::* 2.1 '''Bronchitis'''
:::* Antibiotic therapy for C. pneumoniae is not required.
::* 2.2 '''Pharyngitis'''
:::* Antibiotic therapy for C. pneumoniae is not required.
::* 2.3 '''Sinusitis'''
:::* Antibiotic therapy is advisable if symptoms remain beyond 7-10 days.

----

==Chlamydia trachomatis==
{{PBI| Chlamydia trachomatis}}
:* 1 '''Chlaymydial infections '''<ref>{{Cite journal| issn = 1545-8601| volume = 64| issue = RR-03| pages = 1–137| last1 = Workowski| first1 = Kimberly A.| last2 = Bolan| first2 = Gail A.| title = Sexually transmitted diseases treatment guidelines, 2015| journal = MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control| date = 2015-06-05| pmid = 26042815}}</ref> 
::* 1.1 '''Chlamydial Infections in Adolescents and Adults'''
:::* Preferred regimen (1): [[Doxycycline]] 100 mg PO bid for 7 days
:::* Preferred regimen (2): [[Azithromycin]] 1 g PO in a single dose
:::* Alternative regimen (1): [[ Erythromycin]] base 500 mg PO qid for 7 days 
:::* Alternative regimen (2): [[Erythromycin]] ethylsuccinate 800 mg PO qid for 7 days
:::* Alternative regimen (3): [[Levofloxacin]] 500 mg PO qd for 7 days
:::* Alternative regimen (4): [[Ofloxacin]] 300 mg PO bid for 7 days. 
:::* Note: Patients should be instructed to refer their sex partners for evaluation, testing, and treatment if they had sexual contact with the patient during the 60 days preceding onset of the patient's symptoms or chlamydia diagnosis.
::* 1.2 '''Chlamydial Infections in patients with HIV Infection'''
:::* Preferred regimen (1): [[Doxycycline]] 100 mg PO bid for 7 days
:::* Preferred regimen (2): [[Azithromycin]] 1 g PO in a single dose
:::* Preferred regimen (3): [[Azithromycin]] 1 g PO in a single dose
:::* Alternative regimen (1): [[ Erythromycin]] base 500 mg PO qid for 7 days
:::* Alternative regimen (2): [[Erythromycin]] ethylsuccinate 800 mg PO  qid for 7 days
:::* Alternative regimen (3): [[Levofloxacin]] 500 mg  PO qd for 7 days 
:::* Alternative regimen (4): [[Ofloxacin]] 300 mg PO bid for 7 days. 
::* 1.3 '''Pregancy'''
:::* Preferred regimen: [[Azithromycin]] 1 g PO in a single dose
:::* Alternative regimen (1): [[ Amoxicillin]]  500 mg PO tid for 7 days
:::* Alternative regimen (2): [[ Erythromycin]] base 500 mg PO qid for 7 days 
:::* Alternative regimen (3): [[Erythromycin]] base 250 mg PO  qid for 14 days
:::* Alternative regimen (4): [[ Erythromycin]] ethylsuccinate 800 mg PO qid for 7 days
:::* Alternative regimen (5): [[Erythromycin]] ethylsuccinate 400 mg PO qid for 14 days
:::* Note:[[ Doxycycline]], [[Ofloxacin]], and [[Levofloxacin]] are contraindicated in pregnant women
::* 1.4 '''Management of sex partners'''
:::* Preferred regimen (1): [[Doxycycline]] 100 mg PO bid for 7 days 
:::* Preferred regimen (2): [[Azithromycin]] 1 g PO in a single dose
:::* Alternative regimen (1): [[ Erythromycin]] base 500 mg PO qid for 7 days 
:::* Alternative regimen (2): [[Erythromycin]] ethylsuccinate 800 mg PO qid for 7 days
:::* Alternative regimen (3): [[Levofloxacin]] 500 mg  PO qd for 7 days 
:::* Alternative regimen (4): [[Ofloxacin]] 300 mg PO bid for 7 days. 
:::* Note (1): Recent sex partners (i.e., persons having sexual contact with the infected patient within the 60 days preceding onset of symptoms or Chlamydia  diagnosis) should be referred for evaluation, testing, and presumptive dual treatment. 
:::* Note (2): If the patient’s last potential sexual exposure was >60 days before onset of symptoms or diagnosis, the most recent sex partner should be treated. 
:::* Note (3): To avoid reinfection, sex partners should be instructed to abstain from unprotected sexual intercourse for 7 days after they and their sexual partner(s) have completed treatment and after resolution of symptoms, if present
:* 2. '''Chlamydial infection among neonates'''
::* 2.1 '''Ophthalmia Neonatorum'''caused by ''C. trachomatis''
:::* Preferred regimen: [[ Erythromycin]]  base or ethylsuccinate 50 mg/kg/ day  PO qid for 14 days
:::* Alternative regimen: [[Azithromycin ]]suspension 20 mg/kg /day PO qd for 3 days
:::* Note: The mothers of infants who have chlamydial infection and the sex partners of these women should be evaluated and treated.
::* 2.2 '''Infant Pneumonia'''
:::* Preferred regimen: [[ Erythromycin]]  base or ethylsuccinate 50 mg/kg/ day  PO qid for 14 days
:::* Alternative regimen: [[Azithromycin ]]suspension 20 mg/kg /day PO qd for 3 days
:* 3.'''Chlamydial infection among infants and childern'''
::* 3.1 '''Infants and childern who weigh < 45 kg'''
:::* Preferred regimen: [[Erythromycin]]  base or ethylsuccinate 50 mg/kg/ day PO qid for 14 days
::* 3.2 '''Infants and childern who weigh ≥45 kg but who are aged <8 years'''
:::* Preferred regimen: [[Azithromycin]] 1 g PO in a single dose
::* 3.3 '''Infants and childern aged  ≥8 years'''
:::* Preferred regimen (1): [[Azithromycin]] 1 g PO in a single dose 
:::* Preferred regimen (2): [[Doxycycline]] 100 mg PO bid for 7 days
:* 4. '''Lymphogranuloma venereum (LGV) '''<ref>{{Cite journal| issn = 1545-8601| volume = 64| issue = RR-03| pages = 1–137| last1 = Workowski| first1 = Kimberly A.| last2 = Bolan| first2 = Gail A.| title = Sexually transmitted diseases treatment guidelines, 2015| journal = MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control| date = 2015-06-05| pmid = 26042815}}</ref>
::* Preferred regimen: [[Doxycycline]] 100 mg PO bid for 21 days
::* Alternative regimen: [[ Erythromycin]] base 500 mg PO qid for 21 days
::* Note (1): [[Azithromycin]] 1 g PO once weekly for 3 weeks is probably effective based on its chlamydial antimicrobial activity. Fluoroquinolone-based treatments might also be effective, but extended treatment intervals are likely required.
::* Note (2): Pregnant and lactating women should be treated with [[Erythromycin]]. [[Azithromycin]] might prove useful for treatment of LGV in pregnancy, but no published data are available regarding its safety and efficacy. [[Doxycycline]] is contraindicated in pregnant women.
::* Note (3): Persons with both LGV and HIV infection should receive the same regimens as those who are HIV negative. Prolonged therapy might be required, and delay in resolution of symptoms might occur.
::* Note (4): Persons who have had sexual contact with a patient who has LGV within the 60 days before onset of the patient’s symptoms should be examined and tested for urethral, cervical, or rectal chlamydial infection depending on anatomic site of exposure. They should be presumptively treated with a chlamydia regimen ( [[Azithromycin]] 1 g PO single dose {{or}} [[Doxycycline]] 100 mg PO bid for 7 days).

----

==Chlamydophila psittaci==
{{PBI|Chlamydophila psittaci}}
:* 1. '''Respiratory psittacosis (Pneumonia)'''<ref>{{cite book | last = Bennett | first = John | title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases | publisher = Elsevier/Saunders | location = Philadelphia, PA | year = 2015 | isbn = 978-1455748013 }}</ref>
::* 1.1 '''Adult'''
:::* Preferred regimen (1): [[Doxycycline]] 100 mg PO bid for 10-21 days
:::* Preferred regimen (2): [[Tetracycline]] 500  mg PO qid for 10-21 days
:::* Alternative regimen: [[Minocycline]]
::* 1.2 '''Pediatric'''
:::* 1.2.1 '''Mild infection, Infants >3 months'''
::::* Preferred regimen: [[Azithromycin ]] 10 mg/kg PO qd on day 1 {{then}} 5 mg/kg PO q24h  for 4 days; (Maximum, 500 mg for 1st dose, 250 mg for subsequent doses)
:::* 1.2.2 '''Moderate-severe infection, Infants  >3 months'''
::::* Preferred regimen: [[Azithromycin ]] 10 mg/kg IV q24h for 2 days {{then}} 5 mg/kg PO qd for 3 days; (Maximum, 500 mg/dose IV; 250 mg/dose PO) 
::* 1.3 '''Pregnant Patients'''
:::* Preferred regimen: [[Azithromycin ]] 500 mg PO on day 1 {{then}} by 250 mg qd on days 2-5  {{or}}  500 mg  IV as a single dose for at least 2 days, followed by 500 mg  PO qd  for 7- 10 days

==Coxiella burnetii==
{{PBI|Coxiella burnetii}}
:* 1. '''Acute Q fever''' <ref>{{cite web | title =q fever | url = http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6203a1.htm   }}</ref>
::* 1.1 '''Adults'''
:::* Preferred Regimen: [[Doxycycline]] 100 mg PO bid for 14 days

::* 1.2 '''Pediatric'''
:::* 1.2.1 '''≥ 8 years old'''
::::* Preferred regimen:[[Doxycycline]] 2.2 mg/kg PO bid for 14 days (Maximum, 100 mg per dose)
:::* 1.2.2 '''< 8 years old with high risk criteria'''
::::* Preferred regimen:[[Doxycycline]] 2.2 mg/kg PO bid for 14 days (Maximum, 100 mg per dose)
:::* 1.2.3 '''< 8 years old with mild or uncomplicated illness'''
::::* Preferred regimen:[[Doxycycline]] 2.2 mg/kg PO bid for 5 days (Maximum, 100 mg per dose) 
::::* Alternative regimen: (If patient remains febrile past 5 days of treatment) [[Trimethoprim/Sulfamethoxazole]] 4-20 mg/kg PO bid for 14 days (Maximum, 800 mg per dose)

::* 1.3 '''Pregnant women'''
:::* Preferred regimen: [[Trimethoprim/sulfamethoxazole]] 160 mg/800 mg PO bid
:::* Note: Should be given throughout pregnancy

:* 2. '''Chronic Q fever'''
::* 2.1 '''Endocarditis or vascular infection'''
:::* Preferred regimen: [[Doxycycline]] 100 mg PO bid {{and}} [[hydroxychloroquine]] 200 mg PO tid for ≥18 months
:::* Note: Childern and pregnant women consultation recommended

::* 2.2 '''Non-cardiac organ disease'''
:::* Preferred regimen: [[Doxycycline]] 100 mg PO bid {{and}} [[hydroxychloroquine]] 200 mg PO tid 
:::* Note: childern and pregnant women consultation recommended

::* 2.3 '''Postpartumwith serologic profile for chronic Q fever'''
:::* Preferred regimen: [[Doxycycline]] 100 mg PO bid {{and}} [[hydroxychloroquine]] 200 mg PO tid for 12 months
:::* Note (1): Women should only be treated postpartum if serologic titers remain elevated >12 months after delivery (immunoglobulin G phase I titer ≥1:1024); Women treated during pregnancy for acute Q fever should be monitored similarly to other patients who are at high risk for progression to chronic disease (e.g., serologic monitoring at 3, 6, 12, 18, and 24 months after delivery)
:::* Note (2): Post-Q fever fatigue syndrome- no current recommendation

----

==Mycoplasma pneumoniae==
{{PBI|Mycoplasma pneumoniae}}
:* 1. '''Atypical pneumonia'''<ref>{{cite book | last = Bennett | first = John | title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases | publisher = Elsevier/Saunders | location = Philadelphia, PA | year = 2015 | isbn = 978-1455748013 }}</ref><ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
::* Preferred regimen (1): [[Azithromycin]] 500 mg PO qd on day 1 and 250 mg PO qd on days 2 to 5
::* Preferred regimen (2): [[Clarithromycin]] 500 mg PO qd for 14 days
::* Preferred regimen (3): [[Moxifloxacin]] 400 mg PO qd for 14 days
::* Preferred regimen (4): [[Levofloxacin]] 750 mg PO qd for 14 days
::* Alternative regimen : [[Doxycycline]] 100 mg PO bid for 14 days

==Mycoplasma genitalium==
{{PBI|Mycoplasma genitalium}}
:* 1. '''Urethritis and cervicitis'''<ref>{{Cite journal| issn = 1545-8601| volume = 64| issue = RR-03| pages = 1–137| last1 = Workowski| first1 = Kimberly A.| last2 = Bolan| first2 = Gail A.| title = Sexually transmitted diseases treatment guidelines, 2015| journal = MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control| date = 2015-06-05| pmid = 26042815}}</ref>
::* Preferred regimen (macrolide-susceptible strains) (1): [[Azithromycin]] 1 g PO as a single dose 
::* Preferred regimen (macrolide-susceptible strains) (2): [[Azithromycin]] 500 mg PO as a dose followed by 250 mg PO qd for 4 days
::* Preferred regimen (for patients with previous treatment failures): [[Moxifloxacin]] 400 mg PO qd for 7–14 days
:* 2. '''Pelvic inflammatory disease (PID)'''<ref>{{Cite journal| issn = 1545-8601| volume = 64| issue = RR-03| pages = 1–137| last1 = Workowski| first1 = Kimberly A.| last2 = Bolan| first2 = Gail A.| title = Sexually transmitted diseases treatment guidelines, 2015| journal = MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control| date = 2015-06-05| pmid = 26042815}}</ref>
::* Preferred regimen: [[Moxifloxacin]] 400 mg PO qd for 14 days
:* 3. '''Specific considerations'''<ref>{{Cite journal| issn = 1545-8601| volume = 64| issue = RR-03| pages = 1–137| last1 = Workowski| first1 = Kimberly A.| last2 = Bolan| first2 = Gail A.| title = Sexually transmitted diseases treatment guidelines, 2015| journal = MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control| date = 2015-06-05| pmid = 26042815}}</ref>
::* 3.1 '''Management of sex partners'''
::* Sex partners should be managed according to guidelines for patients with nongonococcal urethritis, cervicitis, and pelvic inflammatory disease.
::* 3.2 '''HIV infection'''
::* Persons who have an M. genitalium infection and HIV infection should receive the same treatment regimen as those who are HIV negative.

----

====Bacteria – Miscellaneous====  
{{PBI|Gardnerella vaginalis}}
:* 1.'''Bacterial Vaginosis'''<ref>{{Cite journal| issn = 1545-8601| volume = 64| issue = RR-03| pages = 1–137| last1 = Workowski| first1 = Kimberly A.| last2 = Bolan| first2 = Gail A.| title = Sexually transmitted diseases treatment guidelines, 2015| journal = MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control| date = 2015-06-05| pmid = 26042815}}</ref>
::* Gardnerella vaginalis is one of the anaerobic bacteria causing Bacterial Vaginosis,which is a polymicrobial clinical syndrome
:::* Preferred regimen (1): [[Metronidazole]] 500 mg PO bid for 7 days 
:::* Preferred regimen (2): [[Metronidazole]] gel 0.75%, one full applicator (5 g) intravaginally, qd for 5 days 
:::* Preferred regimen (3): [[Clindamycin]] cream 2%, one full applicator (5 g) intravaginally at bedtime for 7 days
:::* Alternative regimen (1): [[Tinidazole]] 2 g PO qd for 2 days 
:::* Alternative regimen (2): [[Tinidazole]] 1 g  PO qd for 5 days 
:::* Alternative regimen (3): [[Clindamycin]] 300 mg  PO bid for 7 days
:::* Alternative regimen (4): [[Clindamycin]] ovules 100 mg intravaginally once at bedtime for 3 days
:::* Note: [[Clindamycin]] ovules use an oleaginous base that might weaken latex or rubber products (e.g., condoms and vaginal contraceptive diaphragms). Use of such products within 72 hours following treatment with clindamycin ovules is not recommended. 
::* 2. '''Management of Sex Partners'''
:::* Routine treatment of sex partners is not recommended.
::* 3. '''Special Considerations''' 
:::* 3.1 '''Allergy, Intolerance, or Adverse Reactions''' 
:::* Intravaginal [[Clindamycin]] cream is preferred in case of allergy or intolerance to [[Metronidazole]] or [[Tinidazole]]. Intravaginal [[Metronidazole]] gel can be considered for women who are not allergic to [[Metronidazole]] but do not tolerate oral metronidazole. It is advised to avoid consuming alcohol during treatment with nitroimidazoles. To reduce the possibility of a disulfiram-like reaction, abstinence from alcohol use should continue for 24 hours after completion of metronidazole or 72 hours after completion of tinidazole.
::* 3.2  '''Pregnancy'''
:::* Preferred regimen (1): [[Metronidazole]] 500 mg PO bid for 7 days 
:::* Preferred regimen (2): [[Metronidazole]] gel 0.75%, one full applicator (5 g) intravaginally, qd for 5 days  
:::* Note: [[Tinidazole]] should be avoided during pregnancy
::*3.3 '''HIV Infection'''
:::* Women with HIV who have BV should receive the same treatment regimen as those who do not have HIV infection.

{{PBI|Eikenella corrodens}}
{{PBI|Bordetella pertussis}}
{{PBI|Bartonella}}
{{PBI|Stenotrophomonas maltophilia}}
{{PBI|Acinetobacter baumannii}}

====Bacteria – Anaerobic Gram-Negative Bacilli====  
{{PBI|Bacteroides fragilis}}
:* [[Bacteroides fragilis]] <ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
::* 1. '''Monotherapy '''
:::* Preferred regimen (1): [[Imipenem]]

:::* Preferred regimen (2): [[Ertapenem]] 

:::* Preferred regimen (3): [[Meropenem]]  

:::* Preferred regimen (4): [[Doripenem]] 0.5-1.0 g IV q6h  

:::* Preferred regimen (5): [[Piperacillin-tazobactam]] 3.375 g IV q6h  

:::* Preferred regimen (6): [[Ampicillin-sulbactam]] 1-2 g IV q6h  

:::* Preferred regimen (7): [[Tigecycline]] 100 mg IV {{then}} 50 mg IV q12h 

::* 2. '''Combination therapy'''
:::* Preferred regimen: [[Metronidazole]] 0.75-1.0 g IV q12h {{and}} [[Cefotaxime]] 1.5-2 g IV q6h {{or}} [[Aztreonam]] 1-2 g IV q8h {{or}} [[Ceftriaxone]] 1 g IV q12h
{{PBI|Fusobacterium necrophorum}}

====Fungi====  

{{PBI|Aspergillosis}}<ref name="pmid18177225">{{cite journal| author=Walsh TJ, Anaissie EJ, Denning DW, Herbrecht R, Kontoyiannis DP, Marr KA et al.| title=Treatment of aspergillosis: clinical practice guidelines of the Infectious Diseases Society of America. | journal=Clin Infect Dis | year= 2008 | volume= 46 | issue= 3 | pages= 327-60 | pmid=18177225 | doi=10.1086/525258 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18177225  }} </ref>
* '''1. Invasive pulmonary aspergillosis'''
:*Preferred regimen: [[Voriconazole]] 6 mg/kg IV q12h single dose, {{then}} 4 mg/kg IV q12h or PO 200 mg q12h
:*Alternative regimen (1): Liposomal [[Amphotericin B]] (L-AMB) 3–5 mg/kg/day IV qd
:*Alternative regimen (2): [[Amphotericin B]] lipid complex (ABLC) 5 mg/ kg/day IV qd
:*Alternative regimen (3): [[Caspofungin]] 70 mg IV single dose {{then}} 50 mg/day IV qd
:*Alternative regimen (4): [[Posaconazole]] 200 mg PO qid if patient is critical, then 400 mg PO bid after stabilization of the disease.
:*Alternative regimen (5): [[Itraconazole]] dosage depends upon formulation - 600 mg/day PO for 3 days, {{then}} 400 mg/day PO {{or}} 200 mg q12h IV for 2 days, {{then}} 200 mg IV qd
:*Alternative regimen (6): [[Micafungin]] 100–150 mg/day PO qd<ref name="pmid24445340">{{cite journal| author=Paramythiotou E, Frantzeskaki F, Flevari A, Armaganidis A, Dimopoulos G| title=Invasive fungal infections in the ICU: how to approach, how to treat. | journal=Molecules | year= 2014 | volume= 19 | issue= 1 | pages= 1085-119 | pmid=24445340 | doi=10.3390/molecules19011085 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24445340  }} </ref><ref name="pmid18177225">{{cite journal| author=Walsh TJ, Anaissie EJ, Denning DW, Herbrecht R, Kontoyiannis DP, Marr KA et al.| title=Treatment of aspergillosis: clinical practice guidelines of the Infectious Diseases Society of America. | journal=Clin Infect Dis | year= 2008 | volume= 46 | issue= 3 | pages= 327-60 | pmid=18177225 | doi=10.1086/525258 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18177225  }} </ref>
:*Note: Micafungin has been evaluated as salvage therapy for invasive aspergillosis but remains investigational for this indication, and the dosage has not been established.

* '''2. Invasive sinus aspergillosis'''
:*Preferred regimen: [[Voriconazole]] 6 mg/kg IV q12h single dose, {{then}} 4 mg/kg IV q12h or PO 200 mg q12h
:*Alternative regimen (1): Liposomal [[Amphotericin B]] (L-AMB) 3–5 mg/kg/day IV qd
:*Alternative regimen (2): [[Amphotericin B]] lipid complex (ABLC) 5 mg/ kg/day IV qd
:*Alternative regimen (3): [[Caspofungin]] 70 mg IV single dose {{then}} 50 mg/day IV qd
:*Alternative regimen (4): [[Posaconazole]] 200 mg PO qid if patient is critical, then 400 mg PO bid after stabilization of the disease.
:*Alternative regimen (5): [[Itraconazole]] dosage depends upon formulation - 600 mg/day PO for 3 days, {{then}} 400 mg/day PO {{or}} 200 mg q12h IV for 2 days, {{then}} 200 mg IV qd
:*Alternative regimen (6): [[Micafungin]] 100–150 mg/day PO qd<ref name="pmid24445340">{{cite journal| author=Paramythiotou E, Frantzeskaki F, Flevari A, Armaganidis A, Dimopoulos G| title=Invasive fungal infections in the ICU: how to approach, how to treat. | journal=Molecules | year= 2014 | volume= 19 | issue= 1 | pages= 1085-119 | pmid=24445340 | doi=10.3390/molecules19011085 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24445340  }} </ref><ref name="pmid18177225">{{cite journal| author=Walsh TJ, Anaissie EJ, Denning DW, Herbrecht R, Kontoyiannis DP, Marr KA et al.| title=Treatment of aspergillosis: clinical practice guidelines of the Infectious Diseases Society of America. | journal=Clin Infect Dis | year= 2008 | volume= 46 | issue= 3 | pages= 327-60 | pmid=18177225 | doi=10.1086/525258 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18177225  }} </ref>
:*Note: Micafungin has been evaluated as salvage therapy for invasive aspergillosis but remains investigational for this indication, and the dosage has not been established.

* '''3. Tracheobronchial aspergillosis'''
:*Preferred regimen: [[Voriconazole]] 6 mg/kg IV q12h single dose, {{then}} 4 mg/kg IV q12h or PO 200 mg q12h
:*Alternative regimen (1): Liposomal [[Amphotericin B]] (L-AMB) 3–5 mg/kg/day IV qd
:*Alternative regimen (2): [[Amphotericin B]] lipid complex (ABLC) 5 mg/ kg/day IV qd
:*Alternative regimen (3): [[Caspofungin]] 70 mg IV single dose {{then}} 50 mg/day IV qd
:*Alternative regimen (4): [[Posaconazole]] 200 mg PO qid if patient is critical, then 400 mg PO bid after stabilization of the disease.
:*Alternative regimen (5): [[Itraconazole]] dosage depends upon formulation - 600 mg/day PO for 3 days, {{then}} 400 mg/day PO {{or}} 200 mg q12h IV for 2 days, {{then}} 200 mg IV qd
:*Alternative regimen (6): [[Micafungin]] 100–150 mg/day PO qd<ref name="pmid24445340">{{cite journal| author=Paramythiotou E, Frantzeskaki F, Flevari A, Armaganidis A, Dimopoulos G| title=Invasive fungal infections in the ICU: how to approach, how to treat. | journal=Molecules | year= 2014 | volume= 19 | issue= 1 | pages= 1085-119 | pmid=24445340 | doi=10.3390/molecules19011085 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24445340  }} </ref><ref name="pmid18177225">{{cite journal| author=Walsh TJ, Anaissie EJ, Denning DW, Herbrecht R, Kontoyiannis DP, Marr KA et al.| title=Treatment of aspergillosis: clinical practice guidelines of the Infectious Diseases Society of America. | journal=Clin Infect Dis | year= 2008 | volume= 46 | issue= 3 | pages= 327-60 | pmid=18177225 | doi=10.1086/525258 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18177225  }} </ref>
:*Note: Micafungin has been evaluated as salvage therapy for invasive aspergillosis but remains investigational for this indication, and the dosage has not been established.

* '''4. Chronic necrotizing pulmonary aspergillosis'''
:*Preferred regimen: [[Voriconazole]] 6 mg/kg IV q12h single dose, {{then}} 4 mg/kg IV q12h or PO 200 mg q12h
:*Alternative regimen (1): Liposomal [[Amphotericin B]] (L-AMB) 3–5 mg/kg/day IV qd
:*Alternative regimen (2): [[Amphotericin B]] lipid complex (ABLC) 5 mg/ kg/day IV qd
:*Alternative regimen (3): [[Caspofungin]] 70 mg IV single dose {{then}} 50 mg/day IV qd
:*Alternative regimen (4): [[Posaconazole]] 200 mg PO qid if patient is critical, then 400 mg PO bid after stabilization of the disease.
:*Alternative regimen (5): [[Itraconazole]] dosage depends upon formulation - 600 mg/day PO for 3 days, {{then}} 400 mg/day PO {{or}} 200 mg q12h IV for 2 days, {{then}} 200 mg IV qd
:*Alternative regimen (6): [[Micafungin]] 100–150 mg/day PO qd<ref name="pmid24445340">{{cite journal| author=Paramythiotou E, Frantzeskaki F, Flevari A, Armaganidis A, Dimopoulos G| title=Invasive fungal infections in the ICU: how to approach, how to treat. | journal=Molecules | year= 2014 | volume= 19 | issue= 1 | pages= 1085-119 | pmid=24445340 | doi=10.3390/molecules19011085 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24445340  }} </ref><ref name="pmid18177225">{{cite journal| author=Walsh TJ, Anaissie EJ, Denning DW, Herbrecht R, Kontoyiannis DP, Marr KA et al.| title=Treatment of aspergillosis: clinical practice guidelines of the Infectious Diseases Society of America. | journal=Clin Infect Dis | year= 2008 | volume= 46 | issue= 3 | pages= 327-60 | pmid=18177225 | doi=10.1086/525258 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18177225  }} </ref>
:*Note: Micafungin has been evaluated as salvage therapy for invasive aspergillosis but remains investigational for this indication, and the dosage has not been established.

* '''5. Aspergillosis of the CNS'''
:*Preferred regimen: [[Voriconazole]] 6 mg/kg IV q12h single dose, {{then}} 4 mg/kg IV q12h or PO 200 mg q12h
:*Alternative regimen (1): Liposomal [[Amphotericin B]] (L-AMB) 3–5 mg/kg/day IV qd
:*Alternative regimen (2): [[Amphotericin B]] lipid complex (ABLC) 5 mg/ kg/day IV qd
:*Alternative regimen (3): [[Caspofungin]] 70 mg IV single dose {{then}} 50 mg/day IV qd
:*Alternative regimen (4): [[Posaconazole]] 200 mg PO qid if patient is critical, then 400 mg PO bid after stabilization of the disease.
:*Alternative regimen (5): [[Itraconazole]] dosage depends upon formulation - 600 mg/day PO for 3 days, {{then}} 400 mg/day PO {{or}} 200 mg q12h IV for 2 days, {{then}} 200 mg IV qd
:*Alternative regimen (6): [[Micafungin]] 100–150 mg/day PO qd<ref name="pmid24445340">{{cite journal| author=Paramythiotou E, Frantzeskaki F, Flevari A, Armaganidis A, Dimopoulos G| title=Invasive fungal infections in the ICU: how to approach, how to treat. | journal=Molecules | year= 2014 | volume= 19 | issue= 1 | pages= 1085-119 | pmid=24445340 | doi=10.3390/molecules19011085 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24445340  }} </ref><ref name="pmid18177225">{{cite journal| author=Walsh TJ, Anaissie EJ, Denning DW, Herbrecht R, Kontoyiannis DP, Marr KA et al.| title=Treatment of aspergillosis: clinical practice guidelines of the Infectious Diseases Society of America. | journal=Clin Infect Dis | year= 2008 | volume= 46 | issue= 3 | pages= 327-60 | pmid=18177225 | doi=10.1086/525258 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18177225  }} </ref>
:*Note: Micafungin has been evaluated as salvage therapy for invasive aspergillosis but remains investigational for this indication, and the dosage has not been established.

:*Note: There are drug interactions with anticonvulsant therapy.

* '''6. Aspergillus infections of the heart (endocarditis, pericarditis, and myocarditis)'''
:*Preferred regimen: [[Voriconazole]] 6 mg/kg IV q12h single dose, {{then}} 4 mg/kg IV q12h or PO 200 mg q12h
:*Alternative regimen (1): Liposomal [[Amphotericin B]] (L-AMB) 3–5 mg/kg/day IV qd
:*Alternative regimen (2): [[Amphotericin B]] lipid complex (ABLC) 5 mg/ kg/day IV qd
:*Alternative regimen (3): [[Caspofungin]] 70 mg IV single dose {{then}} 50 mg/day IV qd
:*Alternative regimen (4): [[Posaconazole]] 200 mg PO qid if patient is critical, then 400 mg PO bid after stabilization of the disease.
:*Alternative regimen (5): [[Itraconazole]] dosage depends upon formulation - 600 mg/day PO for 3 days, {{then}} 400 mg/day PO {{or}} 200 mg q12h IV for 2 days, {{then}} 200 mg IV qd
:*Alternative regimen (6): [[Micafungin]] 100–150 mg/day PO qd<ref name="pmid24445340">{{cite journal| author=Paramythiotou E, Frantzeskaki F, Flevari A, Armaganidis A, Dimopoulos G| title=Invasive fungal infections in the ICU: how to approach, how to treat. | journal=Molecules | year= 2014 | volume= 19 | issue= 1 | pages= 1085-119 | pmid=24445340 | doi=10.3390/molecules19011085 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24445340  }} </ref><ref name="pmid18177225">{{cite journal| author=Walsh TJ, Anaissie EJ, Denning DW, Herbrecht R, Kontoyiannis DP, Marr KA et al.| title=Treatment of aspergillosis: clinical practice guidelines of the Infectious Diseases Society of America. | journal=Clin Infect Dis | year= 2008 | volume= 46 | issue= 3 | pages= 327-60 | pmid=18177225 | doi=10.1086/525258 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18177225  }} </ref>
:*Note: Micafungin has been evaluated as salvage therapy for invasive aspergillosis but remains investigational for this indication, and the dosage has not been established.
:*Note: endocardial lesions generally require surgical treatment. Aspergillus pericarditis usually requires pericardiectomy.

* '''7. Aspergillus osteomyelitis and septic arthritis'''
:*Preferred regimen: [[Voriconazole]] 6 mg/kg IV q12h single dose, {{then}} 4 mg/kg IV q12h or PO 200 mg q12h
:*Alternative regimen (1): Liposomal [[Amphotericin B]] (L-AMB) 3–5 mg/kg/day IV qd
:*Alternative regimen (2): [[Amphotericin B]] lipid complex (ABLC) 5 mg/ kg/day IV qd
:*Alternative regimen (3): [[Caspofungin]] 70 mg IV single dose {{then}} 50 mg/day IV qd
:*Alternative regimen (4): [[Posaconazole]] 200 mg PO qid if patient is critical, then 400 mg PO bid after stabilization of the disease.
:*Alternative regimen (5): [[Itraconazole]] dosage depends upon formulation - 600 mg/day PO for 3 days, {{then}} 400 mg/day PO {{or}} 200 mg q12h IV for 2 days, {{then}} 200 mg IV qd
:*Alternative regimen (6): [[Micafungin]] 100–150 mg/day PO qd<ref name="pmid24445340">{{cite journal| author=Paramythiotou E, Frantzeskaki F, Flevari A, Armaganidis A, Dimopoulos G| title=Invasive fungal infections in the ICU: how to approach, how to treat. | journal=Molecules | year= 2014 | volume= 19 | issue= 1 | pages= 1085-119 | pmid=24445340 | doi=10.3390/molecules19011085 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24445340  }} </ref><ref name="pmid18177225">{{cite journal| author=Walsh TJ, Anaissie EJ, Denning DW, Herbrecht R, Kontoyiannis DP, Marr KA et al.| title=Treatment of aspergillosis: clinical practice guidelines of the Infectious Diseases Society of America. | journal=Clin Infect Dis | year= 2008 | volume= 46 | issue= 3 | pages= 327-60 | pmid=18177225 | doi=10.1086/525258 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18177225  }} </ref>
:*Note: Micafungin has been evaluated as salvage therapy for invasive aspergillosis but remains investigational for this indication, and the dosage has not been established.
:*Note: Surgical resection of devitalized bone and cartilage is important for curative intent.

* '''8. Aspergillus infections of the eye (endophthalmitis and keratitis)'''
:*Preferred regimen: [[Voriconazole]] 6 mg/kg IV q12h single dose, {{then}} 4 mg/kg IV q12h or PO 200 mg q12h
:*Alternative regimen (1): Liposomal [[Amphotericin B]] (L-AMB) 3–5 mg/kg/day IV qd
:*Alternative regimen (2): [[Amphotericin B]] lipid complex (ABLC) 5 mg/ kg/day IV qd
:*Alternative regimen (3): [[Caspofungin]] 70 mg IV single dose {{then}} 50 mg/day IV qd
:*Alternative regimen (4): [[Posaconazole]] 200 mg PO qid if patient is critical, then 400 mg PO bid after stabilization of the disease.
:*Alternative regimen (5): [[Itraconazole]] dosage depends upon formulation - 600 mg/day PO for 3 days, {{then}} 400 mg/day PO {{or}} 200 mg q12h IV for 2 days, {{then}} 200 mg IV qd
:*Alternative regimen (6): [[Micafungin]] 100–150 mg/day PO qd<ref name="pmid24445340">{{cite journal| author=Paramythiotou E, Frantzeskaki F, Flevari A, Armaganidis A, Dimopoulos G| title=Invasive fungal infections in the ICU: how to approach, how to treat. | journal=Molecules | year= 2014 | volume= 19 | issue= 1 | pages= 1085-119 | pmid=24445340 | doi=10.3390/molecules19011085 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24445340  }} </ref><ref name="pmid18177225">{{cite journal| author=Walsh TJ, Anaissie EJ, Denning DW, Herbrecht R, Kontoyiannis DP, Marr KA et al.| title=Treatment of aspergillosis: clinical practice guidelines of the Infectious Diseases Society of America. | journal=Clin Infect Dis | year= 2008 | volume= 46 | issue= 3 | pages= 327-60 | pmid=18177225 | doi=10.1086/525258 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18177225  }} </ref>
:*Note: Micafungin has been evaluated as salvage therapy for invasive aspergillosis but remains investigational for this indication, and the dosage has not been established.
:*Note: Topical therapy is indicated for keratitis, ophthalmologic intervention and management is recommended for all forms of ocular infection. Systemic therapy may be beneficial when treating aspergillus endophthalmitis.

* '''9. Cutaneous aspergillosis'''
:*Preferred regimen: [[Voriconazole]] 6 mg/kg IV q12h single dose, {{then}} 4 mg/kg IV q12h or PO 200 mg q12h
:*Alternative regimen (1): Liposomal [[Amphotericin B]] (L-AMB) 3–5 mg/kg/day IV qd
:*Alternative regimen (2): [[Amphotericin B]] lipid complex (ABLC) 5 mg/ kg/day IV qd
:*Alternative regimen (3): [[Caspofungin]] 70 mg IV single dose {{then}} 50 mg/day IV qd
:*Alternative regimen (4): [[Posaconazole]] 200 mg PO qid if patient is critical, then 400 mg PO bid after stabilization of the disease.
:*Alternative regimen (5): [[Itraconazole]] dosage depends upon formulation - 600 mg/day PO for 3 days, {{then}} 400 mg/day PO {{or}} 200 mg q12h IV for 2 days, {{then}} 200 mg IV qd
:*Alternative regimen (6): [[Micafungin]] 100–150 mg/day PO qd<ref name="pmid24445340">{{cite journal| author=Paramythiotou E, Frantzeskaki F, Flevari A, Armaganidis A, Dimopoulos G| title=Invasive fungal infections in the ICU: how to approach, how to treat. | journal=Molecules | year= 2014 | volume= 19 | issue= 1 | pages= 1085-119 | pmid=24445340 | doi=10.3390/molecules19011085 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24445340  }} </ref><ref name="pmid18177225">{{cite journal| author=Walsh TJ, Anaissie EJ, Denning DW, Herbrecht R, Kontoyiannis DP, Marr KA et al.| title=Treatment of aspergillosis: clinical practice guidelines of the Infectious Diseases Society of America. | journal=Clin Infect Dis | year= 2008 | volume= 46 | issue= 3 | pages= 327-60 | pmid=18177225 | doi=10.1086/525258 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18177225  }} </ref>
:*Note: Micafungin has been evaluated as salvage therapy for invasive aspergillosis but remains investigational for this indication, and the dosage has not been established.
:*Note: Surgical resection is indicated when feasible.

* '''10. Aspergillus peritonitis'''
:*Preferred regimen: [[Voriconazole]] 6 mg/kg IV q12h single dose, {{then}} 4 mg/kg IV q12h or PO 200 mg q12h
:*Alternative regimen (1): Liposomal [[Amphotericin B]] (L-AMB) 3–5 mg/kg/day IV qd
:*Alternative regimen (2): [[Amphotericin B]] lipid complex (ABLC) 5 mg/kg/day IV qd
:*Alternative regimen (3): [[Caspofungin]] 70 mg IV single dose {{then}} 50 mg/day IV qd
:*Alternative regimen (4): [[Posaconazole]] 200 mg PO qid if patient is critical, then 400 mg PO bid after stabilization of the disease.
:*Alternative regimen (5): [[Itraconazole]] dosage depends upon formulation - 600 mg/day PO for 3 days, {{then}} 400 mg/day PO {{or}} 200 mg q12h IV for 2 days, {{then}} 200 mg IV qd
:*Alternative regimen (6): [[Micafungin]] 100–150 mg/day PO qd<ref name="pmid24445340">{{cite journal| author=Paramythiotou E, Frantzeskaki F, Flevari A, Armaganidis A, Dimopoulos G| title=Invasive fungal infections in the ICU: how to approach, how to treat. | journal=Molecules | year= 2014 | volume= 19 | issue= 1 | pages= 1085-119 | pmid=24445340 | doi=10.3390/molecules19011085 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24445340  }} </ref><ref name="pmid18177225">{{cite journal| author=Walsh TJ, Anaissie EJ, Denning DW, Herbrecht R, Kontoyiannis DP, Marr KA et al.| title=Treatment of aspergillosis: clinical practice guidelines of the Infectious Diseases Society of America. | journal=Clin Infect Dis | year= 2008 | volume= 46 | issue= 3 | pages= 327-60 | pmid=18177225 | doi=10.1086/525258 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18177225  }} </ref>
:*Note: Micafungin has been evaluated as salvage therapy for invasive aspergillosis but remains investigational for this indication, and the dosage has not been established.

* '''11. Prophylaxis against invasive aspergillosis'''
:*Preferred regimen: [[Posaconazole]] PO 200 mg tid
:*Alternative regimen: (1) [[Itraconazole]] 200 mg IV bid for 2 days then 200 mg IV qd {{or}} [[Itraconazole]] PO 200mg bid
:*Alternative regimen: (2) [[Micafungin]] 50 mg/day PO qd

* '''12. Aspergilloma'''
:*Preferred regimen: [[Voriconazole]] 6 mg/kg IV q12h single dose, {{then}} 4 mg/kg IV q12h or PO 200 mg q12h
:*Alternative regimen: [[Itraconazole]] dosage depends upon formulation - 600 mg/day PO for 3 days, {{then}} 400 mg/day PO {{or}} 200 mg q12h IV for 2 days, {{then}} 200 mg IV qd

* '''13. Chronic cavitary pulmonary aspergillosis'''
:*Preferred regimen: [[Voriconazole]] 6 mg/kg IV q12h single dose, {{then}} 4 mg/kg IV q12h or PO 200 mg q12h
:*Alternative regimen (1): Liposomal [[Amphotericin B]] (L-AMB) 3–5 mg/kg/day IV qd
:*Alternative regimen (2): [[Amphotericin B]] lipid complex (ABLC) 5 mg/ kg/day IV qd
:*Alternative regimen (3): [[Caspofungin]] 70 mg IV single dose {{then}} 50 mg/day IV qd
:*Alternative regimen (4): [[Posaconazole]] 200 mg PO qid if patient is critical, then 400 mg PO bid after stabilization of the disease.
:*Alternative regimen (5): [[Itraconazole]] dosage depends upon formulation - 600 mg/day PO for 3 days, {{then}} 400 mg/day PO {{or}} 200 mg q12h IV for 2 days, {{then}} 200 mg IV qd
:*Alternative regimen (6): [[Micafungin]] 100–150 mg/day PO qd<ref name="pmid24445340">{{cite journal| author=Paramythiotou E, Frantzeskaki F, Flevari A, Armaganidis A, Dimopoulos G| title=Invasive fungal infections in the ICU: how to approach, how to treat. | journal=Molecules | year= 2014 | volume= 19 | issue= 1 | pages= 1085-119 | pmid=24445340 | doi=10.3390/molecules19011085 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24445340  }} </ref><ref name="pmid18177225">{{cite journal| author=Walsh TJ, Anaissie EJ, Denning DW, Herbrecht R, Kontoyiannis DP, Marr KA et al.| title=Treatment of aspergillosis: clinical practice guidelines of the Infectious Diseases Society of America. | journal=Clin Infect Dis | year= 2008 | volume= 46 | issue= 3 | pages= 327-60 | pmid=18177225 | doi=10.1086/525258 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18177225  }} </ref>
:*Note: Micafungin has been evaluated as salvage therapy for invasive aspergillosis but remains investigational for this indication, and the dosage has not been established.

:*Note: long-term therapy might be needed.

*'''14. Allergic bronchopulmonary Itraconazole aspergillosis'''
:*Preferred regimen: [[Itraconazole]] dosage depends upon formulation - 600 mg/day PO for 3 days, {{then}} 400 mg/day PO {{or}} 200 mg q12h IV for 2 days, {{then}} 200 mg IV qd
:*Alternative regimen (1): [[Voriconazole]] PO 200 mg bid
:*Alternative regimen (2): [[Posaconazole]] PO 400 mg bid
:*Note: Corticosteroids are a cornerstone of the therapy.

*'''15. Allergic aspergillus sinusitis'''
:*Preferred regimen: None or [[Itraconazole]] dosage depends upon formulation - 600 mg/day PO for 3 days, {{then}} 400 mg/day PO {{or}} 200 mg q12h IV for 2 days, {{then}} 200 mg IV qd
:*Note: Few data available for other agents.

*'''16. Relative indications for surgical treatment of invasive aspergillosis'''
:*Pulmonary lesion in proximity to great vessels or pericardium;
:*Pericardial infection;
:*Invasion of chest wall from contiguous pulmonary lesion;
:*Aspergillus empyema;
:*Persistent hemoptysis from a single cavitary lesion;
:*Infection of skin and soft tissues;
:*Infected vascular catheters and prosthetic devices;
:*Endocarditis;
:*Osteomyelitis;
:*Sinusitis;
:*Cerebral lesions.


{{PBI|Blastomycosis}}
*[[Blastomycosis]]<ref name="pmid18462107">{{cite journal| author=Chapman SW, Dismukes WE, Proia LA, Bradsher RW, Pappas PG, Threlkeld MG et al.| title=Clinical practice guidelines for the management of blastomycosis: 2008 update by the Infectious Diseases Society of America. | journal=Clin Infect Dis | year= 2008 | volume= 46 | issue= 12 | pages= 1801-12 | pmid=18462107 | doi=10.1086/588300 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18462107  }} </ref>

:* '''1. Mild to moderate pulmonary blastomycosis'''
::* Preferred regimen: [[Itraconazole]] 200 mg PO qd or bid for 6–12 months 
::* Note: Oral [[Itraconazole]], 200 mg tid PO for 3 days and {{then}} 200 mg PO qd or bid for 6–12 months

:* '''2. Moderately severe to severe pulmonary blastomycosis'''
::* Preferred regimen (1): Lipid [[Amphotericin B]] 3–5 mg/kg IV qd for 1–2 weeks {{and}} [[Itraconazole]] 200 mg PO bid for 6–12 months 
::* Preferred regimen (2): [[Amphotericin B]] deoxycholate 0.7–1 mg/kg IV qd for 1–2 weeks {{and}} [[Itraconazole]] 200 mg PO bid for 6–12 months
::* Note: Oral [[Itraconazole]], 200 mg tid PO for 3 days {{then}} 200 mg PO bid, for a total of 6–12 months

:* '''3. Mild to moderate disseminated blastomycosis'''
::* Preferred regimen: [[Itraconazole]] 200 mg PO qd or bid for 6–12 months 
::* Note (1): Treat osteoarticular disease for 12 months
::* Note (2): Oral [[Itraconazole]], 200 mg PO tid for 3 days {{then}} 200 mg PO bid, for 6–12 months

:* '''4. Moderately severe to severe disseminated blastomycosis'''
::* Preferred regimen (1): Lipid [[Amphotericin B]] 3–5 mg/kg IV qd, for 1–2 weeks {{and}} [[Itraconazole]] 200 mg PO bid for 6–12 months 
::* Preferred regimen (2): [[Amphotericin B]] deoxycholate 0.7–1 mg/kg IV qd, for 1–2 weeks {{and}} [[Itraconazole]] 200 mg PO bid for 6–12 months
::* Note: oral [[Itraconazole]], 200 mg PO tid for 3 days {{then}} 200 mg PO bid, for 6–12 months

:* '''5. CNS disease''' 
::* Preferred regimen: Lipid [[Amphotericin B]] 5 mg/kg IV qd for 4–6 weeks {{and}} an oral azole for at least 1 year 
::* Note (1): Step-down therapy can be with [[Fluconazole]], 800 mg/day PO qd or bid {{or}} [[Itraconazole]], 200 mg bid or tid {{or}} voriconazole, 200–400 mg bid.
::* Note (2): Longer treatment may be required for immunosuppressed patients. 

:* '''6. Immunosuppressed patients''' 
::* Preferred regimen (1): Lipid [[Amphotericin B]] 3–5 mg/kg IV qd, for 1–2 weeks, {{and}} [[Itraconazole]], 200 mg PO bid for 12 months 
::* Preferred regimen (2): [[Amphotericin B]] deoxycholate, 0.7–1 mg/kg IV qd, for 1–2 weeks, {{and}} [[Itraconazole]], 200 mg PO bid for 12 months
::* Note (1): Oral [[Itraconazole]], 200 mg PO tid for 3 days {{then}} 200 mg PO bid, for 12 months
::* Note (2): Life-long suppressive treatment may be required if immunosuppression cannot be reversed. 

:* '''7. Pregnant women'''
::* Preferred regimen: Lipid [[Amphotericin B]] 3–5 mg/kg IV qd
::* Note (1): Azoles should be avoided because of possible teratogenicity 
::* Note (2): If the newborn shows evidence of infection, treatment is recommended with Amphotericin B deoxycholate, 1.0 mg/kg IV qd 

:* '''8. Children with mild to moderate disease''' 
::* Preferred regimen: [[Itraconazole]] 10 mg/kg PO qd for 6–12 months 
::* Note: Maximum dose 400 mg/day

:* '''9. Children with moderately severe to severe disease'''
::* Preferred regimen (1): Amphotericin B deoxycholate 0.7–1 mg/kg IV qd for 1–2 weeks {{and}} [[Itraconazole]] 10 mg/kg PO qd to a maximum of 400 mg/day for 6–12 months 
::* Preferred regimen (2): Lipid amphotericin B (Lipid AmB) 3–5 mg/kg IV qd for 1–2 weeks {{and}} [[Itraconazole]] 10 mg/kg PO qd to a maximum of 400 mg/day for 6–12 months 
::* Note: Children tolerate Amphotericin B deoxycholate better than adults do.


{{PBI|Paracoccidioidomycosis}}

:* Preferred regimen (1): <ref name="pmid16906260">{{cite journal| author=Shikanai-Yasuda MA, Telles Filho Fde Q, Mendes RP, Colombo AL, Moretti ML| title=[Guidelines in paracoccidioidomycosis]. | journal=Rev Soc Bras Med Trop | year= 2006 | volume= 39 | issue= 3 | pages= 297-310 | pmid=16906260 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16906260  }} </ref>
::* Adults: [[Itraconazole]] 200 mg/day PO
::* Children: [[Itraconazole]] (<30/kg and >5 yr) 5-10 mg/kg/day PO
::*Note: Treatment duration based on organ involvement:
:::*Mild involvement: 6-9 months
:::*Moderate involvement: 12-18 months
:* Preferred regimen (2): <ref name="pmid16906260">{{cite journal| author=Shikanai-Yasuda MA, Telles Filho Fde Q, Mendes RP, Colombo AL, Moretti ML| title=[Guidelines in paracoccidioidomycosis]. | journal=Rev Soc Bras Med Trop | year= 2006 | volume= 39 | issue= 3 | pages= 297-310 | pmid=16906260 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16906260  }} </ref>
::* Adults [[Trimethoprim/sulfamethoxazole]] (TMP/SMX)  TMP: 160-240 mg/day PO/IV, SMX: 800-1200 mg/day PO/IV bid
::* Children [[Trimethoprim/sulfamethoxazole]] (TMP/SMX) TMP: 8-10 mg/kg PO/IV, SMX: 40-50 mg/kg PO/IV, bid
::* Note (1): Treatment duration based on organ involvement:
:::* Minor involvement: 12 months 
:::* Moderate involvement: 18-24 months
::*Note (2): Preferred treatment in children due to larger experience.
::*Note (3): Preferred in IV formulation in severe forms of the disease - 2 ampules IV tid until patient condition improves so that oral medication can be given.
:* Preferred regimen (3): [[Amphotericin B]] deoxycholate 1 mg/kg/day IV until patient improves and can be treated by the oral route.<ref name="pmid16906260">{{cite journal| author=Shikanai-Yasuda MA, Telles Filho Fde Q, Mendes RP, Colombo AL, Moretti ML| title=[Guidelines in paracoccidioidomycosis]. | journal=Rev Soc Bras Med Trop | year= 2006 | volume= 39 | issue= 3 | pages= 297-310 | pmid=16906260 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16906260  }} </ref>
::*Note: Preferred in severe forms of the disease.<ref name="pmid16906260">{{cite journal| author=Shikanai-Yasuda MA, Telles Filho Fde Q, Mendes RP, Colombo AL, Moretti ML| title=[Guidelines in paracoccidioidomycosis]. | journal=Rev Soc Bras Med Trop | year= 2006 | volume= 39 | issue= 3 | pages= 297-310 | pmid=16906260 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16906260  }} </ref>
:* Alternative regimen (4): [[Ketoconazole]] 200-400 mg/day PO for 9-12 months<ref>{{cite book | last = Bennett | first = John | title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases | publisher = Elsevier/Saunders | location = Philadelphia, PA | year = 2015 | isbn = 978-1455748013 }}</ref>
:* Alternative regimen (5): [[Voriconazole]] initial dose 400 mg PO/IV q12h for one day, then 200 mg q12h for 6 months<ref>{{cite book | last = Bennett | first = John | title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases | publisher = Elsevier/Saunders | location = Philadelphia, PA | year = 2015 | isbn = 978-1455748013 }}</ref>
::* Note: Diminish the dose to 50% if weight is <40 kg.

{{PBI|Candidiasis}}:*'''1. Candidemia'''<ref name="pmid19191635">{{cite journal| author=Pappas PG, Kauffman CA, Andes D, Benjamin DK, Calandra TF, Edwards JE et al.| title=Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America. | journal=Clin Infect Dis | year= 2009 | volume= 48 | issue= 5 | pages= 503-35 | pmid=19191635 | doi=10.1086/596757 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19191635  }} </ref>
::*'''1.1. Nonneutropenic adults'''
:::*Preferred regimen (1): [[Fluconazole]] 800 mg (12 mg/kg) loading dose, {{then}} 400 mg (6 mg/kg) daily
:::*Preferred regimen (2): [[Caspofungin]] 70 mg loading dose, {{then}} 50 mg daily
:::*Preferred regimen (3): [[Micafungin]] 100 mg daily
:::*Preferred regimen (4): [[Anidulafungin]] 200 mg loading dose, {{then}} 100 mg daily
:::*Alternative regimen (1): Lipid formulation of amphotericin B(LFAmB) 3–5 mg/kg daily
:::*Alternative regimen (2): Amphotericin B deoxycholate(AmB-d) 0.5–1.0 mg/kg daily
:::*Alternative regimen (3): [[Voriconazole]] 400 mg (6 mg/kg) PO/IV bid for 2 doses, {{then}} 200 mg (3 mg/kg) bid 
:::*Note (1): Echinocandin includes Anidulafungin, Micafungin and Caspofungin.
:::*Note (2): Choose an echinocandin for moderately severe to severe illness and for patients with recent azole exposure.
:::*Note (3): Treat for 14 days after first negative blood culture result and resolution of signs and symptoms associated with candidemia.
:::*Note (4): Ophthalmological examination recommended for all patients.

::*'''1.2. Neutropenic patients'''
:::*Preferred regimen (1): [[Caspofungin]] 70 mg loading dose, {{then}} 50 mg daily
:::*Preferred regimen (2): [[Micafungin]] 100 mg daily
:::*Preferred regimen (3): [[Anidulafungin]] 200 mg loading dose, {{then}} 100 mg daily
:::*Preferred regimen (4): Lipid formulation of amphotericin B(LFAmB) 3–5 mg/kg daily
:::*Alternative regimen (1): [[Fluconazole]] 800 mg (12 mg/kg) loading dose, {{then}} 400 mg (6 mg/kg) daily
:::*Alternative regimen (2): [[Voriconazole]] 400 mg (6 mg/kg) bid for 2 doses, {{then}} 200 mg (3 mg/kg) bid
:::*Note: Fluconazole is recommended for patients without recent azole exposure and who are not critically ill.

:*'''2. Suspected candidiasis treated with empiric antifungal therapy'''<ref name="pmid19191635">{{cite journal| author=Pappas PG, Kauffman CA, Andes D, Benjamin DK, Calandra TF, Edwards JE et al.| title=Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America. | journal=Clin Infect Dis | year= 2009 | volume= 48 | issue= 5 | pages= 503-35 | pmid=19191635 | doi=10.1086/596757 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19191635  }} </ref>
::*'''2.1. Nonneutropenic patients'''
:::*Preferred regimen (1): [[Fluconazole]] 800 mg (12 mg/kg) loading dose, {{then}} 400 mg (6 mg/kg) daily
:::*Preferred regimen (2): [[Caspofungin]] 70 mg loading dose, {{then}} 50 mg daily
:::*Preferred regimen (3): [[Micafungin]] 100 mg daily
:::*Preferred regimen (4): [[Anidulafungin]] 200 mg loading dose, {{then}} 100 mg daily
:::*Alternative regimen (1): Lipid formulation of amphotericin B(LFAmB) 3–5 mg/kg daily
:::*Alternative regimen (2): Amphotericin B deoxycholate(AmB-d) 0.5–1.0 mg/kg daily
:::*Note (1): Duration of therapy is uncertain, but should be discontinued if cultures and/or serodiagnostic tests have negative results.
:::*Note (2): Echinocandin includes Anidulafungin, Micafungin and Caspofungin.
:::*Note (3): Echinocandin is preferred for patients with recent azole exposure, patients with moderately severe to severe illness, or patients who are at high risk of infection due to C. glabrata or C. krusei. 
:::*Note (4): Empirical antifungal therapy should be considered in critically ill patients with risk factors for invasive candidiasis and no other known cause of fever and should be based on clinical assessment of risk factors, serologic markers for invasive candidiasis, and/or culture data from nonsterile sites

::*'''2.2. Neutropenic patients'''
:::*Preferred regimen (1): Lipid formulation of amphotericin B(LFAmB) 3–5 mg/kg daily
:::*Preferred regimen (2): [[Caspofungin]] 70 mg loading dose, {{then}} 50 mg daily
:::*Preferred regimen (3): [[Voriconazole]] 400 mg (6 mg/kg) bid for 2 doses, {{then}} 200 mg (3 mg/kg) bid
:::*Alternative regimen (1): [[Fluconazole]] 800 mg (12 mg/kg) loading dose, {{then}} 400 mg (6 mg/kg) daily
:::*Alternative regimen (2): [[Itraconazole]] 200 mg (3 mg/ kg) bid
:::*Note (1): In most neutropenic patients, it is appropriate to initiate empiric antifungal therapy after 4 days of persistent fever despite antibiotics.
:::*Note (2): Do not use an azole in patients with prior azole prophylaxis.

:*'''3. Urinary tract infection'''<ref name="pmid19191635">{{cite journal| author=Pappas PG, Kauffman CA, Andes D, Benjamin DK, Calandra TF, Edwards JE et al.| title=Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America. | journal=Clin Infect Dis | year= 2009 | volume= 48 | issue= 5 | pages= 503-35 | pmid=19191635 | doi=10.1086/596757 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19191635  }} </ref>
::*'''3.1. Asymptomatic cystitis'''
:::*Preferred regimen: Therapy not usually indicated, unless patients are at high risk (e.g., neonates and neutropenic adults) or undergoing urologic procedures.
:::*Note (1): Elimination of predisposing factors recommended
:::*Note (2): For high-risk patients, treat as for disseminated candidiasis
:::*Note (3): For patients undergoing urologic procedures, fluconazole, 200–400 mg (3–6 mg/kg) daily or Amphotericin B deoxycholate(AmB-d) 0.3–0.6 mg/kg daily for several days before and after the procedure.

::*'''3.2. Symptomatic cystitis'''
:::*Preferred regimen: [[Fluconazole]] 200 mg (3 mg/kg) daily for 2 weeks
:::*Alternative regimen (1): Amphotericin B deoxycholate(AmB-d) 0.3–0.6 mg/kg for 1–7 days
:::*Alternative regimen (2): [[Flucytosine]] 25 mg/kg qid for 7–10 days
:::*Note: Amphotericin B deoxycholate(AmB-d) bladder irrigation is recommended only for patients with refractory fluconazole-resistant organisms (e.g., Candida krusei and Candida glabrata).

::*'''3.3 Pyelonephritis'''
:::*Preferred regimen (1): [[Fluconazole]] 200–400 mg (3–6 mg/kg) daily for 2 weeks
:::*Alternative regimen (1): Amphotericin B deoxycholate(AmB-d) 0.5–0.7 mg/kg daily {{withorwithout}} [[Flucytosine]] (5-FC) 25 mg/kg qid
:::*Alternative regimen (2): [[Flucytosine]] (5-FC) 25 mg/kg qid for 2 weeks
:::*Note: For patients with pyelonephritis and suspected disseminated candidiasis, treat as for candidemia.

:*'''4. Urinary fungus balls'''<ref name="pmid19191635">{{cite journal| author=Pappas PG, Kauffman CA, Andes D, Benjamin DK, Calandra TF, Edwards JE et al.| title=Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America. | journal=Clin Infect Dis | year= 2009 | volume= 48 | issue= 5 | pages= 503-35 | pmid=19191635 | doi=10.1086/596757 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19191635  }} </ref>
::*Preferred regimen (1): Surgical removal strongly recommended
::*Preferred regimen (2): [[Fluconazole]] 200–400 mg (3–6 mg/kg) daily
::*Preferred regimen (3): Amphotericin B deoxycholate(AmB-d) 0.5–0.7 mg/kg daily {{withorwithout}} [[Flucytosine]] (5-FC) 25 mg/kg qid
::*Note (1): Local irrigation with Amphotericin B deoxycholate(AmB-d) may be a useful adjunct to systemic antifungal therapy.
::*Note (2):  Treatment duration should be until symptoms have resolved and urine cultures no longer yield Candida species.

:*'''5. Vulvovaginal candidiasis'''<ref name="pmid19191635">{{cite journal| author=Pappas PG, Kauffman CA, Andes D, Benjamin DK, Calandra TF, Edwards JE et al.| title=Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America. | journal=Clin Infect Dis | year= 2009 | volume= 48 | issue= 5 | pages= 503-35 | pmid=19191635 | doi=10.1086/596757 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19191635  }} </ref>
::*Preferred regimen (1): [[Butoconazole]] 2% cream 5 g intravaginally for 3 days
::*Preferred regimen (2): [[Butoconazole]] 2% cream 5 g (butoconazole1-sustained release), single intravaginal application 
::*Preferred regimen (3): [[Clotrimazole]] 1% cream 5 g intravaginally for 7–14 days
::*Preferred regimen (4): [[Clotrimazole]] 100-mg vaginal tablet for 7 days
::*Preferred regimen (5): [[Clotrimazole]] 100-mg vaginal tablet, 2 tablets for 3 days
::*Preferred regimen (6): [[Miconazole]] 2% cream 5 g intravaginally for 7 days
::*Preferred regimen (7): [[Miconazole]] 100-mg vaginal suppository, 1 suppository for 7 days
::*Preferred regimen (8): [[Miconazole]] 200-mg vaginal suppository, 1 suppository for 3 days
::*Preferred regimen (9): [[Miconazole]] 1200-mg vaginal suppository, 1 suppository for 1 day
::*Preferred regimen (10): [[Nystatin]] 100,000-unit vaginal tablet, 1 tablet for 14 days
::*Preferred regimen (11): [[Tioconazole]] 6.5% ointment 5 g intravaginally in a single application
::*Preferred regimen (12): [[Terconazole]] 0.4% cream 5 g intravaginally for 7 days
::*Preferred regimen (13): [[Terconazole]] 0.4% cream 5 g intravaginally for 3 days
::*Preferred regimen (14): [[Terconazole]] 80-mg vaginal suppository, 1 suppository for 3 days
::*Preferred regimen (15): [[Fluconazole]] 150 mg single dose for uncomplicated vaginitis
::*Note: For recurring Candida Vulvovaginal candidiasis (VVC), 10–14 days of induction therapy with a topical or oral azole, followed by fluconazole at a dosage of 150 mg once per week for 6 months, is recommended

:*'''6. Chronic disseminated candidiasis'''<ref name="pmid19191635">{{cite journal| author=Pappas PG, Kauffman CA, Andes D, Benjamin DK, Calandra TF, Edwards JE et al.| title=Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America. | journal=Clin Infect Dis | year= 2009 | volume= 48 | issue= 5 | pages= 503-35 | pmid=19191635 | doi=10.1086/596757 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19191635  }} </ref>
::*Preferred regimen (1): [[Fluconazole]] 400 mg (6 mg/kg) daily for stable patients
::*Preferred regimen (2): Lipid formulation of amphotericin B(LFAmB) 3–5 mg/kg daily for severely ill patients 
::*Preferred regimen (3): Amphotericin B deoxycholate(AmB-d) 0.5–0.7 mg/kg daily for severely ill patients
::*Alternative regimen (1): [[Caspofungin]] 70 mg loading dose, {{then}} 50 mg daily, followed by oral [[Fluconazole]] when clinically appropriate
::*Alternative regimen (2): [[Micafungin]] 100 mg daily, followed by oral [[Fluconazole]] when clinically appropriate
::*Alternative regimen (3): [[Anidulafungin]] 200 mg loading dose, {{then}} 100 mg daily, followed by oral [[Fluconazole]] when clinically appropriate
::*Note (1): Transition from Lipid formulation of amphotericin B(LFAmB) or Amphotericin B deoxycholate(AmB-d) to fluconazole is favored after several weeks in stable patients.
::*Note (2): Duration of therapy is until lesions have resolved (usually months) and should continue through periods of immunosuppression (e.g., chemotherapy and transplantation).
::*Note (3): Therapy should be continued for weeks to months, until calcification occurs or lesions resolve.

:*'''7. Candida osteoarticular infection'''<ref name="pmid19191635">{{cite journal| author=Pappas PG, Kauffman CA, Andes D, Benjamin DK, Calandra TF, Edwards JE et al.| title=Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America. | journal=Clin Infect Dis | year= 2009 | volume= 48 | issue= 5 | pages= 503-35 | pmid=19191635 | doi=10.1086/596757 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19191635  }} </ref>
::*'''7.1. Osteomyelitis'''
:::*Preferred regimen (1): [[Fluconazole]] 400 mg (6 mg/kg) daily for 6–12 months
:::*Preferred regimen (2): Lipid formulation of amphotericin B(LFAmB) 3–5 mg/kg daily for at least 2 weeks, then [[Fluconazole]] 400 mg daily for 6–12 months
:::*Alternative regimen (1): [[Caspofungin]] 70 mg loading dose, {{then}} 50 mg daily for at least 2 weeks followed by [[Fluconazole]] at a dosage of 400 mg daily for 6–12 months
:::*Alternative regimen (2): [[Micafungin]] 100 mg daily for at least 2 weeks followed by [[Fluconazole]] at a dosage of 400 mg daily for 6–12 months
:::*Alternative regimen (3): [[Anidulafungin]] 200 mg loading dose, {{then}} 100 mg daily for at least 2 weeks followed by [[Fluconazole]] at a dosage of 400 mg daily for 6–12 months
:::*Alternative regimen (4): Amphotericin B deoxycholate(AmB-d) 0.5–1.0 mg/kg daily followed by [[Fluconazole]] at a dosage of 400 mg daily for 6–12 months
:::*Note (1): Duration of therapy usually is prolonged (6–12 months)
:::*Note (2): Surgical debridement is frequently necessary

::*'''7.2. Septic arthritis'''
:::*Preferred regimen (1): [[Fluconazole]] 400 mg (6 mg/kg) for at least 6 weeks
:::*Preferred regimen (2): Lipid formulation of amphotericin B (LFAmB) 3–5 mg/kg daily for at least 2 weeks followed by [[Fluconazole]] at a dosage of 400 mg daily
:::*Alternative regimen (1): [[Caspofungin]] 70 mg loading dose, {{then}} 50 mg daily for at least 2 weeks followed by [[Fluconazole]] at a dosage of 400 mg daily
:::*Alternative regimen (2): [[Micafungin]] 100 mg daily for at least 2 weeks followed by [[Fluconazole]] at a dosage of 400 mg daily
:::*Alternative regimen (3): [[Anidulafungin]] 200 mg loading dose, {{then}} 100 mg daily for at least 2 weeks followed by [[Fluconazole]] at a dosage of 400 mg daily
:::*Note (1): Duration of therapy usually is for at least 6 weeks, but few data are available.
:::*Note (2): Surgical debridement is recommended for all cases.
:::*Note (3): For infected prosthetic joints, removal is recommended for most cases.

:*'''8. CNS candidiasis'''<ref name="pmid19191635">{{cite journal| author=Pappas PG, Kauffman CA, Andes D, Benjamin DK, Calandra TF, Edwards JE et al.| title=Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America. | journal=Clin Infect Dis | year= 2009 | volume= 48 | issue= 5 | pages= 503-35 | pmid=19191635 | doi=10.1086/596757 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19191635  }} </ref>
::*Preferred regimen (1): Lipid formulation of amphotericin B(LFAmB) at a dosage of 3–5 mg/kg daily {{withorwithout}} [[Flucytosine]] at a dosage of 25 mg/kg qid for several weeks followed by [[Fluconazole]] 400–800 mg (6–12 mg/kg) daily
::*Alternative regimen (1): [[Fluconazole]] 400–800 mg (6–12 mg/ kg) daily for patients unable to tolerate Lipid formulation of amphotericin B (LFAmB)
::*Note (1): Treat until all signs and symptoms, CSF abnormalities, and radiologic abnormalities have resolved.
::*Note (2): Removal of intraventricular devices is recommended.

:*'''9. Candida endophthalmitis'''<ref name="pmid19191635">{{cite journal| author=Pappas PG, Kauffman CA, Andes D, Benjamin DK, Calandra TF, Edwards JE et al.| title=Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America. | journal=Clin Infect Dis | year= 2009 | volume= 48 | issue= 5 | pages= 503-35 | pmid=19191635 | doi=10.1086/596757 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19191635  }} </ref>
::*Preferred regimen (1): Amphotericin B deoxycholate(AmB-d) 0.7–1 mg/kg {{and}} [[Flucytosine]] 25 mg/ kg qid
::*Preferred regimen (2): [[Fluconazole]] 400–800 mg daily (loading dose of 12 mg/kg then 6–12 mg/kg daily) is an acceptable alternative for less severe endophthalmitis
::*Alternative regimen (1): Lipid formulation of amphotericin B(LFAmB) at a dosage of 3–5 mg/kg daily
::*Alternative regimen (2): [[Voriconazole]] 6 mg/kg q12h for 2 doses, then 3–4 mg/kg q12h
::*Alternative regimen (3): [[Caspofungin]] 70 mg loading dose, {{then}} 50 mg daily
::*Alternative regimen (4): [[Micafungin]] 100 mg daily
::*Alternative regimen (5): [[Anidulafungin]] 200 mg loading dose, {{then}} 100 mg daily
::*Note (1): Alternative therapy is recommended for patients intolerant of or experiencing failure of Amphotericin B and Flucytosine therapy
::*Note (2): Duration of therapy is at least 4–6 weeks as determined by repeated examinations to verify resolution.
::*Note (3): Diagnostic vitreal aspiration should be done if etiology unknown.
::*Note (4): Fluconazole at a dosage of 400–800 mg daily (loading dose of 12 mg/kg then 6–12 mg/kg daily) is an acceptable alternative for less severe endophthalmitis
::*Note (5): Surgical intervention for patients with severe endophthalmitis or vitreitis 

:*'''10. Candida infection of the cardiovascular system'''<ref name="pmid19191635">{{cite journal| author=Pappas PG, Kauffman CA, Andes D, Benjamin DK, Calandra TF, Edwards JE et al.| title=Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America. | journal=Clin Infect Dis | year= 2009 | volume= 48 | issue= 5 | pages= 503-35 | pmid=19191635 | doi=10.1086/596757 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19191635  }} </ref>
::*'''10.1. Endocarditis'''
:::*Preferred regimen (1): Lipid formulation of amphotericin B(LFAmB) at a dosage of 3–5 mg/kg daily {{withorwithout}} [[Flucytosine]] at a dosage of 25 mg/kg qid
:::*Preferred regimen (2): Amphotericin B deoxycholate AmB-d 0.6–1 mg/kg daily {{withorwithout}} [[Flucytosine]] 25 mg/kg qid
:::*Preferred regimen (3): [[Caspofungin]] 50–150 mg daily
:::*Preferred regimen (4): [[Micafungin]]  100–150 mg daily
:::*Preferred regimen (5): [[Anidulafungin]]  100–200 mg daily
:::*Alternative regimen (1): Step-down therapy to [[Fluconazole]] 400–800 mg (6–12 mg/kg) daily for susceptible organism in stable patient with negative blood culture results
:::*Note (1): Valve replacement is strongly recommended.
:::*Note (2): For those who are unable to undergo surgical removal of the valve, chronic suppression with fluconazole 400–800 mg (6–12 mg/kg) daily is recommended.
:::*Note (3): Lifelong suppressive therapy for prosthetic valve endocarditis if valve cannot be replaced is recommended.

::*'''10.2. Pericarditis or myocarditis'''
:::*Preferred regimen (1): Lipid formulation of amphotericin B (LFAmB) at a dosage of 3–5 mg/kg daily
:::*Preferred regimen (2): [[Fluconazole]] 400–800 mg (6–12 mg/kg) daily
:::*Preferred regimen (3): [[Caspofungin]] 50–150 mg daily
:::*Preferred regimen (4): [[Micafungin]] 100–150 mg daily
:::*Preferred regimen (5): [[Anidulafungin]] 100–200 mg daily
:::*Alternative regimen (1): After stable, step-down therapy to [[Fluconazole]] 400–800 mg (6–12 mg/kg) daily
:::*Note(1): Therapy is often for several months, but few data are available
:::*Note(2): A pericardial window or pericardiectomy is recommended.

::*'''10.3. Suppurative thrombophlebitis'''
:::*Preferred regimen (1): Lipid formulation of amphotericin B (LFAmB) at a dosage of 3–5 mg/kg daily
:::*Preferred regimen (2): [[Fluconazole]] 400–800 mg (6–12 mg/kg) daily
:::*Preferred regimen (3): [[Caspofungin]] 50–150 mg daily
:::*Preferred regimen (4): [[Micafungin]] 100–150 mg daily
:::*Preferred regimen (5): [[Anidulafungin]] 100–200 mg daily
:::*Alternative regimen (1): After stable, step-down therapy to [[Fluconazole]] 400–800 mg (6–12 mg/kg) daily
:::*Note(1): Surgical incision and drainage or resection of the vein is recommended if feasible.
:::*Note(2): Treat for at least 2 weeks after candidemia has cleared.

::*'''10.4. Infected pacemaker, ICD, or VAD'''
:::*Preferred regimen (1): Lipid formulation of amphotericin B(LFAmB) at a dosage of 3–5 mg/kg daily {{withorwithout}} [[Flucytosine]] at a dosage of 25 mg/kg qid
:::*Preferred regimen (2): Amphotericin B deoxycholate (AmB-d) 0.6–1 mg/kg daily {{withorwithout}} [[Flucytosine]] 25 mg/kg qid
:::*Preferred regimen (3): [[Caspofungin]] 50–150 mg daily
:::*Preferred regimen (4): [[Micafungin]]  100–150 mg daily
:::*Preferred regimen (5): [[Anidulafungin]]  100–200 mg daily
:::*Alternative regimen (1): Step-down therapy to [[Fluconazole]] 400–800 mg (6–12 mg/kg) daily for susceptible organism in stable patient with negative blood culture results
:::*Note(1): Removal of pacemakers and ICDs strongly recommended.
:::*Note(2): Treat for 4–6 weeks after the device removed.
:::*Note(3): For VAD that cannot be removed, chronic suppressive therapy with fluconazole is recommended.

:*'''11. Neonatal candidiasis'''<ref name="pmid19191635">{{cite journal| author=Pappas PG, Kauffman CA, Andes D, Benjamin DK, Calandra TF, Edwards JE et al.| title=Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America. | journal=Clin Infect Dis | year= 2009 | volume= 48 | issue= 5 | pages= 503-35 | pmid=19191635 | doi=10.1086/596757 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19191635  }} </ref>
::*Preferred regimen (1): Amphotericin B deoxycholate (AmB-d) 1 mg/kg daily for 3 weeks
::*Preferred regimen (2): [[Fluconazole]] 12 mg/kg daily for 3 weeks
::*Alternative regimen (1): Lipid formulation of amphotericin B (LFAmB) 3–5 mg/kg daily for 3 weeks
::*Note (1): A lumbar puncture and dilated retinal examination should be performed on all neonates with suspected invasive candidiasis.
::*Note (2): Intravascular catheter removal is strongly recommended.
::*Note (3): Duration of therapy is at least 3 weeks.
::*Note (4): Lipid formulation of amphotericin B (LFAmB) used only if there is no renal involvement.
::*Note (5): Echinocandins should be used with caution when other agents cannot be used.

:*'''12. Candida isolated from respiratory secretions'''<ref name="pmid19191635">{{cite journal| author=Pappas PG, Kauffman CA, Andes D, Benjamin DK, Calandra TF, Edwards JE et al.| title=Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America. | journal=Clin Infect Dis | year= 2009 | volume= 48 | issue= 5 | pages= 503-35 | pmid=19191635 | doi=10.1086/596757 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19191635  }} </ref>
::*Preferred regimen (1): Therapy not recommended
::*Note (1): Candida lower respiratory tract infection is rare and requires histopathologic evidence to confirm a diagnosis.

:*'''13. Nongenital mucocutaneous candidiasis'''<ref name="pmid19191635">{{cite journal| author=Pappas PG, Kauffman CA, Andes D, Benjamin DK, Calandra TF, Edwards JE et al.| title=Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America. | journal=Clin Infect Dis | year= 2009 | volume= 48 | issue= 5 | pages= 503-35 | pmid=19191635 | doi=10.1086/596757 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19191635  }} </ref>
::* '''13.1. Oropharyngeal'''
:::*Preferred regimen (1): [[Clotrimazole]] troches 10 mg 5 times daily
:::*Preferred regimen (2): [[Nystatin]] suspension at a concentration of 100,000 U/mL and a dosage of 4–6 mL qid {{or}} 1–2 [[Nystatin]] pastilles (200,000 U each) administered qid for 7–14 days
:::*Preferred regimen (3): [[Fluconazole]] 100–200 mg PO (3 mg/kg) daily for 7–14 days
:::*Alternative regimen (1): [[Itraconazole]] solution 200 mg daily
:::*Alternative regimen (2): [[Posaconazole]] suspension at a dosage of 400 mg twice daily for 3 days, {{then}} 400 mg daily for up to 28 days
:::*Alternative regimen (3): [[Voriconazole]] 200 mg bid
:::*Alternative regimen (4): Amphotericin B deoxycholate (AmB-d) 1-mL oral suspension administered at a dosage of 100 mg/mL qid
:::*Alternative regimen (5): [[Caspofungin]] 70 mg IV loading dose, {{then}} 50 mg daily
:::*Alternative regimen (6): [[Micafungin]] 100 mg IV daily
:::*Alternative regimen (7): [[Anidulafungin]] 200 mg IV loading dose, {{then}} 100 mg daily
:::*Alternative regimen (8): Amphotericin B deoxycholate (AmB-d) 0.3 mg/kg daily
:::*Note(1): [[Fluconazole]] is recommended for moderate-to-severe disease, and topical therapy with clotrimazole or nystatin is recommended for mild disease.
:::*Note(2): Treat uncomplicated disease for 7–14 days.
:::*Note(3): For refractory disease, itraconazole, voriconazole, posaconazole, or AmB suspension is recommended.

::*'''13.2. Esophageal'''
:::*Preferred regimen (1): Fluconazole 200–400 mg  (3–6 mg/kg) PO daily
:::*Preferred regimen (2): [[Caspofungin]] 70 mg IV loading dose, {{then}} 50 mg daily
:::*Preferred regimen (3): [[Micafungin]] 100 mg IV daily
:::*Preferred regimen (4): [[Anidulafungin]] 200 mg IV loading dose, {{then}} 100 mg daily
:::*Preferred regimen (4): AmB-d 0.3–0.7 mg/kg daily
:::*Alternative regimen (1): [[Itraconazole]] oral solution 200 mg daily
:::*Alternative regimen (2): [[Posaconazole]] 400 mg bid
:::*Alternative regimen (3): [[Voriconazole]] 200 mg bid
:::*Note(1): Oral fluconazole is preferred.
:::*Note(2): For patients unable to tolerate an oral agent, IV fluconazole, an echinocandin, or AmB-d is appropriate.
:::*Note(3): Treat for 14–21 days.
:::*Note(4): For patients with refractory disease, the alternative therapy as listed or AmB-d or an echinocandin is recommended.


{{PBI|Chromoblastomycosis}}<ref name="pmid25395928">{{cite journal| author=Krzyściak PM, Pindycka-Piaszczyńska M, Piaszczyński M| title=Chromoblastomycosis. | journal=Postepy Dermatol Alergol | year= 2014 | volume= 31 | issue= 5 | pages= 310-21 | pmid=25395928 | doi=10.5114/pdia.2014.40949 | pmc=PMC4221348 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25395928  }} </ref>
:*Preferred regimen: [[Itraconazole]] 200-400 mg PO q24h {{or}} 400 mg pulse therapy once daily for 1 week monthly for 6-12 months
:*Note: Pulse therapy reduces cost but it is questionable if it produces resistance to the drug.
:*Alternative regimen (1): [[Terbinafine]] 500-1000 mg PO qd for 6-12 months
:*Alternative regimen (2): [[Posaconazole]] 800 mg PO qd for 6-12 months
:*Alternative regimen (3): [[5-fluorocytosine]] 100-150 mg/kg/day PO qd for 6-12 months
:*Note: This disease has a low cure ratio and high relapse ratio. Physical treatment is needed to achieve better results:
::*Cryosurgery with liquid nitrogen - most used physical therapy, it's used in localized lesions and it has a very good treatment response, probably achieved by immune mechanisms since fungi are eliminated from lesions as late as 1-2 weeks after the therapy.
::*Thermotherapy - used in conjunction with systemic therapy, was developed by Japanese authors and consists in placing "pocket warmers" in the lesions for 24h/day for some months, as the fungi is sensible to heat.
::*Laser vaporization - studied in Germany as an alternative therapy, reported to successfully treat relapsing lesions.


{{PBI|Coccidioidomycosis}}
:* 1. '''Primary pulmonary infection'''  <ref name="pmid16206093">{{cite journal| author=Galgiani JN, Ampel NM, Blair JE, Catanzaro A, Johnson RH, Stevens DA et al.| title=Coccidioidomycosis. | journal=Clin Infect Dis | year= 2005 | volume= 41 | issue= 9 | pages= 1217-23 | pmid=16206093 | doi=10.1086/496991 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16206093  }} </ref>
::* 1.1 '''Indications for antifungal therapy'''
::::* Immunosupression (AIDS, therapy with high dose corticosteroids, receiptients of TNF-alpha, receiptients of an organ transplant)
::::* Diabetes
::::* Preexisting cardiomyopathy
::::* Pregnancy (third trimester)
::::* Filipino or African
::::* Weight loss of > 10%
::::* Intense night sweats persisting longer than 3 weeks
::::* Infiltrates involving more than one-half of one lung or portions of both lungs
::::* Prominent or persistent hilar adenopathy
::::* Anticoccidiodial complement-fixing antibody concentrations in excess of 1:16
::* 1.2 '''Patients with low risk of complications or dissemination'''
::::* For many (if not most) patients, management may rely on periodic reassessment of symptoms and radiographic findings to assure resolution without antifungal treatment.
::* 1.3 '''Patients with high risk of complications or dissemination'''
:::* 1.3.1 '''Mild to moderate pneumonia'''
::::* Preferred regimen (1): [[Itraconazole]] solution 200 mg PO bid or IV q12h
::::* Preferred regimen (2): [[Fluconazole]] 400 mg PO q24h for 3–12 months
:::* 1.3.2 '''Locally severe or disseminated pneumonia'''
::::* Preferred regimen: ([[Amphotericin B]] 0.6–1 mg/kg PO qd every 7 days {{then}} 0.8 mg/kg PO every other day {{or}} [[Liposomal Amphotericin B]] 3-5 mg/kg IV q24 hrs {{or}} [[Amphotericin B lipid complex]] 5 mg/kg IV q24 hrs until clinical improvement) followed by [[Itraconazole]] {{or}} [[Fluconazole]] for at least 1 year.
::::* Note (1): Some use combination of Amphotericin B and Fluconazole for progressive severe disease; controlled series lacking.
::::* Note (2): Consultation with specialist recommendation, surgery may be required.

:* 2. '''Meningitis'''
::* 2.1 '''Adult'''
::::* Preferred regimen: [[Fluconazole]] 400–1,000 mg PO q24h indefinitely.
::::* Alternative regimen: [[Amphotericin B]] 3-5 mg/kg IV q24 hrs {{plus}} 0.1–0.3 mg qd intrathecal (intraventricular) via reservoir device {{or}} [[Itraconazole]] 400–800 mg q24h {{or}} [[Voriconazole]]
::::* Note: Some use combination of [[Amphotericin B]] and [[Fluconazole]] for progressive severe disease; controlled series lacking.
::* 2.2 '''Child'''
::::* Preferred regimen: [[Fluconazole]] PO (Pediatric dose not established, 6 mg per kg q24h used)
::::* Alternative regimen: [[Amphotericin B]] 3-5 mg/kg IV q24 hrs {{plus}} 0.1–0.3 mg daily intrathecal (intraventricular) via reservoir device {{or}} itra 400–800 mg q24h {{or}} [[Voriconazole]]

:* 3. '''Special considerations for HIV/AIDS patients'''<ref>{{ cite web | title = Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents | url = https://aidsinfo.nih.gov/contentfiles/lvguidelines/AdultOITablesOnly.pdf }}</ref>
::* 3.1 '''Clinically mild infections (e.g., focal pneumonia)'''
:::* Preferred regimen: [[Fluconazole]] 400 mg PO daily {{or}} [[Itraconazole]] 200 mg PO bid
:::* Alternative regimen (unresponsive to Fluconazole or Itraconazole): [[Posaconazole]] 200 mg PO bid {{or}} [[Voriconazole]] 200 mg PO bid
:::* Note: Itraconazole, posaconazole, and voriconazole may have significant interactions with certain antiretro viral agents. These interactions are complex and can be bi-directional
::* 3.2 '''Severe, non-meningeal infection (diffuse pulmonary infection or severely ill patients with extrathoracic, disseminated disease)'''
:::* 3.2.1 Preferred regimen: [[Amphotericin B]] deoxycholate 0.7–1.0 mg/kg IV q12hrs {{or}} Lipid formulation [[Amphotericin B]] 4–6 mg/kg IV q24hrs. Duration of therapy: continue until clinical improvement, then switch to an azole.
:::* 3.2.2 Alternative regimen: Some specialists will add a triazole ([[Fluconazole]] or [[Itraconazole]], with [[Itraconazole]] (preferred for bone disease) 400 mg per day to [[Amphotericin B]] therapy and continue triazole once [[Amphotericin B]] is stopped
:::* Note (1): Therapeutic drug monitoring and dosage adjustment may be necessary to ensure triazole antifungal and antiretroviral efficacy and reduce concentration-related toxicities.
:::* Note (2): Therapy should be continued indefinitely in patients with diffuse pulmonary or disseminated diseases because relapse can occur in 25%–33% of HIV-negative patients. It can also occur in HIV-infected patients with CD4 counts >250 cells/μL
::* 3.3 '''Meningeal Infections'''
:::* Preferred regimen: [[Fluconazole]] 400–800 mg IV or PO daily
:::* Alternative regimen: [[Itraconazole]] 200 mg PO tid for 3 days {{then}} 200 mg PO bid {{or}} [[Posaconazole]] 200 mg PO bid {{or}} [[Voriconazole]] 200–400 mg PO bid {{or}} Intrathecal [[Amphotericin B]] deoxycholate when triazole antifungals are ineffective.
:::* Note (1): Intrathecal amphotericin B should only be given in consultation with a specialist and administered by an individual with experience with the technique.
:::* Note (2): Some patients with meningitis may develop hydrocephalus and require CSF shunting
:::* Note (3): Therapy should be lifelong in patients with meningeal infections because relapse occurs in 80% of HIV-infected patients after discontinuation of triazole therapy
::* 3.4 '''Chronic Suppressive Therapy'''
:::* Preferred regimen (1): [[Fluconazole]] 400 mg PO qd
:::* Preferred regimen (2): [[Itraconazole]] 200 mg PO bid
:::* Alternative regimen (1): [[Posaconazole]] 200 mg PO bid
:::* Alternative regimen (2): [[Voriconazole]] 200 mg PO bid


{{PBI|Cryptococcosis}}
{{PBI|Cryptococcus}}
:* 1. '''Cryptococcus neoformans'''
::* 1.1 '''Cryptococcus neoformans meningitis in HIV infected patients'''<ref name="pmid20047480">{{cite journal| author=Perfect JR, Dismukes WE, Dromer F, Goldman DL, Graybill JR, Hamill RJ et al.| title=Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the infectious diseases society of america. | journal=Clin Infect Dis | year= 2010 | volume= 50 | issue= 3 | pages= 291-322 | pmid=20047480 | doi=10.1086/649858 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20047480  }} </ref>
:::*Preferred regimen for induction and consolidation: ([[Amphotericin B]] deoxycholate 0.7-1.0 mg/kg IV qd (consider using lipid formulations for patients with renal dysfunction) {{or}} [[Liposomal AmB]] 3-4mg/kg IV qd {{or}} [[Amphotericin B]] lipid complex (ABLC) 5mg/kg IV qd) {{plus}} [[Flucytosine]] 100mg/kg/day PO or IV qid for at least 2 weeks followed by [[Fluconazole]] 400mg (6mg/kg) PO qd for at least 8 weeks.
:::*Alternative regimen for induction and consolidation (1): [[Amphotericin B]] deoxycholate 0.7-1.0 mg/kg IV qd {{or}} [[Liposomal AmB]] 3-4 mg/kg IV qd {{or}} AmB lipid complex 5mg/kg IV qd for 4-6 weeks
:::*Alternative regimen for induction and consolidation (2): [[Amphotericin B]] deoxycholate 0.7 mg/kg IV qd {{plus}} [[Fluconazole]] 800mg PO qd for 2 weeks, followed by [[Fluconazole]] 800mg PO qd for at least 8 weeks
:::*Alternative regimen for induction and consolidation (3): [[Fluconazole]] (>800 mg PO qd, 1200mg PO qd is favored) {{plus}} [[Flucytosine]] (100mg/kg/day PO qid) for 6 weeks
:::*Alternative regimen for induction and consolidation (4): [[Fluconazole]] PO 800-2000mg qd for 10-12 weeks
:::*Preferred regimen for maintenance and prophylactic therapy: Initiate HAART 2-10 weeks after commencing initial antifungal therapy {{and}} [[Fluconazole]] 200mg PO qd
:::*Alternative regimen for maintenance and prophylactic therapy: [[Itraconazole]] 200mg PO bid - monitor drug-level {{or}} [[Amphotericin B]] deoxycholate (1 mg/kg) per week IV (should be used in azole-intolerant patients).
:::* Note (1): Consider discontinuing supressive therapy if CD4 count is higher than 100 cells/uL {{and}} undetectable {{or}} very low HIV RNA level for more than 3 months. Consider reinstitution of maintenance therapy if CD4 count <100 cels/uL.
:::* Note (2): Do not use [[acetazolamide]] {{or}} [[mannitol]] {{or}} [[corticosteroids]] to treat increased intracranial pressure, instead it should be used lombar puncture in the absence of focal neurologic signs or impaired mentation (which, if present, patient must be submitted to CT or MRI scan first).

::'''1.2. Cerebral cryptococcomas'''
:::*Preferred regimen for induction and consolidation: ([[Amphotericin B]] deoxycholate 0.7-1.0 mg/kg IV qd (consider using lipid formulations for patients with renal dysfunction) {{or}} [[Liposomal AmB]] 3-4mg/kg IV qd {{or}} [[Amphotericin B]] lipid complex (ABLC) 5mg/kg IV qd) {{plus}} [[Flucytosine]] 100mg/kg/day PO or IV qid for at least 2 weeks followed by [[Fluconazole]] 400mg (6mg/kg) PO qd for at least 8 weeks
:::*Note: Consider surgery if lesions are larger than 3cm, accessible lesions with mass effect or lesions that are enlarging and not explained by IRIS.

::'''1.3. Cryptococcus neoformans meningitis in HIV negative patients'''
:::*Preferred regimen: [[Amphotericin B deoxycholate]] 0.7-1.0 mg/kg IV qd {{plus}} [[Flucytosine]] 100mg/kg/day PO or IV qid for at least 4 weeks (which may be extended to 6 weeks if there is any neurological complication) followed by [[Fluconazole]] 400mg PO qd for 8 weeks. If there's toxicity to AmBd, consider changing to LFAmB in the second 2 weeks. 
:::*Note (1): After induction and consolidation therapy, start [[Fluconazole]] 200mg (3mg/kg) PO qd for 6-12 months.
:::*Note (2): If [[Flucytosine]] is not given, consider lengthening the induction therapy for at least 2 weeks.

::'''1.4. Cryptococcus neoformans pulmonary disease - immunosupressed'''
:::*Mild-moderate symptoms, without severe immunosupression and absence of diffuse pulmonary infiltrates:
::::*Preferred regimen: [[Fluconazole]] 400mg PO qd for 6-12 months
:::*Severe pneumonia or disseminated disease or CNS infection:
::::*Preferred regimen: treat like CNS cryptococcosis.
:::*Note (1): In HIV- infected patients, treatment should be stopped after 1 year if CD4 count is >100 and a cryptococcal antigen titer is <1:512 and not increasing.
:::*Note (2): Consider [[corticosteroid]] if [[ARDS]] is present in a context which it might be attributed to [[IRIS]].

::'''1.5 Cryptococcus neoformans pulmonary disease - non-immunosupressed'''
:::*Mild-moderate symptoms, without severe immunosupression and absence of diffuse pulmonary infiltrates:
::::*Preferred regimen: [[Fluconazole]] 400mg PO qd for 6-12 months
::::*Alternative regimen: if [[Fluconazole]] is unavailable or contraindicated, [[Itraconazole]] 200mg PO bid, [[Voriconazole]] 200 mg PO bid, and [[Posaconazole]] 400mg PO bid
:::*If there's severe pneumonia, disseminated disease or CNS infection:
::::*Preferred regimen: treat like CNS cryptococcosis for 6-12 months.

::'''1.6 Cryptococcus neoformans non-lung, non-CNS infection'''
:::*Cryptococcemia or disseminated cryptococcic disease  (involvement of at least 2 noncontiguous sites or cryptococcal antigen titer >1:512):
::::*Preferred regimen: treat like CNS infection. 
:::*If infection occurs at a single site and no immunosupressive risk factors
::::*Preferred regimen: [[Fluconazole]] 400mg PO qd for 6-12 months

::'''1.7. Cryptococcosis in Children'''
::::*Preferred regimen for induction and consolidation: [[Amphotericin B]] deoxycholate 1.0 mg/kg qd IV {{plus}} [[Flucytosine]] 100mg/kg PO or IV qid for 2 weeks followed by [[Fluconazole]] 10-12mg/kg PO qd for 8 weeks
::::*Alternative regimen: patients with renal dysfunction: change [[Amphotericin B]] deoxycholate by [[Liposomal AmB]] 5mg/kg IV qd or [[Amphotericin B]] lipid complex (ABLC) 5mg/kg IV qd
::::*Preferred regimen for maintenance: Fluconazole 6mg/kg PO qd. Discontinuation of maintenance therapy is poorly studied and should be individualized.
:::*Cryptococcal pneumonia:
::::*Preferred regimen Fluconazole 6-12mg/kg PO qd for 6-12 months

::'''1.8. Cryptococcosis in Pregnant Women'''
:::*Preferred regimen for induction and consolidation: [[Amphotericin B]] deoxycholate 0.7-1.0 mg/kg IV qd (consider using lipid formulations for patients with renal dysfunction - [[Liposomal AmB]] 3-4mg/kg IV qd {{or}} [[Amphotericin B]] lipid complex (ABLC) 5mg/kg IV qd. Consider using [[Flucytosine]] in relationship to benefit risk basis, since it is a Category C drug for pregnancy. Start [[Fluconazole]] after delivery. Avoid use during first trimester and consider use in the last 2 trimesters with the need for continuous antifungal therapy during pregnancy. 
:::*Note: If pulmonary cryptococcosis: perform close follow-up and administer fluconazole after delivery.

:'''2. Cryptococcus gatti'''
::*Disseminated cryptococcosis or CNS disease:
:::*Preferred regimen: treatment is the same as C. neoformans. 
::*Pulmonary disease: single and small cryptococcoma:
:::*Preferred regimen: [[Fluconazole]] 400mg per day PO for 6-18months
::*Pulmonary disease: Very large or multiple cryptococcomas:
:::*Preferred regimen: administer [[Flucytosine]] {{and}} [[AmB deocycholate]] for 4-6 weeks, followed by fluconazole for 6-18 months.
:::*Note: Surgery should be considered if there is compression of vital structures {{or}} failure to reduce the size of the cryptococcoma after 4 weeks of therapy
----

{{PBI|Tinea cruris}}
:*'''Tinea Cruris'''<ref>{{cite book | last = Bennett | first = John | title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases | publisher = Elsevier/Saunders | location = Philadelphia, PA | year = 2015 | isbn = 978-1455748013 }}</ref>
::* Preferred regimen: Interdigital: Topical cream/ointment: [[terbinafine]], [[imidazoles]] ([[miconazole]], [[econazole]], [[clotrimazole]]), [[Griseofulvin]] 250mg tid PO for 14 days should be used in resistant to topic therapy cases.
----

{{PBI|Tinea corporis}}
:* '''Tinea Corporis'''
::*2.1 Small, well-defined lesions:
:::* Preferred regimen: Topical cream/ointment: [[terbinafine]], [[imidazoles]] ([[miconazole]], [[econazole]], [[clotrimazole]]).
::*2.2 Larger lesions:
:::*Preferred regimen: Larger lesions: [[terbinafine]] PO 250mg/day for 2 weeks; [[itraconazole]] PO 200mg/day for 1 week, [[fluconazole]] PO 250mg weekly for 2-4 weeks.
----

{{PBI|Tinea pedis}}
:*'''1. Tinea Pedis'''
::*Preferred regimen: Interdigital: Topical cream/ointment: [[terbinafine]], [[imidazoles]] ([[miconazole]], [[econazole]], [[clotrimazole]]), [[undecenoic acid]], [[tolnaftate]].
::*Note (1): If "Dry type": Oral: [[terbinafine]] PO 250mg/day for 2-4 weeks, [[itraconazole]] PO 400mg/day for 1 week per month (repeat if necessary), [[fluconazole]] PO 200mg weekly for 4-8 weeks.

----

{{PBI|Tinea capitis}}
:*'''Tinea Capitis'''
::*Preferred regimen: [[Griseofulvin]] PO 10-20mg/kg/day for at least 6 weeks (Preferred for children).
::*Alternative regimens: [[Terbinafine]] PO 62.5mg/day if <20kg; 125 mg/day if 20-40kg; 250mg/day if >40kg {{or}} [[Itraconazole]] PO 4-6mg/kg pulsed dose weekly.
:::*Note: [[Nistatin]] is not effective in the treatment of dermatophytosis.
----

{{PBI|Tinea barbae}}
:*'''Tinea Barbae'''
::*Preferred regimen: [[Terbinafine]] PO 250mg/day for 4 weeks.
::*Alternative regimen: [[Itraconazole]] PO 200mg/day for 2 weeks.
----

{{PBI|Tinea incognito}}
:*'''Tinea Incognito'''
::*Preferred regimen: Stop topical [[steroids]] and treat with topical 1% [[terbinafine]] cream for 6 weeks.
----

{{PBI|Tinea manuum}}
:*'''Tinea Manuum'''
::*Preferred regimen: topical or systemic [[terbinafine]] PO 250 mg/day por 2-4 weeks.
----

{{PBI|Tinea versicolor}}
:*'''Tinea Versicolor'''
::*Preferred regimen: [[Itraconazole]] 200mg daily for a week.
::*Alternative regimen: [[Ketoconazole]] 200mg daily for 4 weeks.
----

{{PBI|Majocchi's granuloma}}
:*'''Majocchi's Granuloma'''
::*Preferred regimen: [[Terbinafine]] PO 250mg/day for 2-4 weeks.
::*Alternative regimen: [[Itraconazole]] 200mg PO bid for 1 week, per month for 2 months.
----

{{PBI|Onychomycosis}}
:*'''Onychomycosis'''<ref name="pmid19439745">{{cite journal| author=de Berker D| title=Clinical practice. Fungal nail disease. | journal=N Engl J Med | year= 2009 | volume= 360 | issue= 20 | pages= 2108-16 | pmid=19439745 | doi=10.1056/NEJMcp0804878 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19439745  }} </ref>
:::*10.1 Fingernails
::::*Preferred regimen: [[Terbinafine]] PO 250mg/day for 6 weeks {{or}} [[Itraconazole]] PO 200mg twice a day for a week a month for 2 months (European guidelines).
:::*10.2 Toenails
::::*Preferred regimen: Toenails [[Terbinafine]] PO 250mg/day for 12 weeks {{or}} [[Itraconazole]] PO 200mg/day for 12 weeks (U.S. guidelines) {{or}} [[Itraconazole]] PO 200mg twice a day for a week a month for 3 months (European guidelines).
:::*Note (1): There is no evidence that combining systemic and topic treatments has any benefit to the patient.

----

{{PBI|Histoplasmosis}}
:* 1. '''Adult treatment:''' <ref name="pmid17806045">{{cite journal| author=Wheat LJ, Freifeld AG, Kleiman MB, Baddley JW, McKinsey DS, Loyd JE et al.| title=Clinical practice guidelines for the management of patients with histoplasmosis: 2007 update by the Infectious Diseases Society of America. | journal=Clin Infect Dis | year= 2007 | volume= 45 | issue= 7 | pages= 807-25 | pmid=17806045 | doi=10.1086/521259 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17806045  }} </ref>
::* 1.1 '''Pulmonary'''
:::* 1.1.1 '''Acute pulmonary histoplasmosis'''
::::* 1.1.1.1 '''Moderate severe or severe'''
:::::* Preferred regimen (1): Lipid formulation of [[Amphotericin B]] (3.0–5.0 mg/kg IV q12h for 1–2 weeks) {{then}} [[Itraconazole]] (200 mg tid for 3 days {{then}} 200 mg bid for a total of 12 weeks).
:::::* Preferred regimen (2): [[Methylprednisolone]] (0.5–1.0 mg/kg IV q24h) during the first 1–2 weeks of antifungal therapy is recommended for patients who develop respiratory complications, including hypoxemia or significant respiratory distress
:::::* Alternative regimen: The deoxycholate formulation of [[Amphotericin B]] (0.7–1.0 mg/kg q24h IV) is an alternative to a lipid formulation in patients who are at a low risk for nephrotoxicity.
:::::* Note (1): In severe cases, cases accompanied by respiratory insufficiency, or hypoxemia, anecdotal reports suggest that corticosteroid therapy may hasten recovery
:::::* Note (2): The pulmonary infiltrates should be resolved on the chest radiograph before antifungal therapy is stopped.
::::* 1.1.1.2 '''Mild to moderate:'''
:::::* Treatment is usually unnecessary
:::::* Preferred regimen for patients who continue to have symptoms for >1 month: [[Itraconazole]] (200 mg tid for 3 days {{then} 200 mg qd {{or}} bid for 6–12 weeks)
:::::* Note (1): Antifungal treatment is unnecessary in patients with mild symptoms caused by acute pulmonary histoplasmosis

:::* 1.1.2 '''Chronic cavitary pulmonary histoplasmosis:'''
::::* Preferred regimen: [[Itraconazole]] (200 mg tid for 3 days and {{then}} qd or bid for at least 1 year) is recommended
::::* Note (1): Blood levels of itraconazole should be obtained after the patient has been receiving this agent for at least 2 weeks to ensure adequate drug exposure
::::* Note (2): Patients with underlying emphysema often develop progressive pulmonary disease, which is characterized by cavities with surrounding inflammation after infection with hysotplasma capsulatum

:::* 1.1.3 '''Broncholithiasis'''
::::* Antifungal treatment is not recommended
::::* Note: Bronchoscopic or surgical removal of the broncholith is recommended

:::* 1.1.4 '''Pulmonary nodules (Histoplasmomas)'''
::::* Antifungal treatment is not recommended**
::::* Note: There is no evidence that antifungal agents have any effect on histoplasmomas or that histoplasmomas contain viable organisms.

::* 1.2 '''Mediastinitis'''

:::* 1.2.1 '''Mediastinal lymphadenitis'''
::::* 1.2.1.1 '''Asymptomatic cases'''
:::::* Treatment is usually unnecessary
::::* 1.2.1.2 '''Patients who have symptoms that warrant treatment with corticosteroids and in those who continue to have symptoms for > 1 month'''
:::::* [[Itraconazole]] (200 mg 3 tid for 3 days and {{then}} 200 mg qd or bid for 6–12 weeks)
::::* 1.2.1.2 '''Severe cases with obstruction or compression of contiguous structures'''
:::::* Preferred regimen: [[Prednisone]] (0.5–1.0 mg/kg qd [maximum 80 mg qd] in tapering doses over 1–2 weeks)
:::::* Note (1): Antifungal treatment is unnecessary in most patients with symptoms due to mediastinal lymphadenitis
:::::* Note (2): Itraconazole is recommended for 6–12 weeks to reduce the risk of progressive disseminated disease caused by corticosteroid-induced immunosuppression in patients who are given corticosteroids and in patients whose symptoms last longer than 1 month.

:::* 1.2.2 '''Mediastinal granuloma'''
::::* 1.2.2.1 '''Asymptomatic cases'''
:::::* Treatment is usually unnecessary
::::* 1.2.2.2 '''Symptomatic cases'''
:::::* Preferred regimen: [[Itraconazole]] (200 mg 3 times qd for 3 days and {{then}} qd or bid for 6–12 weeks)
:::::* Note (1): [[Itraconazole]] is appropriate for symptomatic cases but there are no controlled trials to prove its efficacy.
:::::* Note (2): There is no evidence that mediastinal granuloma evolves into mediastinal fibrosis. Thus treatment with either surgery or itraconazole should not be used to prevent the development of mediastinal fibrosis

:::* 1.2.3 '''Mediastinal fibrosis'''
::::* Antifungal treatment is not recommended**
:::* 1.2.3.1 '''If clinical findings cannot differentiate mediastinal fibrosis from mediastinal granuloma'''
::::* Preferred regimen: [[Itraconazole]] (200 mg qd or bid for 12 weeks)
::::* Note: The placement of intravascular stents is recommended for selected patients with pulmonary vessel obstruction
::::* Note (2): Mediastinal fibrosis is characterized by invasive fibrosis that encases mediastinal or hilar nodes and that is defined by occlusion of central vessels and airways

::* 1.3 '''Pericarditis:'''
:::* 1.3.1 '''Mild cases'''
::::* Preferred regimen: Nonsteroidal anti-inflammatory therapy
:::* 1.3.2 '''Patients with evidence of hemodynamic compromise or unremitting symptoms after several days of therapy with nonsteroidal anti-inflammatory therapy'''
::::* [[Prednisone]] (0.5–1.0 mg/kg qd [maximum, 80 mg qd] in tapering doses over 1–2 weeks)
:::* 1.3.3 '''If corticosteroids are administered'''
::::* Preferred regimen: [[Itraconazole]] (200 mg tid for 3 days and {{then}} qd or bid for 6–12 weeks)
::::* Note (1): Pericardial fluid removal is indicated for patients with hemodynamic compromise.
::::* Note (2): Pericarditis occurs as a complication of inflammation in adjacent mediastinal lymph nodes in patients with acute pulmonary histoplasmosis.

::* 1.4 '''Central nervous system histoplasmosis'''
:::* Preferred regimen: Liposomal [[Amphotericin B]] (5.0 mg/kg qd for a total of 175 mg/kg given over 4–6 weeks) followed by [[Itraconazole]] (200 mg 2 or 3 times qd) for at least 1 year and until resolution of cerebro spinal fluid abnormalities including Histoplasma antigen levels.
:::* Note: Blood levels of Itraconazole should be obtained to ensure adequate drug exposure

::* 1.5 '''Rheumatologic syndromes'''
:::* 1.5.1 '''Mild cases'''
::::* Preferred regimen: Nonsteroidal anti-inflammatory therapy
:::* 1.5.2 '''Severe cases'''
::::* Preferred regimen: [[Prednisone]] (0.5–1.0 mg/kg qd [maximum, 80 mg qd] in tapering doses over 1–2 weeks)
:::* 1.5.3 '''Corticosteroids administration'''
::::* [[Itraconazole]] (200 mg 3 times tid for 3 days and {{then}} qd or bid for 6–12 weeks)
::::* Note (1): If corticosteroids are used, concurrent itraconazole treatment is recommended to reduce the risk of progressive infection
::::* Note (2): Bone or joint involvement is very rare in progressive disseminated histoplasmosis but it should not be overlooked.

::* 1.6 '''Progressive disseminated histoplasmosis'''
:::* 1.6.1 '''Moderately severe to severe disease'''
::::* Preferred regimen: Liposomal [[Amphotericin B]] (3.0 mg/kg qd) is recommended for 1–2 weeks followed by oral [[Itraconazole]] (200 mg 3 times qd for 3 days and {{then}} 200 mg bid for a total of at least 12 months)
::::* Note (1): Substitution of another lipid formulation at a dosage of 5.0 mg/kg qd may be preferred in some patients because of cost or tolerability
::::* Note (2): The deoxycholate formulation of Amphotericin B (0.7–1.0 mg/kg qd) is an alternative to a lipid formulation in patients who are at a low risk for nephrotoxicity
:::* 1.6.2 '''Immunosupressed patients'''
::::* Lifelong suppressive therapy with [[Itraconazole]] (200 mg qd)
:::* 1.6.3 '''Mild to moderate disease'''
::::* [[Itraconazole]] (200 mg tid for 3 days and then bid qid for at least 12 months)
::::* Note (1): Lifelong suppressive therapy with itraconazole (200 mg daily) may be required in immunosuppressed patients if immunosuppression cannot be reversed and in patients who relapse despite receipt of appropriate therapy
::::* Note (2): Blood levels of itraconazole should be obtained to ensure adequate drug exposure
::::* Note (3): Antigen levels should be measured during therapy and for 12 months after therapy is ended to monitor for relapse. Persistent low-level antigenuria may not be a reason to prolong treatment in patients who have completed appropriate therapy and have no evidence of active infection.
::::* Note (4): Progressive disseminated histoplasmosis is fatal without therapy and treatment with either Amphotericin B or Itraconazole is highly effective. Among patients with AIDS and moderately severe to severe disseminated histoplasmosis, the rate of response was higher (88% vs. 64%) and the mortality rate was lower (2% vs. 13%) among recipients of liposomal amphotericin B (3 mg/kg qd for 1–2 weeks) than among recipients of the deoxycholate formulation.

::* 1.7 '''Prophylaxis recommended for immunosuppressed patients'''
:::* Preferred regimen: [[Itraconazole]] (200 mg qd) in patients with HIV infection with CD4 cell counts <150 cells/mm3 in specific areas of endemicity where the incidence of histoplasmosis is >10 cases per 100 patient-years
:::* Note: Prophylaxis with Itraconazole (200 mg qd) may be appropriate in specific circumstances in other immunosuppressed patients

::* 1.8 '''Performance Measures'''
:::* Preferred regimen: [[Itraconazole]] is the preferred azole for initial therapy for patients with mild-to-moderate histoplasmosis and as step-down therapy after receipt of [[Amphotericin B]]
:::* Note: When other azole agents are used, the medical record should document the specific reasons that Itraconazole was not used and why other azoles were used.
:::* 14.1 '''Severe or moderately severe histoplasmosis'''
:::* Preferred regimen: [[Amphotericin B]]
:::* Note: When Amphotericin B is used the patient's electrolyte level renal function and blood cell count should be monitored several times per week and documented in the medical record.
:::* Note (2): Itraconazole drug levels should be measured during the first month in patients with disseminated or chronic pulmonary histoplasmosis and these levels should be documented in the medical record as well as the physician's response to levels that are too low.
:::* Note (3): Itraconazole should not be given to patients receiving contraindicated medications (i.e., pimozide, quinidine, dofetilide, lovastatin, simvastatin, midazolam, and triazolam). Reasons for deviation from this practice should be documented in the medical record.

::* 2. '''Pregnancy treatment'''
::::* Preferred regimen: Lipid formulation [[Amphotericin B]] (3.0–5.0 mg/kg qd for 4–6 weeks) is recommended
::::* Prefered regimen low risk for nephrotoxicity: The deoxycholate formulation of [[Amphotericin B]] (0.7–1.0 mg/kg qd) is an alternative to a lipid formulation
::::* Note (1): If the newborn shows evidence for infection, treatment is recommended with [[Amphotericin B]] deoxycholate (1.0 mg/kg daily for 4 weeks)
::::* Note (2): Unique issues in pregnancy include the risk of teratogenic complications of azole therapy and of transplacental transmission of Histoplasma capsulatum to the fetus

::* 3. '''Children treatment'''
::::* 3.1 '''Acute pulmonary histoplasmosis'''
::::* Treatment indications and regimens are similar to those for adults, except that [[Amphotericin B]] deoxycholate (1.0 mg/kg daily) is usually well tolerated and the lipid preparations are not preferred
::::* Note: [[Itraconazole]] dosage: 5.0–10.0 mg/kg daily in 2 divided doses (not to exceed 400 mg daily), generally using the solution formulation

::::* '''Progressive disseminated histoplasmosis'''
::::* Prefered regimen: [[Amphotericin B]] deoxycholate (1.0 mg/kg qd for 4–6 weeks)
::::* Alternative regimen: [[Amphotericin B]] deoxycholate (1.0 mg/kg qd for 2–4 weeks) followed by itraconazole (5.0–10.0 mg/kg qd in 2 divided doses) to complete 3 months of therapy.
::::* '''Immunosuppressed patients if immunosuppression cannot be reversed and patients in relapse despite appropiate therapy'''
::::: Preferred regimen: Lifelong suppressive therapy with [[Itraconazole]] (5.0 mg/kg qd up to 200 mg qd)
::::* Note (1): Longer therapy may be needed for patients with severe disease, immunosuppression, or primary immunodeficiency syndromes
::::* Note (2): Blood levels of itraconazole should be obtained to ensure adequate drug exposure
::::* Note (3): Antigen levels should be monitored during therapy and for 12 months after therapy is ended to monitor for relapse. Persistent low-level antigenuria may not be a reason to prolong treatment in patients who have completed appropriate therapy and have no evidence of active infection.

----

{{PBI|Mucormycosis}}
* '''Mucormycosis'''<ref name="pmid19435437">{{cite journal| author=Spellberg B, Walsh TJ, Kontoyiannis DP, Edwards J, Ibrahim AS| title=Recent advances in the management of mucormycosis: from bench to bedside. | journal=Clin Infect Dis | year= 2009 | volume= 48 | issue= 12 | pages= 1743-51 | pmid=19435437 | doi=10.1086/599105 | pmc=PMC2809216 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19435437  }} </ref>
:* Treatment include surgical debridement of involved tissues, antifungal therapy, use of growth factors to accelerate recovery from neutropenia, provision of granulocyte transfusions with sustained circulating neutrophils until the patient recovers from neutropenia, and discontinuation or reduction in the dose of glucocorticoids, correction of metabolic acidosis and hyperglycemia.
:* Preferred regimen (1): [[Amphotericin B]] Deoxycholate 1.0-1.5 mg/kg/day IV q24h
:* Preferred regimen (2): Lipid [[Amphotericin B]] 5-10 mg/kg/day IV q24h
:* Preferred regimen (3): [[Amphotericin B]] lipid complex 5-7.5 mg/kg/day IV q24h
:* Alternative regimen (1):[[Caspofungin]] 70 mg IV load dose, 50 mg/day for >2 weeks {{plus}} Lipid [[Amphotericin B]] 5-10 mg/kg/day IV q24h
::*Pediatric dose: [[Caspofungin]] 50 mg/m² IV q24h {{plus}}  Lipid [[Amphotericin B]] 5-10 mg/kg/day IV q24h
:* Alternative regimen (2): [[Micafungin]] {{or}} [[Anidulafungin]] 100 mg/day for 2 weeks {{plus}} Lipid [[Amphotericin B]] 5-10 mg/kg/day IV q24h
::*Pediatric dose: [[Micafungin]] 4 mg/kg/day; [[Micafungin]] 10mg/kg/day for low-birth weight infants; [[Anidulafungin]] 1.5 mg/kg/day
:* Alternative regimen (3): [[Deferasirox]] 20 mg/kg PO qd for 2–4 weeks {{plus}} Lipid [[Amphotericin B]] 5-10 mg/kg/day IV q24h
:* Alternative regimen (4): [[Posaconazole]] 800 mg/day PO qid or bid
:* Alternative regimen (5): Initial: [[Isavuconazole]] 200 mg PO/IV q8h for 6 doses; maintenance: 200 mg PO/IV qd
:* Note (1): start maintenance dose 12 to 24 hours after the last loading dose.
:* Note (2): For salvage therapy: ([[Posaconazole]] 800 mg/day PO qid or bid {{withorwithout}} Lipid [[Amphotericin B]] 5-10 mg/kg/day IV q24h) {{or}} ([[Deferasirox]] 20 mg/kg PO qd for 2–4 weeks {{plus}} Lipid [[Amphotericin B]] 5-10 mg/kg/day IV q24h) {{or}} Granulocyte transfusions (for persistently neutropenic patients) ∼10ˆ9 cells/kg {{or}} Recombinant cytokines G-CSF 5 μg/kg/day, GM-CSF 100–250 μg/m², or IFN-g at 50 μg/m² for those with body surface area ≥ 0.5 m² and 1.5 μg/kg for those with body surface area <0.5 m²

{{PBI|Penicilliosis}}
:* '''Penicilliosis treatment'''
::*1. '''Mild disease'''
:::* Preferred regimen: [[Itraconazole]] 200 mg PO bid for 8 to 12 weeks without amphotericin B induction therapy<ref name="pmid1339213">{{cite journal| author=Supparatpinyo K, Chiewchanvit S, Hirunsri P, Baosoung V, Uthammachai C, Chaimongkol B et al.| title=An efficacy study of itraconazole in the treatment of Penicillium marneffei infection. | journal=J Med Assoc Thai | year= 1992 | volume= 75 | issue= 12 | pages= 688-91 | pmid=1339213 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1339213  }} </ref>
:::* Alternative regimen: [[Voriconazole]] 400 mg PO bid on day 1 {{then}} 200 mg PO bid for 12 weeks<ref name="pmid17690411">{{cite journal| author=Supparatpinyo K, Schlamm HT| title=Voriconazole as therapy for systemic Penicillium marneffei infections in AIDS patients. | journal=Am J Trop Med Hyg | year= 2007 | volume= 77 | issue= 2 | pages= 350-3 | pmid=17690411 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17690411  }} </ref>
::*2. '''Moderate-severe disease'''
:::* Preferred regimen: Liposomal [[Amphotericin B]] 3-5 mg/kg/day IV qd {{or}} [[Amphotericin B]] lipid complex 5 mg/kg/day IV qd for 2 weeks {{then}} [[Itraconazole]] 200 mg PO bid for 10 weeks<ref name="pmid9831676">{{cite journal| author=Sirisanthana T, Supparatpinyo K| title=Epidemiology and management of penicilliosis in human immunodeficiency virus-infected patients. | journal=Int J Infect Dis | year= 1998 | volume= 3 | issue= 1 | pages= 48-53 | pmid=9831676 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9831676  }} </ref>
:::* Alternative regimen:  [[Voriconazole]] 6 mg/kg IV q12h on day 1 {{then}} 4 mg/kg q12h for at least 3 days {{then}} [[Voriconazole]] 200 mg PO bid for a total of 12 weeks<ref name="pmid17690411">{{cite journal| author=Supparatpinyo K, Schlamm HT| title=Voriconazole as therapy for systemic Penicillium marneffei infections in AIDS patients. | journal=Am J Trop Med Hyg | year= 2007 | volume= 77 | issue= 2 | pages= 350-3 | pmid=17690411 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17690411  }} </ref>
::*3. '''Maintenance therapy'''<ref name="pmid9845708">{{cite journal| author=Supparatpinyo K, Perriens J, Nelson KE, Sirisanthana T| title=A controlled trial of itraconazole to prevent relapse of Penicillium marneffei infection in patients infected with the human immunodeficiency virus. | journal=N Engl J Med | year= 1998 | volume= 339 | issue= 24 | pages= 1739-43 | pmid=9845708 | doi=10.1056/NEJM199812103392403 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9845708  }} </ref>
:::* Preferred regimen [[Itraconazole]] 200 mg PO qd 
:::* Alternative regimen: [[Voriconazole]] 200 mg PO bid
::* Note: [[Voriconazole]] and [[Itraconazole]] use require serum levels to be monitored to ensure adequate absorption.

{{PBI|Sporotrichosis}}
<ref name="KauffmanBustamante2007">{{cite journal|last1=Kauffman|first1=C. A.|last2=Bustamante|first2=B.|last3=Chapman|first3=S. W.|last4=Pappas|first4=P. G.|title=Clinical Practice Guidelines for the Management of Sporotrichosis: 2007 Update by the Infectious Diseases Society of America|journal=Clinical Infectious Diseases|volume=45|issue=10|year=2007|pages=1255–1265|issn=1058-4838|doi=10.1086/522765}}</ref>
:* '''Lymphocutaneous/cutaneous'''
::* Preferred regimen: [[Itraconazole]] 200mg PO qd 
::* Alternative regimen: [[Itraconazole]] 200 mg PO bid {{or}} [[Terbinafine]] 500 mg PO bid {{or}} Saturated solution potassium iodide with increasing doses {{or}} [[Fluconazole]] 400–800 mg PO qd {{or}} local hyperthermia
::* Note (1): Treat for 2–4 weeks after lesions resolved 
::* Note (2): SSKI initiated at a dosage of 5 drops (using a standard eyedropper) q8h, increasing as tolerated to 40–50 drops q8h

:* '''Osteoarticular'''
::* Preferred regimen: [[Itraconazole]] 200mg PO bid for 12 months
::* Alternative regimen: Lipid amphotericin B (Lipid AmB) 3–5 mg/kg/day IV {{or}} [[Amphotericin B]] deoxycholate 0.7–1 mg/kg/day IV
::* Note (1): Switch to [[Itraconazole]] after favorable response if AmB used
::* Note (2): Treat for a total of at least 12 months

:* '''Pulmonary'''
::* Preferred regimen(1): Lipid amphotericin B (Lipid AmB) 3–5 mg/kg/day IV for severe or life-threatening pulmonary sporotrichosis, then [[Itraconazole]] 200 mg PO bid
::* Preferred regimen(2): [[Itraconazole]] 200 mg PO bid for 12 months for less severe disease 
::* Alternative regimen: [[Amphotericin B]] deoxycholate 0.7–1 mg/kg/d IV {{then}} [[Itraconazole]] 200 mg PO bid {{or}} surgical removal
::* Note (1): Treat severe disease with an AmB formulation followed by [[Itraconazole]]
::* Note (2): Treat less severe disease with [[Itraconazole]]
::* Note (3): Treat for a total of at least 12 monthsSurgery combined with amphotericin B therapy is rec- ommended for localized pulmonary disease 

:* '''Meningitis'''
::* Preferred regimen: Lipid amphotericin B (Lipid AmB) 5 mg/kg daily for 4–6 weeks, then [[Itraconazole]] 200 mg PO bid
::* Alternative regimen: [[Amphotericin B]] deoxycholate 0.7–1 mg/kg/d, then [[Itraconazole]] 200 mg PO bid
::* Note  (1): Length of therapy with AmB not established, but therapy for at least 4–6 weeks is recommended.
::* Note (2): Treat for a total of at least 12 months.
::* Note (3): May require long-term suppression with [[Itraconazole]].

:* '''Disseminated'''
::* Preferred regimen: Lipid amphotericin B (Lipid AmB) 3–5 mg/kg/day, then [[Itraconazole]] 200 mg PO bid
::* Alternative regimen: [[Amphotericin B]] deoxycholate 0.7–1 mg/kg/day, then [[Itraconazole]] 200 mg PO bid
::* Note(1): Therapy with AmB should be continued until the patient shows objective evidence of improvement.
::* Note(2): Treat for a total of at least 12 months.
::* Note(3): May require long-term suppression with [[Itraconazole]].

:* '''Pregnant women'''
::* Preferred regimen(1): Lipid amphotericin B (Lipid AmB) 3–5 mg/kg/day IV {{or}} [[Amphotericin B]] deoxycholate 0.7–1 mg/kg/day IV for severe sporotrichosis
::* Preferred regimen(2): Local hyperthermia for cutaneous disease.
::* Note (1): It is preferable to wait until after delivery to treat non–life-threatening forms of sporotrichosis.
::* Note (2): Azoles should be avoided.

:* '''Children'''
::* Preferred regimen:
:::* Mild disease: [[Itraconazole]] 6–10 mg/kg/day PO (400 mg/day maximum)
:::* Severe disease: [[Amphotericin B]] deoxycholate 0.7 mg/kg/day IV followed by [[Itraconazole]] 6–10 mg/kg PO up to a maximum of 400 mg PO daily, as step-down therapy
::* Alternative regimen: Saturated solution potassium iodide with increasing doses for mild disease initiated at a dosage of 1 drop (using a standard eyedropper) q8h and increased as tolerated up to a maximum of 1 drop/kg or 40–50 drops q8h, whichever is lowest

{{PBI|Pneumocystis jiroveci}}
:*'''1. Preventing First Episode of PCP (Primary Prophylaxis)'''<ref>{{Cite web | title = Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents | url =https://aidsinfo.nih.gov/guidelines/html/4/adult-and-adolescent-oi-prevention-and-treatment-guidelines/321/pcp 
}}</ref>
::*Preferred regimen: [[TMP-SMX]] 1 Double-Strength(DS) PO daily {{or}} [[TMP-SMX]] 1 Single-Strength(SS) PO daily
::*Alternative regimen (1): [[TMP-SMX]] 1 Double-Strength(DS) tid weekly {{or}} [[Dapsone]] 100 mg PO daily or 50 mg PO bid
::*Alternative regimen (2): [[Dapsone]] 50 mg PO {{and}} ([[Pyrimethamine]] 50 mg PO {{and}} [[Leucovorin]] 25 mg) PO weekly
::*Alternative regimen (3): [[Dapsone]] 200 mg PO {{and}} [[Pyrimethamine]] 75 mg PO {{and}} [[Leucovorin]] 25 mg PO weekly
::*Alternative regimen (4): Aerosolized Pentamidinec 300 mg via Respigard II™ nebulizer every month
::*Alternative regimen (5): [[Atovaquone]] 1500 mg PO qd with food
::*Alternative regimen (6): [[Atovaquone]] 1500 mg PO {{and}} [[Pyrimethamine]] 25 mg PO {{and}} [[Leucovorin]] 10 mg PO daily with food

:*'''2. Treatment of Pneumocystis Pneumonia'''<ref>{{Cite web | title = Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents | url =https://aidsinfo.nih.gov/guidelines/html/4/adult-and-adolescent-oi-prevention-and-treatment-guidelines/321/pcp 
}}</ref>
::*'''2.1. Moderate to Severe PCP'''
:::*Preferred regimen: [[TMP-SMX]] (TMP 15–20 mg and SMX 75–100 mg)/kg/day IV given q6h or q8h
:::*Note: May switch to PO after clinical improvement
:::*Alternative regimen (1): [[Pentamidine]] 4 mg/kg IV once daily infused over at least 60 minutes
:::*Note: May reduce the dose to 3 mg/kg IV once daily because of toxicities.
:::*Alternative regimen (2): [[Primaquine]] 30 mg (base) PO once daily {{and}} ([[Clindamycin]] [IV 600 mg q6h or 900 mg q8h] or [PO 450 mg q6h or 600 mg q8h])
::*Note (1): Duration of PCP treatment is 21 days
::*Note (2): Adjunctive corticosteroid may be indicated in some moderate to severe cases.Prednisone doses (beginning as early as possible and within 72 hours of PCP therapy) (AI):
::*Note (3): Prednisone doses (beginning as early as possible and within 72 hours of PCP therapy)
:::*Days 1–5 40 mg PO BID
:::*Days 6–10 40 mg PO daily
:::*Days 11–21 20 mg PO daily

::*'''2.2. Mild to Moderate PCP'''
:::*Preferred regimen: [[TMP-SMX]] (TMP 15–20 mg/kg/day and SMX 75–100 mg/kg/day), given PO in 3 divided doses {{or}} [[TMP-SMX]] Double-Strength(DS) - 2 tablets tid
:::*Alternative regimen (1): [[Dapsone]] 100 mg PO daily {{and}} [[TMP]] 15 mg/kg/day PO (3 divided doses)
:::*Alternative regimen (2): [[Primaquine]] 30 mg (base) PO daily {{and}} [[Clindamycin]] PO (450 mg q6h or 600 mg q8h)
:::*Alternative regimen (3): [[Atovaquone]] 750 mg PO BID with food
::*Note: Duration of PCP treatment is 21 days

:*'''3. Preventing Subsequent Episode of PCP (Secondary Prophylaxis)'''<ref>{{Cite web | title = Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents | url =https://aidsinfo.nih.gov/guidelines/html/4/adult-and-adolescent-oi-prevention-and-treatment-guidelines/321/pcp 
}}</ref>
::*Preferred regimen: [[TMP-SMX]] 1 Double-Strength(DS) PO daily {{or}} [[TMP-SMX]] 1 Single-Strength(SS) PO daily
::*Alternative regimen (1): [[TMP-SMX]] 1 Double-Strength(DS) tid weekly {{or}} [[Dapsone]] 100 mg PO daily or 50 mg PO BID
::*Alternative regimen (2): [[Dapsone]] 50 mg PO daily {{and}} ([[Pyrimethamine]] 50 mg + [[Leucovorin]] 25 mg) PO weekly
::*Alternative regimen (3): [[Dapsone]] 200 mg {{and}} [[Pyrimethamine]] 75 mg {{and}} [[Leucovorin]] 25 mg PO weekly
::*Alternative regimen (4): Aerosolized Pentamidinec 300 mg via Respigard II™ nebulizer every month
::*Alternative regimen (5): [[Atovaquone]] 1500 mg PO daily with food
::*Alternative regimen (6): [[Atovaquone]] 1500 mg {{and}} [[Pyrimethamine]] 25 mg {{and}} [[Leucovorin]] 10 mg PO daily with food

====Mycobacteria====  
{{PBI|Mycobacterium tuberculosis}}
:* 1. '''Standard Regimens for new patients''' <ref>{{cite book | title = Treatment of tuberculosis guidelines | publisher = World Health Organization | location = Geneva | year = 2010 | isbn = 9789241547833 }}</ref>
::* 1.1 '''Adult'''
:::* 1.1.1 '''Initial phase'''
::::* Preferred regimen: [[Isoniazid]] 300 mg PO (5 mg/kg/day) qd for 8 weeks {{and}} [[Rifampicin]] 600 mg PO (10 mg/kg/day) qd for 8 weeks {{and}} [[Pyrazinamide]] 2 g PO (25 mg/kg/day) qd for 8 weeks {{and}} [[Ethambutol]] 1.6 g PO (15 mg/kg/day) qd for 8 weeks
::::* Alternative regimen (1): [[Isoniazid]] 300 mg/day PO for 2 weeks (5 mg/kg/day) {{and}} [[Rifampicin]] 600 mg/day PO for 2 weeks (10 mg/kg/day) {{and}} [[Pyrazinamide]] 2 g/day PO for 2 weeks (25 mg/kg/day) {{and}} [[Ethambutol]] 1.6 g PO for 2 weeks (15 mg/kg/day), followed by [[Isoniazid]] 300 mg/day PO twice weekly for 6 weeks (5 mg/kg/day) {{and}} [[Rifampicin]] 600 mg/day PO twice weekly for 6 weeks (10 mg/kg/day) {{and}} [[Pyrazinamide]] 2 g/day PO twice weekly for 6 weeks {{and}} [[Ethambutol]] 1.6 g PO for 2 weeks (15 mg/kg/day)
::::* Alternative regimen (2): [[Isoniazid]] 300 mg/day PO thrice weekly for 8 weeks (5 mg/kg/day) {{and}} [[Rifampicin]] 600 mg/day PO thrice weekly for 8 weeks (10 mg/kg/day) {{and}} [[Pyrazinamide]] 2g/day PO thrice weekly for 8 week (25 mg/kg/day) {{and}} [[Ethambutol]] 1.6 g PO thrice weekly for 8 weeks (15 mg/kg/day)
:::* 1.1.2 '''Continuation phase'''
::::* Preferred regimen (1): [[Isoniazid]] 300 mg PO (5 mg/kg/day) qd {{and}} [[Rifampicin]] 600 mg PO (10 mg/kg/day) qd for 18 weeks
::::* Preferred regimen (2): [[Isoniazid]] 300 mg PO twice weekly (5 mg/kg/day) {{and}} [[Rifampicin]] 600 mg/day PO twice weekly (10 mg/kg/day) for 18 weeks
::::* Alternative regimen (1): [[Isoniazid]] 300 mg/day PO biweekly for 18 weeks (5 mg/kg/day) {{and}} [[Rifampicin]] 600 mg/day PO biweekly for 18 weeks (10 mg/kg/day)
::::* Alternative regimen (2): [[Isoniazid]] 300 mg/day PO thrice weekly for 18 weeks (5 mg/kg/day) {{and}} [[Rifampicin]] 600 mg/day PO thrice weekly for 18 weeks (10 mg/kg/day)

::* 1.2 '''Pediatric'''
:::* 1.2.1 '''Initial phase'''
::::* Preferred regimen: [[Isoniazid]] 10 mg/kg PO (Maximum, 300 mg/day) {{and}} [[Rifampicin]] 15 mg/kg PO (Maximum, 600 mg/day) {{and}} [[Pyrazinamide]] 35 mg/kg PO (Maximum, 2 g/day) {{and}} [[Ethambutol]] 20 mg/kg PO (Maximum, 1.6 g/day), each for 8 weeks
:::* 1.2.2 '''Continuation phase'''
::::* Preferred regimen: [[Isoniazid]] 10 mg/kg PO (Maximum, 300 mg/day) {{and}} [[Rifampicin]] 15 mg/kg PO (Maximum, 600 mg/day), each drug daily for 18 weeks

:* 2. '''MDR Tuberculosis''' <ref name=WHO>{{cite web | title = The use of delamanid in the treatment of multidrug-resistant tuberculosis| url =http://apps.who.int/iris/bitstream/10665/137334/1/WHO_HTM_TB_2014.23_eng.pdf?ua=1 }}</ref>
::* 2.1 '''Adult'''
:::* Preferred regimen: 4 agents combination
::::* Agent 1: [[Pyrazinamide]] 20–30 mg/kg {{or}} [[Ethambutol]] 15–25 mg/kg {{or}} [[Rifabutin]] 5 mg/kg 
::::* Agent 2: [[Capreomycin]] 15 mg/kg {{or}} [[Kanamycin]] 15 mg/kg {{or}} [[Amikacin]] 7.5-10 mg/kg {{or}} [[Streptomycin]] 12–18 mg/kg  
::::* Agent 3: [[Levofloxacin]] 500-1000 mg {{or}} [[Moxifloxacin]] 400 mg {{or}} [[Ofloxacin]] 400 mg 
::::* Agent 4: [[Ethionamide]] 15-20 mg/kg {{or}} [[Protionamide]] 15-20 mg/kg {{or}} [[Cycloserine]] 10-15 mg/kg {{or}} [[Terizidone]] 10-20 mg/kg {{or}} Para-[[aminosalicylic acid]] 8-12 g/day IV q8-12h

::* 2.2 '''Pediatric'''
:::* Preferred regimen: 4 agents combination

::::* Agent 1: [[Pyrazinamide]] 20-30 mg/kg (Maximum: 600 mg) {{or}} [[Ethambutol]] 15-20 mg/kg {{or}} [[Rifabutin]] 5 mg/kg 
::::* Agent 2: [[Capreomycin]] 15-30 mg/kg (Maximum: 1000 mg) {{or}} [[Kanamycin]] 15-30 mg/kg (Maximum: 1000 mg) {{or}} [[Amikacin]] 15-22.5 mg/kg (Maximum: 1000 mg) {{or}} [[Streptomycin]] 12-18 mg/kg {{and}} 
::::* Agent 3: [[Levofloxacin]] 7.5-10 mg/kg {{or}} [[Moxifloxacin]] 7.5-10 mg/kg {{or}} [[Ofloxacin]] 15-20 mg/kg/day q12h (Maximum: 800 mg) 
::::* Agent 4: [[Ethionamide]] 15-20 mg/kg/day q12h (Maximum: 1000 mg) {{or}} [[Protionamide]] 15-20 mg/kg/day q12h (Maximum: 1000 mg) {{or}} [[Cycloserine]] 10-20 mg/kg (Maximum: 1000 mg) {{or}} [[Terizidone]] 10-20 mg/kg (Maximum: 1000 mg) {{or}} Para-aminosalicylic acid 150 mg/kg/day q8-12h(Maximum: 12,000 mg)

:* 3. '''XDR Tuberculosis''' <ref>{{cite web | title = WHO| url =http://www.who.int/tb/challenges/mdr/programmatic_guidelines_for_mdrtb/en/}}</ref>
::* 3.1 '''Adult'''
:::* Preferred regimen: 3 agents combination
::::* Agent 1: [[Pyrazinamide]] 20–30 mg/kg {{or}} [[Ethambutol]] 15–25 mg/kg {{or}} [[Rifabutin]] 5 mg/kg  
::::* Agent 2: [[Ethionamide]] 15-20 mg/kg {{or}} [[Protionamide]] 15-20 mg/kg {{or}} [[Cycloserine]] 10-15 mg/kg {{or}} [[Terizidone]] 10-20 kg/mg {{or}} Para-[[aminosalicylic acid]] 8-12 g/day q8-12h 
::::* Agent 3: [[Clofazimine]] 50 mg/d AND 300 mg once a month {{or}} [[Amoxicillin]]/clavulanate 500 mg/125 mg q12h {{or}} [[Linezolid]] 300-600 mg {{or}} [[Imipenem]] 500mg q6h {{or}} [[Clarithromycin]] 500-1000 mg q12h {{or}} [[Thioacetazone]] 2.5 mg/kg {{or}} [[Isoniazid]] (high-dose) 16–20 mg/kg

::* 3.2 '''Pediatric'''
:::* Preferred regimen: 3 agents combination

::::* Agent 1: [[Pyrazinamide]] 20-30 mg/kg (Maximum: 600 mg) {{or}} [[Ethambutol]] 15 mg/kg {{or}} [[Rifabutin]] 5 mg/kg  

::::* Agent 2: [[Ethionamide]] 15-20 mg/kg (Maximum: 1000 mg) {{or}} [[Protionamide]] 15-20 mg/kg (Maximum: 1000 mg) {{or}} [[Cycloserine]] 10-20 mg/kg (Maximum: 1000 mg) {{or}} [[Terizidone]] 10-20 mg/kg (Maximum: 1000 mg) {{or}} Para-[[aminosalicylic acid]] 150 mg/kg/day q8-12h 

::::* Agent 3: [[Clofazimine]] 50 mg/d AND 300 mg once a month {{or}} [[Amoxicillin]]/clavulanate {{or}} [[Linezolid]] 300-600 mg {{or}} [[Imipenem]] 500mg q6h {{or}} [[Clarithromycin]] 500-1000 mg q12h {{or}} [[Thioacetazone]] 2.5 mg/kg {{or}} [[Isoniazid]] (high-dose) 16–20 mg/kg
{{PBI|Mycobacterium abscessus}}
*1.'''Limited, localized extrapulmonary disease ''' <ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>

:* Preferred regimen: [[Clarithromycin]] 500 mg PO bid {{withorwithout}} [[Amikacin]] 10-15 mg/kg/day IV or 25 mg/kg three times weekly for 4 months 

:* Alternative regimen (1): [[Amikacin]] {{and}} [[Cefoxitin]] 12 g/day PO for two weeks 
:* Note: until clinical improvement in severe cases

:* Alternative regimen (2): [[Amikacin]] {{and}} [[Imipenem]] 500 mg IV q6-8h for two weeks 
:* Note(1): Until clinical improvement in severe cases
:* Note(2): Osteomyelitis should be treated for as least 6 months; Infected foreign bodies should be removed

*2.'''Pulmonary or serious extrapulmonary disease'''
:* Preferred regimen: [[Clarithromycin]] 500 mg PO bid {{and}} [[Amikacin]] 15 mg/kg/day IV {{and}} [[Cefoxitin]] 2g IV q4h {{or}} [[Imipenem]] 1g IV q6h for at least 2-4 months 
:* Note: If limited by adverse effects {{then}} [[Clarithromycin]] 500 mg PO bid or 1000 mg XR qd {{or}} [[Azithromycin]] 250 mg PO qd
:* Alternative regimen(1): [[Tigecycline]] 100 mg IV loading dose {{then}} 50 mg IV q12h 
:* Note: could be substituted as one of the injectables 
:* Alternative regimen(2): [[Linezolid]] 600 mg PO bid or 600 mg PO qd {{and}} [[Clarithromycin]] 
:* Note: Could replace parental tx if not tolerated or feasible

{{PBI|Mycobacterium bovis}}
:* [[Mycobacterium bovis]] <ref name="pmid12836625">{{cite journal| author=American Thoracic Society. CDC. Infectious Diseases Society of America| title=Treatment of tuberculosis. | journal=MMWR Recomm Rep | year= 2003 | volume= 52 | issue= RR-11 | pages= 1-77 | pmid=12836625 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12836625  }} </ref>
::* Note: Is intrinsically resistant to [[Pyrazinamide]] (PZA). The treatment of M. bovis is extrapolated from experience with the treatment of PZA-resistant ''M. tuberculosis''
::* 1. '''Pulmonary and most extrapulmonary disease'''

:::* Preferred regimen: [[Isoniazid]] {{and}} [[Rifampin]] {{and}} [[Ethambutol]] for 2 months, followed by [[Isoniazid]] {{and}} [[Rifampin]] for 7 months
::* 2. '''Meningitis '''
:::* Preferred regimen: [[Isoniazid]] {{and}} [[Rifampin]] {{and}} [[Ethambutol]] for 2 months, followed by [[Isoniazid]] {{and}} [[Rifampin]] for 10 months
{{PBI|Mycobacterium avium-intracellulare}}
:* 1. '''Treatment of MAC pulmonary disease''' <ref>{{Cite journal| doi = 10.1164/rccm.200604-571ST| issn = 1073-449X| volume = 175| issue = 4| pages = 367–416| last1 = Griffith| first1 = Daviday E.| last2 = Aksamit| first2 = Timothy| last3 = Brown-Elliott| first3 = Barbara A.| last4 = Catanzaro| first4 = Antonino| last5 = Daley| first5 = Charles| last6 = Gordin| first6 = Fred| last7 = Holland| first7 = Steven M.| last8 = Horsburgh| first8 = Robert| last9 = Huitt| first9 = Gwen| last10 = Iademarco| first10 = Michael F.| last11 = Iseman| first11 = Michael| last12 = Olivier| first12 = Kenneth| last13 = Ruoss| first13 = Stephen| last14 = von Reyn| first14 = C. Fordham| last15 = Wallace| first15 = Richarday J.| last16 = Winthrop| first16 = Kevin| last17 = ATS Mycobacterial Diseases Subcommittee| last18 = American Thoracic Society| last19 = Infectious Disease Society of America| title = An official ATS/IDSA statement: diagnosis, treatment, anday prevention of nontuberculous mycobacterial diseases| journal = American Journal of Respiratory anday Critical Care Medicine| date = 2007-02-15| pmiday = 17277290}}</ref>
::* 1.1 '''Patients with nodular/bronchiectatic disease'''
:::* Preferreday regimen: [[Clarithromycin]] 1,000 mg three times weekly {{or}} [[Azithromycin]] 500–600 mg three times weekly {{and}} [[Ethambutol]] 25 mg/kg three times weekly {{and}} [[Rifampin]] 600 mg three times weekly
:::* Note: Patients should be treated until culture negative on therapy for 1 year
::* 1.2 '''Patients with fibrocavitary or severe nodular/bronchiectatic disease'''
:::* Preferreday regimen: [[Clarithromycin]] 500–1,000 mg/day {{or}} [[Azithromycin]] 250–300 mg/day {{or}} [[Rifampin]] 600 mg/day {{or}} [[Rifabutin]] 150–300 mg/day {{and}} [[Ethambutol]] 15 mg/kg/day 
:::* Note(1): [[Amikacin]] {{or}} [[Streptomycin]] threetimes-weekly can be used early in therapy 
:::* Note(2): Patients should be treated until culture negative on therapy for 1 year
:* 2. '''Disseminateday MAC disease'''
::* Preferreday regimen: [[Clarithromycin]] 1,000 mg/day {{or}} [[Azithromycin]] 250 mg/day {{and}} [[Ethambutol]] 15 mg/kg/day {{withorwithout}} [[Rifabutin]] 150–350 mg/day
{{PBI|Mycobacterium celatum}}
:* [[Mycobacterium celatum]] <ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
::* Preferred regimen: [[Clarithromycin]] {{and}} [[Ethambutol]] {{and}} [[Ciprofloxacin]] {{withorwithout}} [[Rifabutin]]

{{PBI|Mycobacterium chelonae}}
:* [[Mycobacterium chelonae]] <ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
:* 1. '''Localized infections''' 
::* Preferred regimen: [[Clarithromycin]] 500 mg PO bid 
::* Alternative regimen: [[Azithromycin]] 
:* 2. '''Disseminated or extensive disease'''
::* 2.1 '''monotherapy '''
:::* Preferred regimen: [[Clarithromycin]] 500 mg PO bid for 6 months
::* 2.2 '''multidrug therapy '''
:::* preferred regimen: [[Clarithromycin]] 500 mg PO bid {{and}} [[Tobramycin]] 5 mg/kg IV q24h {{or}} [[Imipenem]] 0.5-1 g IV q6h {{or}} [[Linezolid]] 600 mg IV/PO q12h/bid for 4-8 weeks 
:::* Alternative regimen: [[Moxifloxacin]] 400 mg PO qd {{and}} [[Linezolid]] 600 mg PO bid
:::* Note(1): During initial treatment, multidrug therapy may prevent development of acquired resistance 
:::* Note(2): Total treatment duration is 6 months
:* 3. '''Keratitis (LASIK-related)'''
::* Preferred regimen: [[Clarithromycin]] 500 mg PO bid {{and}} [[Tobramycin]] 0.3% 2 gtts q4h {{and}} [[Gatifloxacin]] 0.3% 1 gtt q4h {{or}} [[Moxifloxacin]] 0.5% 1 gtt q4h

{{PBI|Mycobacterium foruitum}}
:* [[Mycobacterium foruitum]] <ref>{{Cite journal| doi = 10.1164/rccm.200604-571ST| issn = 1073-449X| volume = 175| issue = 4| pages = 367–416| last1 = Griffith| first1 = David E.| last2 = Aksamit| first2 = Timothy| last3 = Brown-Elliott| first3 = Barbara A.| last4 = Catanzaro| first4 = Antonino| last5 = Daley| first5 = Charles| last6 = Gordin| first6 = Fred| last7 = Holland| first7 = Steven M.| last8 = Horsburgh| first8 = Robert| last9 = Huitt| first9 = Gwen| last10 = Iademarco| first10 = Michael F.| last11 = Iseman| first11 = Michael| last12 = Olivier| first12 = Kenneth| last13 = Ruoss| first13 = Stephen| last14 = von Reyn| first14 = C. Fordham| last15 = Wallace| first15 = Richard J.| last16 = Winthrop| first16 = Kevin| last17 = ATS Mycobacterial Diseases Subcommittee| last18 = American Thoracic Society| last19 = Infectious Disease Society of America| title = An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases| journal = American Journal of Respiratory and Critical Care Medicine| date = 2007-02-15| pmid = 17277290}}</ref>
::* 1. '''In vitro isolates '''
:::* Susceptible agents: [[Amikacin]] (100%), [[Ciprofloxacin]] and [[Ofloxacin]] (100%), [[Sulfonamides]] (100%), [[Cefoxitin]] (50%), [[Imipenem]] (100%), [[Clarithromycin]] (80%), and [[Doxycycline]] (50%)
::* 2. '''Disease'''
:::* 2.1 '''M. fortuitum lung disease'''
::::* At least two agents with in vitro activity against the clinical isolate should be given for at least 12 months of negative sputum cultures
:::* 2.2 '''Serious skin, bone, and soft tissue M fortuitum disease'''
::::* At least two agents with in vitro activity against the clinical isolate should be given for a minimum of 4 months; For bone infections, 6 months of therapy is recommended


{{PBI|Mycobacterium haemophilum}}
:* [[Mycobacterium haemophilum]] <ref>{{Cite journal| doi = 10.1164/rccm.200604-571ST| issn = 1073-449X| volume = 175| issue = 4| pages = 367–416| last1 = Griffith| first1 = David E.| last2 = Aksamit| first2 = Timothy| last3 = Brown-Elliott| first3 = Barbara A.| last4 = Catanzaro| first4 = Antonino| last5 = Daley| first5 = Charles| last6 = Gordin| first6 = Fred| last7 = Holland| first7 = Steven M.| last8 = Horsburgh| first8 = Robert| last9 = Huitt| first9 = Gwen| last10 = Iademarco| first10 = Michael F.| last11 = Iseman| first11 = Michael| last12 = Olivier| first12 = Kenneth| last13 = Ruoss| first13 = Stephen| last14 = von Reyn| first14 = C. Fordham| last15 = Wallace| first15 = Richard J.| last16 = Winthrop| first16 = Kevin| last17 = ATS Mycobacterial Diseases Subcommittee| last18 = American Thoracic Society| last19 = Infectious Disease Society of America| title = An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases| journal = American Journal of Respiratory and Critical Care Medicine| date = 2007-02-15| pmid = 17277290}}</ref>
::* 1. '''In vitro''' 
:::* Susceptible: [[Amikacin]], [[Clarithromycin]], [[Ciprofloxacin]], [[Rifampin]], and [[Rifabutin]]
:::* Less susceptible: [[Doxycycline]] and [[Sulfonamides]]
::* 2. '''Infection'''
:::* 2.1 '''Disseminated disease'''
::::* Preferred regimen: [[Clarithromycin]] {{and}} [[Rifampin]] {{and}} [[Rifabutin]] {{and}} [[Ciprofloxacin]]

{{PBI|Mycobacterium genavense}}
:* [[Mycobacterium genavense]] <ref>{{Cite journal| doi = 10.1164/rccm.200604-571ST| issn = 1073-449X| volume = 175| issue = 4| pages = 367–416| last1 = Griffith| first1 = David E.| last2 = Aksamit| first2 = Timothy| last3 = Brown-Elliott| first3 = Barbara A.| last4 = Catanzaro| first4 = Antonino| last5 = Daley| first5 = Charles| last6 = Gordin| first6 = Fred| last7 = Holland| first7 = Steven M.| last8 = Horsburgh| first8 = Robert| last9 = Huitt| first9 = Gwen| last10 = Iademarco| first10 = Michael F.| last11 = Iseman| first11 = Michael| last12 = Olivier| first12 = Kenneth| last13 = Ruoss| first13 = Stephen| last14 = von Reyn| first14 = C. Fordham| last15 = Wallace| first15 = Richard J.| last16 = Winthrop| first16 = Kevin| last17 = ATS Mycobacterial Diseases Subcommittee| last18 = American Thoracic Society| last19 = Infectious Disease Society of America| title = An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases| journal = American Journal of Respiratory and Critical Care Medicine| date = 2007-02-15| pmid = 17277290}}</ref>
::* Susceptibility: [[Amikacin]], [[Rifamycin]], [[Fluoroquinolones]], [[Streptomycin]], and [[Macrolides]]
::* Note(1): [[Ethambutol]] has limited activity
::* Note(2): Optimal therapy is not determined, but multidrug therapies including [[Clarithromycin]] appear to be more effective than those without [[Clarithromycin]]
{{PBI|Mycobacterium gordonae}}
:* [[Mycobacterium gordonae]] <ref>{{Cite journal| doi = 10.1164/rccm.200604-571ST| issn = 1073-449X| volume = 175| issue = 4| pages = 367–416| last1 = Griffith| first1 = David E.| last2 = Aksamit| first2 = Timothy| last3 = Brown-Elliott| first3 = Barbara A.| last4 = Catanzaro| first4 = Antonino| last5 = Daley| first5 = Charles| last6 = Gordin| first6 = Fred| last7 = Holland| first7 = Steven M.| last8 = Horsburgh| first8 = Robert| last9 = Huitt| first9 = Gwen| last10 = Iademarco| first10 = Michael F.| last11 = Iseman| first11 = Michael| last12 = Olivier| first12 = Kenneth| last13 = Ruoss| first13 = Stephen| last14 = von Reyn| first14 = C. Fordham| last15 = Wallace| first15 = Richard J.| last16 = Winthrop| first16 = Kevin| last17 = ATS Mycobacterial Diseases Subcommittee| last18 = American Thoracic Society| last19 = Infectious Disease Society of America| title = An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases| journal = American Journal of Respiratory and Critical Care Medicine| date = 2007-02-15| pmid = 17277290}}</ref>
::* Preferred regimen: [[Ethambutol]] {{or}} [[Rifabutin]] {{or}} [[Clarithromycin]] {{or}} [[Linezolid]] {{or}} [[Fluoroquinolones]]


{{PBI|Mycobacterium kansasii}}
:* [[Mycobacterium kansasii]] <ref>{{Cite journal| doi = 10.1164/rccm.200604-571ST| issn = 1073-449X| volume = 175| issue = 4| pages = 367–416| last1 = Griffith| first1 = David E.| last2 = Aksamit| first2 = Timothy| last3 = Brown-Elliott| first3 = Barbara A.| last4 = Catanzaro| first4 = Antonino| last5 = Daley| first5 = Charles| last6 = Gordin| first6 = Fred| last7 = Holland| first7 = Steven M.| last8 = Horsburgh| first8 = Robert| last9 = Huitt| first9 = Gwen| last10 = Iademarco| first10 = Michael F.| last11 = Iseman| first11 = Michael| last12 = Olivier| first12 = Kenneth| last13 = Ruoss| first13 = Stephen| last14 = von Reyn| first14 = C. Fordham| last15 = Wallace| first15 = Richard J.| last16 = Winthrop| first16 = Kevin| last17 = ATS Mycobacterial Diseases Subcommittee| last18 = American Thoracic Society| last19 = Infectious Disease Society of America| title = An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases| journal = American Journal of Respiratory and Critical Care Medicine| date = 2007-02-15| pmid = 17277290}}</ref>
::* 1. '''pulmonary disease''' 
:::* Preferred regimen: [[Rifampin]] 10 mg/kg/day (Maximum, 600 mg) PO {{and}} [[Ethambutol]] 15 mg/kg/ day PO {{and}} [[Isoniazid]] 5 mg/kg/day (Maximum 300 mg) PO {{and}} [[Pyridoxine]] 50 mg/day PO
:::* Note: Treatment duration for M. kansasii lung disease should include 12 months of negative sputum cultures

::* 2. '''Rifampin-resistant M. kansasii disease'''
:::* Preferred regimen: [[Clarithromycin]] {{or}} [[Azithromycin]] {{or}} [[Moxifloxacin]] {{or}} [[Ethambutol]] {{or}} [[Sulfamethoxazole]] {{or}} [[Streptomycin]]
:::* Note(1): Use three-drug regimen
:::* Note(2): Patients undergoing therapy for M. kansasii lung disease should have close clinical monitoring with frequent sputum examinations for mycobacterial culture throughout therapy

::* 3. '''Disseminated M. kansasii disease'''
:::* Note: The treatment regimen for disseminated disease should be the same as for pulmonary disease

{{PBI|Mycobacterium marinum}}
:* [[Mycobacterium marinum]] <ref>{{Cite journal| doi = 10.1164/rccm.200604-571ST| issn = 1073-449X| volume = 175| issue = 4| pages = 367–416| last1 = Griffith| first1 = David E.| last2 = Aksamit| first2 = Timothy| last3 = Brown-Elliott| first3 = Barbara A.| last4 = Catanzaro| first4 = Antonino| last5 = Daley| first5 = Charles| last6 = Gordin| first6 = Fred| last7 = Holland| first7 = Steven M.| last8 = Horsburgh| first8 = Robert| last9 = Huitt| first9 = Gwen| last10 = Iademarco| first10 = Michael F.| last11 = Iseman| first11 = Michael| last12 = Olivier| first12 = Kenneth| last13 = Ruoss| first13 = Stephen| last14 = von Reyn| first14 = C. Fordham| last15 = Wallace| first15 = Richard J.| last16 = Winthrop| first16 = Kevin| last17 = ATS Mycobacterial Diseases Subcommittee| last18 = American Thoracic Society| last19 = Infectious Disease Society of America| title = An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases| journal = American Journal of Respiratory and Critical Care Medicine| date = 2007-02-15| pmid = 17277290}}</ref>

::* 1. '''In vitro M. marinum isolates''' 
:::* Susceptible: [[Rifampin]], [[Rifabutin]], [[Ethambutol]], [[Clarithromycin]], [[Sulfonamides]], and [[Trimethoprim sulfamethoxazole]]
:::* Intermediately susceptible: [[Streptomycin]], [[Doxycycline]], and [[Minocycline]]
:::* Resistant: [[Isoniazid]] and [[Pyrazinamide]]
:::* Note: Two active agents for 1 to 2 months after resolution of symptoms, typically 3 to 4 months in total
::* 2. '''Infection'''
:::* 2.1 '''skin and soft tissue infections'''
::::* Preferred regimen (1): [[Clarithromycin]] {{and}} [[Ethambutol]]
::::* Preferred regimen (2): [[Ethambutol]] {{and}} [[Rifampin]]
::::* Note: [[Azithromycin]] can replace [[Clarithromycin]]
:::* 2.2 '''osteomyelitis or deep structure infection'''
::::* Preferred regimen: [[Clarithromycin]] {{and}} [[Ethambutol]] {{and}} [[Rifampin]]

{{PBI|Mycobacterium scrofulaceum}}
:* [[Mycobacterium scrofulaceum]] <ref>{{Cite journal| doi = 10.1164/rccm.200604-571ST| issn = 1073-449X| volume = 175| issue = 4| pages = 367–416| last1 = Griffith| first1 = David E.| last2 = Aksamit| first2 = Timothy| last3 = Brown-Elliott| first3 = Barbara A.| last4 = Catanzaro| first4 = Antonino| last5 = Daley| first5 = Charles| last6 = Gordin| first6 = Fred| last7 = Holland| first7 = Steven M.| last8 = Horsburgh| first8 = Robert| last9 = Huitt| first9 = Gwen| last10 = Iademarco| first10 = Michael F.| last11 = Iseman| first11 = Michael| last12 = Olivier| first12 = Kenneth| last13 = Ruoss| first13 = Stephen| last14 = von Reyn| first14 = C. Fordham| last15 = Wallace| first15 = Richard J.| last16 = Winthrop| first16 = Kevin| last17 = ATS Mycobacterial Diseases Subcommittee| last18 = American Thoracic Society| last19 = Infectious Disease Society of America| title = An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases| journal = American Journal of Respiratory and Critical Care Medicine| date = 2007-02-15| pmid = 17277290}}</ref>

::* Susceptibility data are lacking and standard treatment regimens for M. scrofulaceum are controversial, emphasizing the need to perform susceptibility testing on confirmed disease-producing isolates of M. scrofulaceum

{{PBI|Mycobacterium simiae}}
:* [[Mycobacterium simiae]] <ref>{{Cite journal| doi = 10.1164/rccm.200604-571ST| issn = 1073-449X| volume = 175| issue = 4| pages = 367–416| last1 = Griffith| first1 = David E.| last2 = Aksamit| first2 = Timothy| last3 = Brown-Elliott| first3 = Barbara A.| last4 = Catanzaro| first4 = Antonino| last5 = Daley| first5 = Charles| last6 = Gordin| first6 = Fred| last7 = Holland| first7 = Steven M.| last8 = Horsburgh| first8 = Robert| last9 = Huitt| first9 = Gwen| last10 = Iademarco| first10 = Michael F.| last11 = Iseman| first11 = Michael| last12 = Olivier| first12 = Kenneth| last13 = Ruoss| first13 = Stephen| last14 = von Reyn| first14 = C. Fordham| last15 = Wallace| first15 = Richard J.| last16 = Winthrop| first16 = Kevin| last17 = ATS Mycobacterial Diseases Subcommittee| last18 = American Thoracic Society| last19 = Infectious Disease Society of America| title = An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases| journal = American Journal of Respiratory and Critical Care Medicine| date = 2007-02-15| pmid = 17277290}}</ref>
::* Preferred regimen: [[Clarithromycin]] {{and}} [[Moxifloxacin]] {{and}} [[Trimethoprim/sulfamethoxazole]]

{{PBI|Mycobacterium ulcerans}}
:* [[Mycobacterium ulcerans]] <ref>{{Cite journal| doi = 10.1164/rccm.200604-571ST| issn = 1073-449X| volume = 175| issue = 4| pages = 367–416| last1 = Griffith| first1 = David E.| last2 = Aksamit| first2 = Timothy| last3 = Brown-Elliott| first3 = Barbara A.| last4 = Catanzaro| first4 = Antonino| last5 = Daley| first5 = Charles| last6 = Gordin| first6 = Fred| last7 = Holland| first7 = Steven M.| last8 = Horsburgh| first8 = Robert| last9 = Huitt| first9 = Gwen| last10 = Iademarco| first10 = Michael F.| last11 = Iseman| first11 = Michael| last12 = Olivier| first12 = Kenneth| last13 = Ruoss| first13 = Stephen| last14 = von Reyn| first14 = C. Fordham| last15 = Wallace| first15 = Richard J.| last16 = Winthrop| first16 = Kevin| last17 = ATS Mycobacterial Diseases Subcommittee| last18 = American Thoracic Society| last19 = Infectious Disease Society of America| title = An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases| journal = American Journal of Respiratory and Critical Care Medicine| date = 2007-02-15| pmid = 17277290}}</ref>

:* 1. '''Preulcerative lesions''' 
::* Excision and primary closure, [[Rifampin]] monotherapy, or heat therapy
:* 2. '''Established ulcers'''
::* Most antimycobacterial agents are ineffective for the treatment of the ulcer; Surgical debridement combined with skin grafting is the usual treatment of choice
:* 3. '''Control complications of the ulcer'''
::* Preferred regimen: [[Clarithromycin]] {{and}} [[Rifampin]]

{{PBI|Mycobacterium xenopi}}
:* [[Mycobacterium xenopi]] <ref>{{Cite journal| doi = 10.1164/rccm.200604-571ST| issn = 1073-449X| volume = 175| issue = 4| pages = 367–416| last1 = Griffith| first1 = David E.| last2 = Aksamit| first2 = Timothy| last3 = Brown-Elliott| first3 = Barbara A.| last4 = Catanzaro| first4 = Antonino| last5 = Daley| first5 = Charles| last6 = Gordin| first6 = Fred| last7 = Holland| first7 = Steven M.| last8 = Horsburgh| first8 = Robert| last9 = Huitt| first9 = Gwen| last10 = Iademarco| first10 = Michael F.| last11 = Iseman| first11 = Michael| last12 = Olivier| first12 = Kenneth| last13 = Ruoss| first13 = Stephen| last14 = von Reyn| first14 = C. Fordham| last15 = Wallace| first15 = Richard J.| last16 = Winthrop| first16 = Kevin| last17 = ATS Mycobacterial Diseases Subcommittee| last18 = American Thoracic Society| last19 = Infectious Disease Society of America| title = An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases| journal = American Journal of Respiratory and Critical Care Medicine| date = 2007-02-15| pmid = 17277290}}</ref>

:* 1. '''The cornerstone of therapy for M. xenopi''' 
::* Preferred regimen: [[Clarithromycin]] {{and}} [[Rifampin]] {{and}} [[Ethambutol]]
::* Note: Therapy should be continued until the patient has maintained negative sputum cultures while on therapy for 12 months
:* 2. '''Pulmonary disease'''
::* Preferred regimen: [[INH]] {{and}} [[Rifabutin]] {{or}} [[Rifampin]] {{and}} [[Ethambutol]] {{and}} [[Clarithromycin]] {{withorwithout}} [[Streptomycin]]
::* Note: A quinolone, preferably [[Moxifloxacin]], could be substituted for one of the antituberculous drugs
:* 3. '''Extrapulmonary disease'''
::* Note: Therapy for extrapulmonary disease would include the same agents as for pulmonary disease

{{PBI|Mycobacterium leprae}}
:* [[Mycobacterium leprae]] <ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
::* 1. '''Multibacillary Leprosy (Skin smear positive) ''' 
:::* 1.1 '''Adult'''
::::* Preferred regimen: [[Dapsone]] 100 mg/day PO {{and}} [[Rifampin]] 600 mg PO 4 times per week {{and}} [[Clofazimine]] 50 mg PO qd for 12-24 months 
::::* Note: [[Clofazimine]] should be supplemented by loading dose 300 mg PO monthly     
:::* 1.2 '''Pediatric'''
::::* 1.2.1 '''< 35 kg'''
:::::* Preferred regimen: [[Dapsone]] 1-2 mg/kg/day PO {{and}} [[Rifampin]] 450 mg PO for 12-24 months 

::::* 1.2.2 '''< 20 kg'''
:::::* Preferred regimen: [[Dapsone]] 1-2 mg/kg/day PO {{and}} [[Rifampin]] 300 mg PO for 12-24 months 

::::* 1.2.3 '''< 12 kg'''
:::::* Preferred regimen: [[Dapsone]] 1-2 mg/kg/day PO {{and}} [[Rifampin]] 150 mg PO for 12-24 months 
::* 2. '''Paucibacillary Leprosy (Skin Smear negative)'''
:::* Preferred regimen: [[Rifampin]] 600 mg PO once a month for 6 months {{and}} [[Dapsone]] 100 mg PO qd for 6 months
::* 3. '''Erythema Nodosum Leprosum (ENL)''' 
:::* 3.1 '''Mild'''
::::* Preferred regimen: Rest affect limb, analgesics, follow-up twice a week, check for iridocyclitis; [[Chloroquine]] {{or}} [[Aspirin]] may be useful 
:::* 3.2 '''Severe (numerous nodules + fever, ulcerating/pustular ENL, visceral involvement, nodules + neuritis, recurrent ENL)'''
::::* Preferred regimen: [[Prednisolone]] 30-40 mg/day PO for 1-2 weeks {{then}} taper over 12 weeks
::::* Alternative regimen (1): (If unresponsive to corticosteroids or if risk of corticosteroids prevent administration) [[Clofazimine]] 100 mg PO tid for maximum of 12 weeks {{then}} taper the dose to 100 mg PO bid for 12 weeks {{then}} 100 mg qd for 12-24 weeks
::::* Alternative regimen (2): (if not contraindicated) [[Thalidomide]] 200-400 mg/day PO {{then}} 50-100 mg/day after 1-2 weeks
::* 4. '''Reversal Reaction'''
:::* Preferred regimen: [[Prednisolone]] start with 40 mg/day PO {{then}} taper by 10 mg twice a week for 12 weeks

{{PBI|Mycobacterium smegmatis}}
:* [[Mycobacterium smegmatis]] <ref>{{Cite journal| doi = 10.1164/rccm.200604-571ST| issn = 1073-449X| volume = 175| issue = 4| pages = 367–416| last1 = Griffith| first1 = David E.| last2 = Aksamit| first2 = Timothy| last3 = Brown-Elliott| first3 = Barbara A.| last4 = Catanzaro| first4 = Antonino| last5 = Daley| first5 = Charles| last6 = Gordin| first6 = Fred| last7 = Holland| first7 = Steven M.| last8 = Horsburgh| first8 = Robert| last9 = Huitt| first9 = Gwen| last10 = Iademarco| first10 = Michael F.| last11 = Iseman| first11 = Michael| last12 = Olivier| first12 = Kenneth| last13 = Ruoss| first13 = Stephen| last14 = von Reyn| first14 = C. Fordham| last15 = Wallace| first15 = Richard J.| last16 = Winthrop| first16 = Kevin| last17 = ATS Mycobacterial Diseases Subcommittee| last18 = American Thoracic Society| last19 = Infectious Disease Society of America| title = An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases| journal = American Journal of Respiratory and Critical Care Medicine| date = 2007-02-15| pmid = 17277290}}</ref>
::* 1. '''Mild disease'''
:::* Preferred regimen: [[Doxycycline]] PO {{and}} [[ Trimethoprim sulfamethoxazole]] PO
::* 2. '''Severe disease'''
:::* Preferred regimen: [[Amikacin]] IV {{or}} [[Imipenem]] IV

{{PBI|Mycobacterium immunogenum}}
:* [[Mycobacterium immunogenum]] <ref>{{Cite journal| doi = 10.1164/rccm.200604-571ST| issn = 1073-449X| volume = 175| issue = 4| pages = 367–416| last1 = Griffith| first1 = David E.| last2 = Aksamit| first2 = Timothy| last3 = Brown-Elliott| first3 = Barbara A.| last4 = Catanzaro| first4 = Antonino| last5 = Daley| first5 = Charles| last6 = Gordin| first6 = Fred| last7 = Holland| first7 = Steven M.| last8 = Horsburgh| first8 = Robert| last9 = Huitt| first9 = Gwen| last10 = Iademarco| first10 = Michael F.| last11 = Iseman| first11 = Michael| last12 = Olivier| first12 = Kenneth| last13 = Ruoss| first13 = Stephen| last14 = von Reyn| first14 = C. Fordham| last15 = Wallace| first15 = Richard J.| last16 = Winthrop| first16 = Kevin| last17 = ATS Mycobacterial Diseases Subcommittee| last18 = American Thoracic Society| last19 = Infectious Disease Society of America| title = An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases| journal = American Journal of Respiratory and Critical Care Medicine| date = 2007-02-15| pmid = 17277290}}</ref>

::* In vitro
:::* Susceptible: [[Amikacin]] and [[Clarithromycin]]
:::* Resistant: [[Ciprofloxacin]], [[Doxycycline]], [[Cefoxitin]], [[Tobramycin]], and [[Sulfamethoxazole]]
:::* Note: The optimal therapy for this organism is unknown; however, successful therapy is likely difficult due to the extensive antibiotic resistance of the organism

{{PBI|Mycobacterium malmoense }}
:* [[Mycobacterium malmoense]]<ref>{{Cite journal| doi = 10.1164/rccm.200604-571ST| issn = 1073-449X| volume = 175| issue = 4| pages = 367–416| last1 = Griffith| first1 = David E.| last2 = Aksamit| first2 = Timothy| last3 = Brown-Elliott| first3 = Barbara A.| last4 = Catanzaro| first4 = Antonino| last5 = Daley| first5 = Charles| last6 = Gordin| first6 = Fred| last7 = Holland| first7 = Steven M.| last8 = Horsburgh| first8 = Robert| last9 = Huitt| first9 = Gwen| last10 = Iademarco| first10 = Michael F.| last11 = Iseman| first11 = Michael| last12 = Olivier| first12 = Kenneth| last13 = Ruoss| first13 = Stephen| last14 = von Reyn| first14 = C. Fordham| last15 = Wallace| first15 = Richard J.| last16 = Winthrop| first16 = Kevin| last17 = ATS Mycobacterial Diseases Subcommittee| last18 = American Thoracic Society| last19 = Infectious Disease Society of America| title = An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases| journal = American Journal of Respiratory and Critical Care Medicine| date = 2007-02-15| pmid = 17277290}}</ref>
::* 1. '''In vitro '''
:::* Susceptible: [[Ethambutol]], [[Ethionamide]], [[Kanamycin]], and [[Cycloserine]]
:::* Resistant: [[INH]], [[Streptomycin]], [[Rifampin]], and [[Capreomycin]]
::* 2. '''Pulmonary M. malmoense infection'''
:::* Preferred regimen: [[INH]] {{and}} [[Rifampin]] {{and}} [[Ethambutol]] {{withorwithout}} [[Quinolones]] {{and}} [[Macrolides]]

{{PBI|Mycobacterium mucogenicum}}
:* [[Mycobacterium mucogenicum]] <ref>{{Cite journal| doi = 10.1164/rccm.200604-571ST| issn = 1073-449X| volume = 175| issue = 4| pages = 367–416| last1 = Griffith| first1 = David E.| last2 = Aksamit| first2 = Timothy| last3 = Brown-Elliott| first3 = Barbara A.| last4 = Catanzaro| first4 = Antonino| last5 = Daley| first5 = Charles| last6 = Gordin| first6 = Fred| last7 = Holland| first7 = Steven M.| last8 = Horsburgh| first8 = Robert| last9 = Huitt| first9 = Gwen| last10 = Iademarco| first10 = Michael F.| last11 = Iseman| first11 = Michael| last12 = Olivier| first12 = Kenneth| last13 = Ruoss| first13 = Stephen| last14 = von Reyn| first14 = C. Fordham| last15 = Wallace| first15 = Richard J.| last16 = Winthrop| first16 = Kevin| last17 = ATS Mycobacterial Diseases Subcommittee| last18 = American Thoracic Society| last19 = Infectious Disease Society of America| title = An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases| journal = American Journal of Respiratory and Critical Care Medicine| date = 2007-02-15| pmid = 17277290}}</ref>
::* In vitro susceptible agents: [[Aminoglycosides]], [[Cefoxitin]], [[Clarithromycin]], [[Minocycline]], [[Doxycycline]], [[Quinolones]], [[Trimethoprim/sulfamethoxazole]], and [[Imipenem]]

{{PBI|Mycobacterium szulgai}}
:* [[Mycobacterium szulgai]] <ref>{{Cite journal| doi = 10.1164/rccm.200604-571ST| issn = 1073-449X| volume = 175| issue = 4| pages = 367–416| last1 = Griffith| first1 = David E.| last2 = Aksamit| first2 = Timothy| last3 = Brown-Elliott| first3 = Barbara A.| last4 = Catanzaro| first4 = Antonino| last5 = Daley| first5 = Charles| last6 = Gordin| first6 = Fred| last7 = Holland| first7 = Steven M.| last8 = Horsburgh| first8 = Robert| last9 = Huitt| first9 = Gwen| last10 = Iademarco| first10 = Michael F.| last11 = Iseman| first11 = Michael| last12 = Olivier| first12 = Kenneth| last13 = Ruoss| first13 = Stephen| last14 = von Reyn| first14 = C. Fordham| last15 = Wallace| first15 = Richard J.| last16 = Winthrop| first16 = Kevin| last17 = ATS Mycobacterial Diseases Subcommittee| last18 = American Thoracic Society| last19 = Infectious Disease Society of America| title = An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases| journal = American Journal of Respiratory and Critical Care Medicine| date = 2007-02-15| pmid = 17277290}}</ref><ref>{{Cite journal| issn = 0903-1936| volume = 11| issue = 4| pages = 975–977| last1 = Tortoli| first1 = E.| last2 = Besozzi| first2 = G.| last3 = Lacchini| first3 = C.| last4 = Penati| first4 = V.| last5 = Simonetti| first5 = M. T.| last6 = Emler| first6 = S.| title = Pulmonary infection due to Mycobacterium szulgai, case report and review of the literature| journal = The European Respiratory Journal| date = 1998-04| pmid = 9623706}}</ref>

::* '''1. in vitro susceptibility''' 
:::* M. szulgai is susceptible in vitro to most antituberculous drugs including [[Quinolones]] and newer [[Macrolides]]
::* '''2. Infection'''
:::* '''2.1 Pulmonary infection'''
::::* Three- or four-drug regimen based on susceptibility that includes 12 months of negative sputum cultures while on therapy
:::* '''2.2 Extrapulmonary infection'''
::::* Combination anti-tuberculous medications based on in vitro susceptibilities for 4-6 months

{{PBI|Mycobacterium terrae}}
:* [[Mycobacterium terrae]] <ref>{{Cite journal| doi = 10.1164/rccm.200604-571ST| issn = 1073-449X| volume = 175| issue = 4| pages = 367–416| last1 = Griffith| first1 = David E.| last2 = Aksamit| first2 = Timothy| last3 = Brown-Elliott| first3 = Barbara A.| last4 = Catanzaro| first4 = Antonino| last5 = Daley| first5 = Charles| last6 = Gordin| first6 = Fred| last7 = Holland| first7 = Steven M.| last8 = Horsburgh| first8 = Robert| last9 = Huitt| first9 = Gwen| last10 = Iademarco| first10 = Michael F.| last11 = Iseman| first11 = Michael| last12 = Olivier| first12 = Kenneth| last13 = Ruoss| first13 = Stephen| last14 = von Reyn| first14 = C. Fordham| last15 = Wallace| first15 = Richard J.| last16 = Winthrop| first16 = Kevin| last17 = ATS Mycobacterial Diseases Subcommittee| last18 = American Thoracic Society| last19 = Infectious Disease Society of America| title = An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases| journal = American Journal of Respiratory and Critical Care Medicine| date = 2007-02-15| pmid = 17277290}}</ref>
::* 1. '''In vitro susceptibility''' 
:::* All six of the isolates from a single center and 90% or more of an additional 22 isolates of M. terrae complex were susceptible to [[Ciprofloxacin]] and [[Sulfonamides]]. Recently, 11 isolates of M. terrae complex were also shown to be susceptible to [[Linezolid]]
::* 2. '''Antimicrobial therapy'''
:::* Based on in vitro susceptibility results

----

====Parasites – Intestinal Protozoa====  

{{PBI|Balantidium coli}}

----

{{PBI|Blastocystis hominis}}
:* Blastocystis<ref>{{cite book | last = Bennett | first = John | title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases | publisher = Elsevier/Saunders | location = Philadelphia, PA | year = 2015 | isbn = 978-1455748013 }}</ref>
::* Preferred regimen (1): [[Metronidazole]] 750 mg PO tid or 1.5 g qd for 10 days  

::* Preferred regimen (2): [[Trimethoprim-sulfamethoxazole]] 1 DS PO bid or 2 DS PO qd for 7 days 

::* Preferred regimen (3): [[Iodoquinol]] 650 mg PO tid for 20 days  

::* Preferred regimen (4): [[Nitazoxanide]] 500 mg PO bid for 3 days  

::* Preferred regimen (5): [[Paromomycin]] 25-35 mg/kg/day PO tid for 7 days
::* Note (1): Treatment of asymptomatic infections is unnecessary
::* Note (2): One double strength tablet contains 160 mg trimethoprim/800 mg sulfamethoxazole

----

{{PBI|Cryptosporidium parvum}}
::* '''1. Immunocompetent'''<ref name="pmid11398117">{{cite journal| author=Rossignol JF, Ayoub A, Ayers MS| title=Treatment of diarrhea caused by Cryptosporidium parvum: a prospective randomized, double-blind, placebo-controlled study of Nitazoxanide. | journal=J Infect Dis | year= 2001 | volume= 184 | issue= 1 | pages= 103-6 | pmid=11398117 | doi=10.1086/321008 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11398117  }} </ref>
:::* Preferred regimen: No specific therapy recommended since healthy patients usually recover within a few weeks, but if needed: [[Nitazoxanide]] 500 mg PO bid for 3 days.
::* '''2. HIV'''<ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
:::* Preferred regimen: [[Nitazoxanide]] 500 mg PO bid for 3 days
::* '''3. HIV and Immunodeficiency'''<ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
:::* Preferred regimen: Effective antiretroviral therapy 
:::* Note: Nitazoxanide is not licensed for immunodeficient patients

----

{{PBI|Cryptosporidium hominis}}
::* '''1. Immunocompetent'''<ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
:::* Preferred regimen: No specific therapy recommended since healthy patients usually recover within a few weeks, but if needed: [[Nitazoxanide]] 500 mg PO bid for 3 days.<ref name="pmid15640710">{{cite journal| author=Smith HV, Corcoran GD| title=New drugs and treatment for cryptosporidiosis. | journal=Curr Opin Infect Dis | year= 2004 | volume= 17 | issue= 6 | pages= 557-64 | pmid=15640710 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15640710  }} </ref>
::* '''2. HIV'''<ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
:::* Preferred regimen: [[Nitazoxanide]] 500 mg PO bid for 3 days
::* '''3. HIV and Immunodeficiency'''<ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
:::* Preferred regimen: Effective antiretroviral therapy 
:::* Note: Nitazoxanide is not licensed for immunodeficient patients

----

{{PBI|Cyclospora cayetanensis}}
:* '''Cyclosporiasis'''<ref>{{cite book | last = Bennett | first = John | title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases | publisher = Elsevier/Saunders | location = Philadelphia, PA | year = 2015 | isbn = 978-1455748013 }}</ref>
::* Preferred regimen: [[Trimethoprim-Sulfamethoxazole]] double-strength (160 mg TMP/800 mg SMX) 1 tablet PO bid for 7-10 days
::* Alternative regimen (1): [[Ciprofloxacin]] 500 mg PO bid for 7 days
::* Alternative regimen (2): [[Nitazoxanide]] 500 mg PO bid for 7 days
::* Note: Treatment is continued for 7 days in immunocompetent hosts and for 7 to 10 days in patients with HIV infection.

----

{{PBI|Dientamoeba fragilis}}
:*'''Dientamoebiasis'''<ref>{{citeweb|title=CDC Dientamoeba fragilis|url=http://www.cdc.gov/parasites/dientamoeba/health_professionals/index.html}}</ref><ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy 2014 | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2014 | isbn = 978-1930808782 }}</ref><ref>{{Cite journal| doi = 10.1016/j.ijpddr.2012.08.002| issn = 2211-3207| volume = 2| pages = 204–215| last1 = Nagata| first1 = Noriyuki| last2 = Marriott| first2 = Deborah| last3 = Harkness| first3 = John| last4 = Ellis| first4 = John T.| last5 = Stark| first5 = Damien| title = Current treatment options for Dientamoeba fragilis infections| journal = International Journal for Parasitology. Drugs and Drug Resistance| date = 2012-12| pmid = 24533282| pmc = PMC3862407}}</ref>
::* Preferred regimen: [[Iodoquinol]] 650 mg PO tid for 20 days
::* Alternative regimen (1): [[Paromomycin]] 25–35 mg/kg/day PO in three divided doses for 7 days
::* Alternative regimen (2): [[Metronidazole]] 500–750 mg PO tid for 10 days
::* Alternative regimen (3): [[Tetracycline]] 500 mg PO qid for 10 days

:::* 1.1 '''Treatment in pregnancy'''
::::* The use of [[Iodoquinol]] in pregnancy is limited, and risk to the embryo-fetus is unknown, should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
::::* Oral dose of [[Paromomycin]] generally is poorly absorbed from the gastrointestinal tract, with minimal, if any, systemic availability.
::::* [[Metronidazole]] is in pregnancy category B. Data on the use of this drug in pregnant women are conflicting. The available evidence suggests use during pregnancy has a low risk of congenital anomalies. May be used during pregnancy in those patients who will clearly benefit from the drug, although its use in the first trimester is generally not advised.
:::* 1.2 '''Treatment during lactation'''
::::* [[Iodoquinol]] should be used with caution in breastfeeding women.
::::* Oral dose of [[Paromomycin]] is unlikely to be excreted in breast milk, and the drug generally is poorly absorbed from the gastrointestinal tract.
::::* [[Metronidazole]] should be used during lactation only if the potential benefit of therapy to the mother justifies the potential risk to the infant.
:::* 1.3 '''Treatment in pediatric patients'''
::::* [[Iodoquinol]] 30–40 mg/kg/day (maximum 2 g) PO in 3 doses for 􏰄20 days. The safety of iodoquinol in children has not been established.
::::* [[Paromomycin]] 25–35 mg/kg/day PO in 3 doses􏰄 for 7 days. The safety of oral dose in children has not been formally evaluated. However, the safety profiles likely are comparable in children and adults.
::::* [[Metronidazole]] 35–50 mg/kg/day PO in 3 doses for􏰄 10 days. The safety in children has not been established, is listed as an antiamebic and antigiardiasis medicine on the WHO Model List of Essential Medicines for Children, intended for the use of children up to 12 years of age.
::::* [[Tetracycline]] 40 mg/kg/day (maximum 2 g) PO in 4 doses for􏰄 10 days

----

{{PBI|Entamoeba histolytica}}
:* '''1. Amebic Liver Abscess'''<ref>{{cite book | last = Bennett | first = John | title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases | publisher = Elsevier/Saunders | location = Philadelphia, PA | year = 2015 | isbn = 978-1455748013 }}</ref>
::* Preferred regimen: ([[Metronidazole]] 750 mg PO tid for 10 days {{or}} [[Tinidazole]] 2 g PO qd for 5 days) {{and}} ([[Paromomycin]] 30 mg/kg/day PO tid for 5-10 days {{or}} [[Diloxanide furoate]] 500 mg PO tid for 10 days)
::*Alternative regimen (1): [[Nitazoxanide]] 500 mg bid for 10 days {{and}} ([[Paromomycin]] 30 mg/kg/day PO tid for 5-10 days {{or}} [[Diloxanide furoate]] 500 mg PO tid for 10 days)
::* Alternative regimen (2): [[Tinidazole]] 2 g PO qd for 5 days {{and}} ([[Paromomycin]] 30 mg/kg/day PO tid for 5-10 days {{or}} [[Diloxanide furoate]] 500 mg PO tid for 10 days)
::* Alternative regimen (2): [[Tinidazole]] 2 g PO qd for 5 days 

:* '''2. Amebic Colitis'''<ref>{{cite book | last = Bennett | first = John | title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases | publisher = Elsevier/Saunders | location = Philadelphia, PA | year = 2015 | isbn = 978-1455748013 }}</ref>
::* Preferred regimen: [[Metronidazole]] 500-750 mg PO tid for 7-10 days. Pediatric dose: 35-50 mg/kg per day tid {{and}} ([[Paromomycin]] 30 mg/kg/day PO tid for 5-10 days {{or}} [[Diloxanide furoate]] 500 mg PO tid for 10 days)
::* Alternative regimen: [[Tinidazole]] 2 g PO qd for 5 days {{and}} ([[Paromomycin]] 30 mg/kg/day PO tid for 5-10 days {{or}} [[Diloxanide furoate]] 500 mg PO tid for 10 days)

:* '''3. Asymptomatic Intestinal Colonization'''<ref>{{cite book | last = Bennett | first = John | title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases | publisher = Elsevier/Saunders | location = Philadelphia, PA | year = 2015 | isbn = 978-1455748013 }}</ref>
::* Preferred regimen: [[Paromomycin]] 30 mg/kg/day PO tid for 5-10 days
::* Alternative regimen (1): [[Diloxanide furoate]] 500 mg PO tid for 10 days
::* Alternative regimen (2): [[Diiodohydroxyquin]] 650 mg PO tid for 20 days for adults and 30 to 40 mg/kg per day tid for 20 days for children
----

{{PBI|Giardia lamblia}}
:* 1. '''Giardiasis'''<ref>{{cite web | title = CDC Parasites - Giardia | url = http://www.cdc.gov/parasites/giardia/treatment.html }}</ref><ref name="pmid11148005">{{cite journal| author=Gardner TB, Hill DR| title=Treatment of giardiasis. | journal=Clin Microbiol Rev | year= 2001 | volume= 14 | issue= 1 | pages= 114-28 | pmid=11148005 | doi=10.1128/CMR.14.1.114-128.2001 | pmc=PMC88965 | url=http://www.ncbi.nlm.nih.gov/entrez/11148005  }} </ref>
::* 1.1 '''Adult'''
:::* Preferred regimen (1): [[Metronidazole]] 250 mg tid 5–7 days
:::* Preferred regimen (2): [[Tinidazole]] 2 g single dose 
:::* Preferred regimen (3): [[Nitazoxanide]] 500 mg PO bid (with food) 
:::* Alternative regimen (1): [[Paromomycin]] 500 mg tid 3 5–10 days
:::* Alternative regimen (2): [[Quinacrine]] 100 mg tid 3 5–7 days
:::* Alternative regimen (3): [[Furazolidone]] 100 mg qid 3 7–10 days
::* 1.2 '''Pediatric'''
:::* Preferred regimen (1): [[Metronidazole]] 5 mg/kg tid 3 5–7 days
:::* Preferred regimen (2): [[Tinidazole]] 50 mg/kg single dose (max, 2 g)
:::* Preferred regimen (3): [[Nitazoxanide]] 100 mg PO bid for age 1-3 years or 200 mg PO bid for age 4-11 years (with food)
:::* Alternative regimen (1): [[Paromomycin]] 30 mg/kg/day in 3 doses 3 5–10 days
:::* Alternative regimen (2): [[Quinacrine]] 2 mg/kg tid 3 7 days
:::* Alternative regimen (3): [[Furazolidone]] 2 mg/kg qid 3 10 days

----

{{PBI|Cystoisospora belli}}
:* 1. '''Cystoisospora belli treatment'''<ref>{{cite web | title = CDC - Cystoisosporiasis | url = http://www.cdc.gov/parasites/cystoisospora/health_professionals/index.html }}</ref>
::* 1.1 '''Immunocompetent hosts'''
:::* In the immunocompetent hosts, symptoms of Cystoisospora infection are usually self-limited. 
:::* Antimicrobial therapy to immunocompetent patients may be considered if symptoms do not start to resolve spontaneously after 5 to 7 days (depending upon severity)
:::* Prefered regimen: [[Trimethoprim-sulfamethoxazole]] 160 mg/800 mg PO bid for 7-10 days
:::* Alternative regimen (1) (for patients who are allergic to or intolerant of TMP-SMX): [[Pyrimethamine]] 50-75 mg/day PO qd or divided in 2 equal doses {{and}} [[Leucovorin]] 10–25 mg PO qd
:::* Alternative regimen (2): [[Ciprofloxacin]] 500 mg PO bid for 7 days (second-line alternative)
::::* 1.1.1 '''In pregnancy'''
:::::* TMP-SMX should be avoided near-term because of the potential for hyperbilirubinemia and kernicterus in the newborn.
:::::* Ciprofloxacin should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
::::* 1.1.2 '''During lactation'''
:::::* TMP-SMX generally should be avoided by women when nursing infants who are premature, jaundiced, ill, or stressed, or who have glucose-6-phosphate dehydrogenase deficiency.
:::::* The American Academy of Pediatrics classifies Ciprofloxacin as usually compatible with breastfeeding, whereas the World Health Organization recommends avoiding Ciprofloxacin while breastfeeding and CDC recommends Ciprofloxacin should be used during lactation only if the potential benefit justifies the potential risk to the fetus.
::::* 1.1.3 '''In pediatric patients'''
:::::* The use of TMP-SMX in children less than 2 months of age generally is not recommended.
:::::* Available evidence is conflicting regarding the potential for growth defects and arthropathies in exposed children. Use of Ciprofloxacin in children requires assessment of potential risks and benefits.
::* 1.2 '''Immunocompromised hosts'''
:::* Preferred regimen (1): [[Trimethoprim-sulfamethoxazole]] 160 mg/800 mg PO/IV qid for 10 days
:::* Preferred regimen (2): [[Trimethoprim-sulfamethoxazole]] 160 mg/800 mg PO/IV bid for 7-10 days
:::* Note (1): One approach is to start with TMP-SMX (160 mg/800 mg) bid regimen first, and increase daily dose and/or duration (up to 3–4 weeks) if symptoms worsen or persist.
:::* Note (2): IV therapy is recommended for patients with potential or documented malabsorption.
:::* Alternative regimen (1): [[Pyrimethamine]] 50–75 mg PO qd {{and}} [[Leucovorin]] 10–25 mg PO qd
:::* Alternative regimen (2): [[Ciprofloxacin]] 500 mg PO bid for 7 days
:* 2. '''Cystoisospora belli prophylaxis'''<ref>{{cite web | title = Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents | url = https://aidsinfo.nih.gov/contentfiles/lvguidelines/adult_oi.pdf }}</ref>
::* 2.1 '''Primary prophylaxis'''
:::* Insufficient evidence is available to support a general recommendation for primary prophylaxis for Cystoisosporiasis per se, especially for U.S. travelers in isoporiasis-endemic areas.
::* 2.2 '''Secondary prophylaxis (preventing recurrence in patients with CD4 count < 200 cells/mm<sup>3</sup>)'''
:::* Prefered regimen: [[Trimethoprim-sulfamethoxazole]] 160 mg/800 mg PO 3 times weekly
:::* Alternative regimen (1): [[Trimethoprim-sulfamethoxazole]] 160 mg/800 mg PO qd
:::* Alternative regimen (2): [[Trimethoprim-sulfamethoxazole]] 320 mg/1600 mg PO 3 times weekly
:::* Alternative regimen (3): [[Pyrimethamine]] 25 mg PO qd {{and}} [[Leucovorin]] 5–10 mg PO qd
:::* Alternative regimen (4): [[Ciprofloxacin]] 500 mg PO 3 times weekly (second-line alternative)
:::* Note (1): Criteria for discontinuation of chronic maintenance therapy: sustained increase in CD4 count > 200 cells/mm<sup>3</sup> for > 6 months in response to ART and without evidence of active Cystoisospora belli infection
:::* Note (2): Because of concerns about possible teratogenicity associated with first-trimester drug exposure, clinicians may withhold secondary prophylaxis during the first trimester and treat only symptomatic infection.

----

{{PBI|Microsporidiosis}}
:* '''1. Ocular'''<ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
::* Preferred regimen: [[Albendazole]] 400 mg PO bid for 3 weeks {{and}} [[Fumagillin]] eye drops.
:* '''2. Intestinal (diarrhea)'''<ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
::* Preferred regimen: 
:::* Adult: [[Albendazole]] 400 mg PO bid for 3 weeks  for E. intestinalis.
:::* Pediatric: [[Albendazole]] 15 mg/kg per day divided into 2 daily doses for 7 days  for E. intestinalis.
::* Note: [[Fumagillin]] 20 mg PO tid is the only reported effective treatment for E. bieneusi.
:* '''3. Disseminated'''<ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref> 
::*Preferred regimen: [[Albendazole]] 400 mg po bid for 3 weeks.

====Parasites – Extraintestinal Protozoa====

==Acanthamoeba==
{{PBI|Acanthamoeba}}
:* 1. '''Granulomatous amoebic encephalitis, meningitis, and disseminated Acanthamoeba disease'''<ref>{{Cite journal| doi = 10.1111/j.1574-695X.2007.00232.x| issn = 0928-8244| volume = 50| issue = 1| pages = 1–26| last1 = Visvesvara| first1 = Govinda S.| last2 = Moura| first2 = Hercules| last3 = Schuster| first3 = Frederick L.| title = Pathogenic and opportunistic free-living amoebae: Acanthamoeba spp., Balamuthia mandrillaris, Naegleria fowleri, and Sappinia diploidea| journal = FEMS immunology and medical microbiology| date = 2007-06| pmid = 17428307}}</ref><ref>{{cite book | last = Bennett | first = John | title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases | publisher = Elsevier/Saunders | location = Philadelphia, PA | year = 2015 | isbn = 978-1455748013 }}</ref>
::* Preferred regimen (1): [[Pentamidine]] {{and}} [[Itraconazole]] {{and}} [[Sulfadiazine]] {{and}} [[Flucytosine]]
::* Preferred regimen (2): [[Sulfadiazine]] {{and}} [[Fluconazole]] {{and}} [[Pyrimethamine]]
::* Preferred regimen (3): [[Sulfadiazine]] {{and}} [[Flucytosine]] {{and}} [[TMP-SMX]]
::* Preferred regimen (4): [[TMP-SMX]] {{and}} [[Rifampin]] {{and}} [[Ketoconazole]]
::* Preferred regimen (5): [[Miltefosine]] {{and}} [[Amikacin]]
::* Preferred regimen (6): [[Miltefosine]] {{and}} [[Voriconazole]]
::* Preferred regimen (7): [[Pentamidine]] {{and}} [[Itraconazole]] {{and}} [[Flucytosine]] {{and}} [[Levofloxacin]] {{and}} [[Amphotericin B]] {{and}} [[Rifampin]]
::* Preferred regimen (8): [[Pentamidine]] {{and}} [[Fluconazole]] {{and}} [[Miltefosine]]
::* Note: The mainstay of successful treatment includes early diagnosis and combination therapy with pentamidine, azole, sulfonamide, miltefosine, and possibly flucytosine.
:* 2. '''Cutaneous acanthamoebiasis'''<ref>{{Cite journal| issn = 0893-8512| volume = 16| issue = 2| pages = 273–307| last1 = Marciano-Cabral| first1 = Francine| last2 = Cabral| first2 = Guy| title = Acanthamoeba spp. as agents of disease in humans| journal = Clinical Microbiology Reviews| date = 2003-04| pmid = 12692099| pmc = PMC153146}}</ref><ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref><ref>{{Cite journal| doi = 10.1111/j.1574-695X.2007.00232.x| issn = 0928-8244| volume = 50| issue = 1| pages = 1–26| last1 = Visvesvara| first1 = Govinda S.| last2 = Moura| first2 = Hercules| last3 = Schuster| first3 = Frederick L.| title = Pathogenic and opportunistic free-living amoebae: Acanthamoeba spp., Balamuthia mandrillaris, Naegleria fowleri, and Sappinia diploidea| journal = FEMS immunology and medical microbiology| date = 2007-06| pmid = 17428307}}</ref>
::* Preferred regimen: [[Pentamidine]] {{and}} [[Sulfadiazine]] {{and}} [[Flucytosine]] {{and}} ([[Itraconazole]] {{or}} [[Fluconazole]]) {{and}} [[Chlorhexidine]] topical {{and}} [[Ketoconazole]] topical
:* 3. '''Acanthamoeba keratitis'''<ref>{{cite web | title = Acanthamoeba Keratitis Fact Sheet (CDC) | url = http://www.cdc.gov/parasites/acanthamoeba/health_professionals/acanthamoeba_keratitis_hcp.html }}</ref>
::* Preferred regimen: ([[Polyhexamethylene biguanide]] topical {{or}} [[Chlorhexidine]] topical) {{withorwithout}} ([[Propamidine]] topical {{or}} [[Hexamidine]] topical)
::* Note (1): Azole antifungal drugs (Ketoconazole, Itraconazole, Voriconazole) may be considered as oral or topical adjuncts.
::* Note (2): The duration of therapy for Acanthamoeba keratitis may last six months to a year.
::* Note (3): Pain control can be helped by topical cyclopegic solutions and oral nonsteroidal medications. 
::* Note (4): The use of corticosteroids to control inflammation is controversial.
::* Note (5): Penetrating keratoplasty may help restore visual acuity.

==Balamuthia mandrillaris==
{{PBI|Balamuthia mandrillaris}}
:* 1. '''Granulomatous Amebic Encephalitis'''<ref>{{cite web | title = Balamuthia mandrillaris - Granulomatous Amebic Encephalitis (CDC) | url = http://www.cdc.gov/parasites/balamuthia/treatment.html }}</ref><ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
::* Preferred regimen (1): [[Pentamidine]] {{and}} [[Flucytosine]] {{and}} [[Fluconazole]] {{and}} [[Sulfadiazine]] {{and}} ([[Azithromycin]] {{or}} [[Clarithromycin]])
::* Preferred regimen (2): [[Pentamidine]] {{and}} [[Albendazole]] {{and}} ([[Itraconazole]] {{or}} [[Fluconazole]]) {{and}} [[Miltefosine]]

==Naegleria fowleri==
{{PBI|Naegleria fowleri}}
:* '''Primary amoebic meningoencephalitis'''<ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref><ref>{{Citeweb|title=PAM | url=http://www.cdc.gov/parasites/naegleria/index.html }}</ref>
::* Preferred regimen: [[Amphotericin B]] 1.5 mg/kg/day bid for 3 days; then 1 mg/kg/day for 6 days {{and}} 1.5 mg/day intrathecal for 2 days; then 1 mg/day intrathecal qd for 8 days.
::* Note: Investigational drug called miltefosine  also available for treatment.

----
==Babesia microti==
{{PBI|Babesia microti}}
:* '''Babesiosis'''
::* 1. '''Mild/moderate disease'''<ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
:::* Preferred regimen: [[Atovaquone]] 750 mg PO bid {{and}} [[Azithromycin]] 600 mg PO qd for 7-10 days
::* 2. '''Severe disease:'''
:::* Preferred regimen: [[Clindamycin]] 600 mg PO tid {{and}} [[Quinine]] 650 mg PO tid for 7–10 days 
:::* Preferred regimen: [[Clindamycin]] 1.2 g IV q12h
:::* Note (1): For overwhelming infection in asplenic patients and immunocompromised patients, treat for 6 or more weeks.  
:::* Note (2): Consider transfusion if 􀂕10% parasitemia.

==Leishmania==
{{PBI|Leishmania}}
:* '''Leishmaniasis'''
::* 1. '''Cutaneous Leishmaniasis'''<ref>{{Citeweb|title=leishmaniasis | url=http://www.cdc.gov/parasites/leishmaniasis/health_professionals/index.html#tx}}</ref>
:::* Different Leishmania species cause Old World versus New World (American) cutaneous leishmaniasis. In the Old World (the Eastern Hemisphere), the etiologic agents include Leishmania tropica, L. major, and L. aethiopica, as well as L. infantum and L. donovani. The main species in the New World (the Western Hemisphere) are either in the L. mexicana species complex (L. mexicana, L. amazonensis, and L. venezuelensis) or the subgenus Viannia (L. [V.] braziliensis, L. [V.] guyanensis, L. [V.] panamensis, and L. [V.] peruviana). The Viannia subgenus is also referred to as the L. (V.) braziliensis species complex.
::::* 1.1 '''Systemic Therapy (Parenteral)'''
:::::* Preferred Regimen (1): [[Sodium stibogluconate]] 20 mg/kg IV/IM q24h for 10-20 days  
:::::* Preferred Regimen (2): [[Meglumine antimoniate]] 20 mg/kg IV/IM  q24h for 10-20 days
:::::* Alternative Regimen (1): [[Liposomal amphotericin B]] 3 mg/kg/day IV infusion for 6-10 days 
:::::* Alternative Regimen (2): [[Pentamidine]] 2-3 mg/kg/day IV/IM for 4-7 days 
:::::* Note: Data supporting the use of amphotericin B for treatment of cutaneous and mucosal leishmaniasis are anecdotal; standard dosage regimens have not been established. In the United States, pentamidine isethionate is uncommonly used for treatment of cutaneous leishmaniasis. Its limitations include the potential for irreversible toxicity and variable effectiveness. 
::::* 1.2 '''Systemic Therapy (Oral)'''
:::::*  1.2.1 '''Adults and adolescents at least 12 years of age, who weigh from 33-44 kg'''
::::::* Preferred Regimen:[[Miltefosine]] 50 mg PO q12h for 28 days
:::::* 1.2.2 '''Adults and adolescents at least 12 years of age, who weigh  >45 kg '''
::::::* Preferred Regimen:[[Miltefosine]] 50 mg PO q8h for 28 days 
::::::* Alternative Regimen (1): [[Ketoconazole]] 600 mg qd for 28 days {{or}} qd for 6 weeks
::::::* Alternative Regimen (2): [[Fluconazole]] 200 mg qd for 6 weeks
::::::* Note:The FDA-approved indications are limited to infection caused by three particular species, all three of which are New World species in the Viannia subgenus—namely, Leishmania (V.) braziliensis, L. (V.) panamensis, and L. (V.) guyanensis.  The "azoles" showed modest activity against some Leishmania species in some cases, but are not FDA approved
::::* 1.3 '''Local Therapy'''
:::::* List of possible local therapies
:::::* Cryotherapy (with [[liquid nitrogen]] {{or}} Thermotherapy (use of localized current field radiofrequency heat) {{or}} Intralesional administration of [[SbV]] {{or}} Topical application of [[Paromomycin]] (such as an ointment containing 15% [[Paromomycin]]/12% methylbenzethonium chloride in soft white paraffin)
::* 2. '''Visceral Leishmaniasis'''
:::* Visceral leishmaniasis usually is caused by the species L. donovani and L. infantum (L. chagasi generally is considered synonymous with L. infantum) 
::::* 2.1 '''Systemic Therapy (Parenteral)'''
:::::* Preferred Regimen (1): [[Liposomal amphotericin B]] 3 mg/kg/day IV for 5 days, then once on day 14 and once on day 21  (Total dose: 21 mg/kg)  
:::::* Preferred Regimen (2): [[Sodium stibogluconate]] 20 mg/kg IV/IM q24h for 28 days 
:::::* Preferred Regimen (3): [[Meglumine antimoniate]] 20 mg/kg IV/IM q24h for 28 days
:::::* Alternative Regimen: [[Amphotericin B]] deoxycholate 0.5-1 mg/kg IV  q24h (Total dose: 15-20 mg/kg)
:::::* Note: In immunosuppressed patients, dose is 4 mg/kg/day for 5 days, then once on day 10,  17, 24, 31, and 38  (Total dose: 40 mg/kg)
::::* 2.2 '''Systemic Therapy (Oral)'''
:::::* 2.2.1 '''Adults and adolescents at least 12 years of age, who weigh from 33-44 kg'''
::::::* Preferred Regimen: [[Miltefosine]] 50 mg PO q12h for 28 days
:::::* 2.2.2 '''Adults and adolescents at least 12 years of age, who weigh >45 kg'''
::::::* Preferred Regimen: [[Miltefosine]] 50 mg PO q8h for 28 days

==Plasmodium==
{{PBI|Plasmodium}}
:* 1. '''Plasmodium falciparum'''<ref>{{cite web | title = Guidelines for the treatment of malaria. Third edition April 2015 | url = http://apps.who.int/iris/bitstream/10665/162441/1/9789241549127_eng.pdf?ua=1&ua=1 }}</ref>
::* 1.1 '''Treatment of uncomplicated P. falciparum malaria'''
:::* 1.1.1 '''Treat children and adults with uncomplicated P. falciparum malaria (except pregnant women in their first trimester) with one of the following recommended ACT (artemisinin-based combination therapy)'''
::::* Preferred regimen (1):  [[Artemether]] 5–24 mg/kg/day PO bid {{and}} [[Lumefantrine]] 29–144 mg/kg/day PO bid for 3 days. 
:::::* Note: The first two doses should, ideally, be given 8 h apart.
:::::* Dosage regimen based on Body weight (kg)
:::::* Body weight (kg)-5 to < 15-     [[Artemether]] 20 mg PO bid {{and}} [[Lumefantrine]] 120 mg PO bid  for 3 days
:::::* Body weight (kg)-15 to < 25-    [[Artemether]] 40 mg PO bid {{and}} [[Lumefantrine]] 240 mg PO bid  for 3 days
:::::* Body weight (kg)-25 to < 35-    [[Artemether]] 60 mg PO bid {{and}} [[Lumefantrine]] 360 mg PO bid  for 3 days
:::::* Body weight (kg)   ≥ 35-       [[Artemether]] 80 mg PO bid {{and}} [[Lumefantrine]] 480 mg PO bid  for 3 days
::::* Preferred regimen (2): [[Artesunate]] 2–10 mg/kg/day PO qd {{and}} [[Amodiaquine]] 7.5–15 mg/kg/day PO qd for 3 days 
:::::* Note: A total therapeutic dose range of 6–30 mg/kg/day artesunate and 22.5–45 mg/kg/day per dose amodiaquine is recommended.
:::::* Dosage regimen based on Body weight (kg)
:::::* Body weight (kg)-4.5 to < 9-   [[Artesunate]] 25 mg PO qd {{and}} [[Amodiaquine]] 67.5 mg PO qd  for 3 days
:::::* Body weight (kg)-9 to < 18 -   [[Artesunate]] 50 mg PO qd {{and}} [[Amodiaquine]] 135 mg PO qd for 3 days
:::::* Body weight (kg)-18 to < 36-   [[Artesunate]] 100 mg PO qd {{and}} [[Amodiaquine]] 270 mg PO qd for 3 days
:::::* Body weight (kg)   ≥ 36 -         [[Artesunate]] 200 mg PO qd {{and}} [[Amodiaquine]] 540 mg PO qd for 3 days
::::* Preferred regimen (3): [[Artesunate]] 2–10 mg/kg/day PO qd {{and}} [[Mefloquine]] 2–10 mg/kg/day PO qd for 3 days
:::::* Dosage regimen based on Body weight (kg)
:::::* Body weight (kg)-5 to < 9-      [[Artesunate]] 25 mg PO qd {{and}} [[Mefloquine]] 55 mg PO qd  for 3 days
:::::* Body weight (kg)-9to < 18-      [[Artesunate]] 50 mg PO qd {{and}} [[Mefloquine]] 110 mg PO qd for 3 days
:::::* Body weight (kg)-18 to < 36-   [[Artesunate]] 100 mg PO qd {{and}} [[Mefloquine]] 220 mg PO qd for 3 days
:::::* Body weight (kg)- ≥ 36  -      [[Artesunate]] 200 mg PO qd {{and}} [[Mefloquine]] 440 mg PO qd for 3 days
::::* Preferred regimen (4): [[Artesunate]] 2–10 mg/kg/day PO qd for 3 days {{and}} [[Sulfadoxine]]-[[Pyrimethamine]]  1.25 (25–70 / 1.25–3.5) mg/kg/day  PO given as a single dose on day 1
:::::* Dosage regimen based on Body weight (kg)
:::::* Body weight (kg)-5 to < 10-      [[Artesunate]] 25 mg PO qd for 3 days {{and}} [[Sulfadoxine]]-[[Pyrimethamine]] 250/12 mg PO given as a single dose on day 1
:::::* Body weight (kg)-10 to < 25-    [[Artesunate]] 50 mg PO qd for 3 days {{and}} [[Sulfadoxine]]-[[Pyrimethamine]] 500/25 mg PO given as a single dose on day 1
:::::* Body weight (kg)-25 to < 50-      [[Artesunate]] 100 mg PO qd for 3 days {{and}} [[Sulfadoxine]]-[[Pyrimethamine]] 1000/50 mg PO given as a single dose on day 1 
:::::* Body weight (kg)-    ≥50-         [[Artesunate]] 200 mg PO qd for 3 days {{and}} [[Sulfadoxine]]-[[Pyrimethamine]] 1500/75 mg PO given as a single dose on day 1
::::*  Preferred regimen (5): [[Dihydroartemisinin]] 2–10 mg/kg/day PO qd {{and}} [[Piperaquine]]16–27 mg/kg/day PO qd for 3 days
:::::* Dosage regimen based on Body weight (kg)
:::::* Body weight (kg)-5 to < 8-     [[Dihydroartemisinin]] 20 mg PO qd {{and}}  [[Piperaquine]] 160 mg PO qd for 3 days
:::::* Body weight (kg)-8 to < 11-      [[Dihydroartemisinin]] 30 mg PO qd {{and}}  [[Piperaquine]] 240 mg PO qd for 3 days
:::::* Body weight (kg)-11 to < 17 -      [[Dihydroartemisinin]] 40 mg PO qd {{and}}  [[Piperaquine]] 320 mg PO qd for 3 days
:::::* Body weight (kg)-17 to < 25-      [[Dihydroartemisinin]] 60 mg PO qd {{and}}  [[Piperaquine]] 480 mg PO qd for 3 days
:::::* Body weight (kg)-25 to < 36-       [[Dihydroartemisinin]] 80 mg PO qd {{and}}  [[Piperaquine]] 640 mg PO qd for 3 days
:::::* Body weight (kg)-36 to < 60-      [[Dihydroartemisinin]] 120 mg PO qd {{and}}  [[Piperaquine]] 960 mg PO qd for 3 days
:::::*  Body weight (kg)-60 < 80 -       [[Dihydroartemisinin]] 160 mg PO qd {{and}}  [[Piperaquine]] 1280 mg PO qd for 3 days
:::::* Body weight (kg)- >80-      Dose of [[Dihydroartemisinin]] 200 mg PO qd {{and}}  [[Piperaquine]] 1600 mg PO qd for 3 days
:::* 1.1.2 '''Reducing the transmissibility of treated P. falciparum infections In low-transmission areas in  patients with P. falciparum malaria (except pregnant women, infants aged < 6 months and women breastfeeding infants aged < 6 months) '''
:::::* Preferred regimen: Single dose of 0.25 mg/kg [[Primaquine]] with ACT 

::* 1.2 '''Recurrent Falciparum Malaria''' 
:::* 1.2.1 '''Failure within 28 days '''
::::* Note:The recommended second-line treatment is an alternative ACT known to be effective in the region. Adherence to 7-day treatment regimens (with artesunate or quinine both of which should be co-administered with + tetracycline, or doxycycline or clindamycin) is likely to be poor if treatment is not directly observed; these regimens are no longer generally recommended. 
:::* 1.2.2 '''Failure after 28 days'''
::::* Note: all presumed treatment failures after 4 weeks of initial treatment should, from an operational standpoint, be considered new infections and be treated with the first-line ACT. However, reuse of mefloquine within 60 days of first treatment is associated with an increased risk for neuropsychiatric reactions, and an alternative ACT should be used.

::* 1.3 '''Reducing the transmissibility of treated P. falciparum infections In low-transmission areas in  patients with P. falciparum malaria (except pregnant women, infants aged < 6 months and women breastfeeding infants aged < 6 months) ''' 
:::* Note: Single dose of 0.25 mg/kg bw [[Primaquine]] with ACT 

::* 1.4 '''Treating uncomplicated P. falciparum malaria in special risk groups'''
:::* 1.4.1 '''Pregnancy '''
::::* First trimester of pregnancy : [[Quinine]] {{and}} [[Clindamycin]] 10mg/kg/day PO bid for 7 days
::::* Second and third trimesters : [[Mefloquine]] is considered safe for the treatment of malaria during the second and third trimesters; however, it should be given only in combination with an artemisinin derivative.
::::* Note (1): Quinine is associated with an increased risk for hypoglycaemia in late pregnancy, and it should be used (with clindamycin) only if effective alternatives are not available.
::::* Note (2): Primaquine and tetracyclines should not be used in pregnancy.
:::* 1.4.2 '''Infants less than 5kg body weight''' :  with an ACT at the same mg/kg bw target dose as for children weighing 5 kg.
:::* 1.4.3 '''Patients co-infected with HIV''': should avoid [[Artesunate]] + SP if they are also receiving [[Co-trimoxazole]], and avoid [[Artesunate]] {{and}} [[Amodiaquine]] if they are also receiving efavirenz or zidovudine.
:::* 1.4.4 '''Large and Obese adults''': For obese patients, less drug is often distributed to fat than to other tissues; therefore, they should be dosed on the basis of an estimate of lean body weight, ideal body weight. Patients who are heavy but not obese require the same mg/kg bw doses as lighter patients.
:::* 1.4.5 '''Patients co-infected with TB''': Rifamycins, in particular rifampicin, are potent CYP3A4 inducers with weak antimalarial activity. Concomitant administration of rifampicin during quinine treatment of adults with malaria was associated with a significant decrease in exposure to quinine and a five-fold higher recrudescence rate 
:::* 1.4.6 '''Non-immune travellers''' : Treat travellers with uncomplicated P. falciparum malaria returning to nonendemic settings with an ACT.
:::* 1.4.7 '''Uncomplicated hyperparasitaemia''': People with P. falciparum hyperparasitaemia are at increased risk of treatment failure, severe malaria and death so should be closely monitored, in addition to receiving an ACT.
:* 2. '''Treatment of uncomplicated malaria caused by P. vivax, P. ovale, P. malariae or P. knowlesi'''
::* 2.1  '''Blood Stage infection'''
:::* 2.1.1.  '''Uncomplicated malaria caused by P. vivax'''
::::* 2.1.1.1 '''In areas with chloroquine-sensitive P. vivax'''
:::::* Preferred regimen: [[Chloroquine]] total dose of 25 mg/kg PO. [[Chloroquine]] is given at an initial dose of 10 mg/kg, followed by 10 mg/kg on the second day and 5 mg/kg on the third day.
::::* 2.1.1.2 '''In areas with chloroquine-resistant P. vivax'''
:::::* Note: ACTs containing [[Piperaquine]], [[Mefloquine]] {{or}} [[Lumefantrine]] are the recommended treatment, although [[Artesunate]] + [[Amodiaquine]] may also be effective in some areas. In the systematic review of ACTs for treating P. vivax malaria, [[Dihydroartemisinin]] + [[Piperaquine]] provided a longer prophylactic effect than ACTs with shorter half-lives ([[Artemether]] + [[Lumefantrine]], [[Artesunate]] + [[Amodiaquine]]), with significantly fewer recurrent parasitaemias during 9 weeks of follow-up.
:::* 2.1.2 '''Uncomplicated malaria caused by P. ovale, P. malariae or P. knowlesi malaria'''
::::* Note: Resistance of P. ovale, P. malariae and P. knowlesi to antimalarial drugs is not well characterized, and infections caused by these three species are generally considered to be sensitive to chloroquine. In only one study, conducted in Indonesia, was resistance to chloroquine reported in P. malariae. The blood stages of P. ovale, P. malariae and P. knowlesi should therefore be treated with the standard regimen of ACT or [[Chloroquine]], as for vivax malaria. 
:::* 2.1.3 '''Mixed malaria infections '''
::::* Note: ACTs are effective against all malaria species and so are the treatment of choice for mixed infections.
::* 2.2 '''Liver stages (hypnozoites) of P. vivax and P. ovale'''
:::* Note: To prevent relapse, treat P. vivax or P. ovale malaria in children and adults (except pregnant women, infants aged < 6 months, women breastfeeding infants < 6 months, women breastfeeding older infants unless they are known not to be G6PD deficient and people with G6PD deficiency) with a 14-day course of primaquine in all transmission settings. Strong recommendation, high-quality evidence In people with G6PD deficiency, consider preventing relapse by giving primaquine base at 0.75 mg base/kg bw once a week for 8 weeks, with close medical supervision for potential primaquine-induced adverse haematological effects.]
::* 2.2.1 '''Primaquine for preventive relapse'''
:::* Preferred regimen: [[Primaquine]] 0.25–0.5 mg/kg/day PO qd for 14 days
::* 2.2.2 '''Primaquine and glucose-6-phosphate dehydrogenase deficiency'''
:::* Preferred regimen: [[Primaquine]] 0.75 mg base/kg/day PO once a week for 8 weeks. 
:::* Note: The decision to give or withhold [[Primaquine]] should depend on the possibility of giving the treatment under close medical supervision, with ready access to health facilities with blood transfusion services.
::* 2.2.3 '''Prevention of relapse in pregnant or lacating women and infants'''
:::* Note: Primaquine is contraindicated in pregnant women, infants < 6 months of age and in lactating women (unless the infant is known not to be G6PD deficient).

:* 3. '''Treatment of severe malaria'''
::* 3.1 Treatment of severe falciparum infection with Artesunate
:::* 3.1.1 Adults and children with severe malaria (including infants, pregnant women in all trimesters and lactating women):- 
::::* Preferred regimen: [[Artesunate]] IV/IM for at least 24 h and until they can tolerate oral medication. Once a patient has received at least 24 h of parenteral therapy and can tolerate oral therapy, complete treatment with 3 days of an ACT (add single dose [[Primaquine]] in areas of low transmission).
:::* 3.1.2 Young children weighing < 20 kg 
::::* Preferred regimen:[[Artesunate]] 3 mg/kg per dose IV/IM q24h
::::* Alternatives regimen: use [[Artemether]] in preference to quinine for treating children and adults with severe malaria
::* 3.2.'''Treating cases of suspected severe malaria pending transfer to a higher-level facility (pre-referral treatment)'''
:::* 3.2.1 '''Adults and children '''
::::* Preferred regimen: [[Artesunate]] IM q24h
::::* Alternative regimen: [[Artemether]] IM {{or}} [[Quinine]] IM
:::* 3.2.2  '''Children < 6 years'''
::::* Preferred regimen: Where intramuscular injections of artesunate are not available, treat with a single rectal dose (10 mg/kg) of [[Artesunate]], and refer immediately to an appropriate facility for further care.
::::* Note: Do not use rectal artesunate in older children and adults.
::* 3.3 '''Pregancy'''
:::* Note: Parenteral artesunate is the treatment of choice in all trimesters. Treatment must not be delayed.
::* 3.4 '''Treatment of severe P. Vivax infection'''
:::* Note: parenteral artesunate, treatment can be completed with a full treatment course of oral ACT or chloroquine (in countries where chloroquine is the treatment of choice). A full course of radical treatment with primaquine should be given after recovery.
::* 3.5 '''Additional aspects of management in severe malaria'''
:::* '''Fluid therapy''':  It is not possible to give general recommendations on fluid replacement; each patient must be assessed individually and fluid resuscitation based on the estimated deficit.
:::* '''Blood Transfusion ''':In high-transmission settings, blood transfusion is generally recommended for children with a haemoglobin level of < 5 g/100 mL(haematocrit < 15%). In low-transmission settings, a threshold of 20% (haemoglobin,7 g/100 mL) is recommended.
:::* '''Exchange blood transfusion''': Exchange blood transfusion requires intensive nursing care and a relatively large volume of blood, and it carries significant risks. There is no consensus on the indications, benefits and dangers involved or on practical details such as the volume of blood that should be exchanged. It is, therefore, not possible to make any recommendation regarding the use of exchange blood transfusion.

==Toxoplasma gondii==
{{PBI|Toxoplasma gondii}}
:* Toxoplasma gondii (treatment)
::* 1. '''Lymphadenopathic toxoplasmosis'''<ref>{{ cite web | title = Parasites - Toxoplasmosis (Toxoplasma infection) |  url = http://www.cdc.gov/parasites/toxoplasmosis/health_professionals/ }}</ref>
:::* Preferred regimen: Treatment of immunocompetent adults with lymphadenopathic toxoplasmosis is rarely indicated; this form of the disease is usually self-limited.
::* 2. '''Ocular disease'''<ref>{{ cite web | title = Parasites - Toxoplasmosis (Toxoplasma infection) |  url = http://www.cdc.gov/parasites/toxoplasmosis/health_professionals/ }}</ref>
:::* 2.1 '''Adults'''
::::* Preferred regimen: [[Pyrimethamine]] 100 mg PO for 1 day as a loading dose, then 25 to 50 mg/day {{and}} [[Sulfadiazine]] 1 g PO qid {{and}} folinic acid ([[Leucovorin]] 5-25 mg PO with each dose of [[Pyrimethamine]]
:::* 2.2 '''Pediatric'''
::::* Preferred regimen: [[Pyrimethamine]] 2 mg/kg PO first day then 1 mg/kg each day {{and}} [[Sulfadiazine]] 50 mg/kg PO bid {{and}} folinic acid ([[Leucovorin]] 7.5 mg/day PO ) for 4 to 6 weeks followed by reevaluation of the patient's condition 
::::* Alternative regimen: The fixed combination of [[Trimethoprim]] with [[Sulfamethoxazole]]  has been used as an alternative.
::::* Note: If the patient has a hypersensitivity reaction to sulfa drugs, [[Pyrimethamine]] {{and}}  [[Clindamycin]] can be used instead.
::* 3. '''Maternal and fetal infection'''<ref>{{ cite web | title = Parasites - Toxoplasmosis (Toxoplasma infection) |  url = http://www.cdc.gov/parasites/toxoplasmosis/health_professionals/ }}</ref>
:::* 3.1 '''First and early second trimesters'''
::::* Preferred regimen: [[Spiramycin]] is recommended 
:::* 3.2 '''Late second and third trimesters'''
::::* Preferred regimen: [[Pyrimethamine]]/[[ Sulfadiazine]] {{and}} [[Leucovorin]] for women with acute T. gondii infection diagnosed at a reference laboratory during gestation.
:::* 3.3 '''Infant'''
::::* Note: If the infant is likely to be infected, then treatment with drugs such as [[Pyrimethamine]], [[Atovaquone]], [[Sulfadiazine]], [[Leucovorin]]  is typical. Congenitally infected newborns are generally treated with [[pyrimethamine]], a sulfonamide, and [[leucovorin]] for 1 year.
::* 4. '''Toxoplasma gondii Encephalitis in AIDS'''<ref>{{ cite web | title = Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents  | url = https://aidsinfo.nih.gov/contentfiles/lvguidelines/AdultOITablesOnly.pdf }}</ref>
:::* 4.1 '''Treatment for acute infection'''
::::* 4.1.1 '''Patients with weight <60 kg'''
::::* Preferred regimen: [[Pyrimethamine]] 200 mg PO 1 time, followed by [[Pyrimethamine]] 50 mg PO qd {{and}} [[Atovaquone]] {{and}} [[Sulfadiazine]] 1000 mg PO q6h {{and}} [[Leucovorin]] 10–25 mg PO qd,  
::::* 4.1.2  '''Patients with weight ≥60 kg'''
:::::* Preferred regimen: [[Pyrimethamine]] 200 mg PO 1 time, followed by [[Pyrimethamine]] 75 mg PO qd {{and}} [[Sulfadiazine]] 1500 mg PO q6h {{and}} [[Leucovorin]] 10–25 mg PO qd and [[Leucovorin]] dose can be increased to 50 mg qd or bid
:::::* Alternative regimen (1): [[Pyrimethamine]] {{and}} [[Leucovorin]] {{and}} [[Clindamycin]] 600 mg IV/ PO q6h
:::::* Alternative regimen (2): [[TMP-SMX]] (TMP 5 mg/kg and SMX 25 mg/kg ) IV/PO bid
:::::* Alternative regimen (3): [[Atovaquone]] 1500 mg PO bid {{and}} [[Pyrimethamine]] {{and}} [[Leucovorin]] 
:::::* Alternative regimen (4): [[Atovaquone]]1500 mg PO bid {{and}} [[sulfadiazine]] 1000–1500 mg PO q6h (weight-based dosing, as in preferred therapy) 
:::::* Alternative regimen (5): [[Atovaquone]] 1500 mg PO bid
:::::* Alternative regimen (6): [[Pyrimethamine]] {{and}} [[Leucovorin]] {{and}} [[Azithromycin]] 900–1200 mg PO qd
:::::* Note: Treatment for at least 6 weeks; longer duration if clinical or radiologic disease is extensive or response is incomplete at 6 weeks.
:::* 4.2  '''Chronic maintenance therapy'''
::::* Preferred regimen:  [[Pyrimethamine]] 25–50 mg PO qd {{and}} [[sulfadiazine]] 2000–4000 mg PO qd (in 2–4 divided doses) {{and}} [[Leucovorin]] 10–25 mg PO qd 
::::* Alternative regimen (1): [[Clindamycin]] 600 mg PO q8h {{and}} ([[Pyrimethamine]] 25–50 mg {{and}} [[Leucovorin]] 10–25 mg) PO qd
::::* Alternative regimen (2): [[TMP-SMX]] DS 1 tablet bid
::::* Alternative regimen (3): [[Atovaquone]] 750–1500 mg PO bid {{and}} ([[Pyrimethamine]] 25 mg {{and}} [[Leucovorin]] 10 mg) PO qd
::::* Alternative regimen (4): [[Atovaquone]] 750–1500 mg PO bid
::::* Alternative regimen (5): [[Sulfadiazine]] 2000–4000 mg PO bid/qid 
::::* Alternative regimen (6): [[Atovaquone]] 750–1500 mg PO bid [[Pyrimethamine]] and [[Leucovorin]] doses are the same as for preferred therapy
::::* Note: Adjunctive corticosteroids (e.g., [[Dexamethasone]]) should only be administered when clinically indicated to treat mass effect associated with focal lesions or associated edema; discontinue as soon as clinically feasible. Anticonvulsants should be administered to patients with a history of seizures and continued through acute treatment, but should not be used as seizure prophylaxis . If [[Clindamycin]] is used in place of [[Sulfadiazine]], additional therapy must be added to prevent PCP.
:* '''Toxoplasma gondii (prophylaxis)'''
::* 1. '''Prophylaxis to prevent first episode of encephalitis in AIDS'''<ref>{{ cite web | title = Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents  | url = https://aidsinfo.nih.gov/contentfiles/lvguidelines/AdultOITablesOnly.pdf }}</ref>
:::* 1.1 '''Indications'''
::::* Toxoplasma IgG-positive patients with CD4 count <100 cells/µL
::::* Seronegative patients receiving PCP prophylaxis not active against toxoplasmosis should have toxoplasma serology retested if CD4 count decline to <100 cells/µL. Prophylaxis should be initiated if seroconversion occurred.
:::* 1.2 '''Prophylactic therapy'''
::::* Preferred regimen: [[TMP-SMX]] 1 DS PO daily 
::::* Alternative regimen (1): [[TMP-SMX]] 1 DS PO three times weekly
::::* Alternative regimen (2): [[TMP-SMX]] 1 SS PO qd 
::::* Alternative regimen (3): [[Dapsone]] 50 mg PO qd {{and}} ([[Pyrimethamine]] 50 mg PO {{and}} [[Leucovorin]] 25 mg) PO weekly 
::::* Alternative regimen (4): [[Dapsone]] 200 mg PO {{and}} [[Pyrimethamine]] 75 mg PO {{and}} [[Leucovorin]] 25 mg PO weekly  
::::* Alternative regimen (5): [[Atovaquone]] 1500 mg PO qd 
::::* Alternative regimen (6): [[Atovaquone]] 1500 mg  PO {{and}} [[Pyrimethamine]] 25 mg PO {{and}} [[Leucovorin]] 10 mg PO qd

==Trichomonas vaginalis==
{{PBI|Trichomonas vaginalis}}
:* 1. '''T. vaginalis infection in adults''' <ref>{{cite web | title =trichomoniasis | url =  http://www.cdc.gov/std/tg2015/trichomoniasis.htm  }}</ref>
::* Preferred regimen (1): [[Metronidazole]] 2 g PO in a single dose
::* Preferred regimen (2): [[Tinidazole]] 2 g PO in a single dose
::* Alternative regimen: [[Metronidazole]] 500  mg PO bid for 7 days
:* 2. '''T. vaginalis infection in pregnant and lactating Women'''
::* 2.1 '''Pregnant women'''
:::* Preferred regimen: [[Metronidazole]] 2 g PO in a single dose. 
::* 2.2 '''Post-partum and Breastfeeding'''
:::* Preferred regimen (1): [[Metronidazole]] 2 g PO in a single dose.
:::* Preferred regimen (2): [[Tinidazole]] 2 g PO in a single dose 
:::* Note (1): Do not breastfeed for 12-24 hrs following [[Metronidazole]] and 72 hrs following  [[Tinidazole]]
:::* Note (2): Symptomatic pregnant women, regardless of pregnancy stage, should be tested and considered for treatment. Pregnant women should be advised of the risk and benefits to treatment as infection (definitely) and treatment (possibly)
:::* Note (3): Pregnant women with HIV who are treated for T. vaginalis infection should be retested 3 months after treatment.
:* 3. '''T. vaginalis infection in patients with HIV'''
::* Preferred regimen: [[Metronidazole]] 500  mg PO bid for 7 days
:* 4. '''Persistent or recurrent trichomoniasis'''
::* 4.1 '''Treatment failure'''
:::* Preferred regimen: [[Metronidazole]] 500  mg PO bid for 7 days
::* 4.2 '''Treatment failure again'''
:::* Preferred regimen (1): [[Metronidazole]] 2 g PO for 7 days 
:::* Preferred regimen (2): [[Tinidazole]] 2 g PO for 7 days 
::* 4.3 '''Nitroimidazole-resistant cases'''
:::* Preferred regimen: [[Tinidazole]] 2-3 g PO for 14 days

==African trypanosomiasis==
{{PBI|African trypanosomiasis}}
:* ''' Sleeping sickness'''<ref>{{cite web|title=African Trypanosomiasis| url=  http://www.cdc.gov/parasites/sleepingsickness/health_professionals/index.html}}</ref>  
::* 1. '''East african trypanosomiasis'''
:::* 1.1 '''T. b. rhodesiense, hemolymphatic stage'''
::::* 1.1.1 '''Adult '''
:::::* Preferred regimen: [[Suramin]] 1 gm IV on days 1,3,5,14, and 21
::::* 1.1.2 '''Pediatric''' 
:::::* Preferred regimen: [[Suramin]] 20 mg/kg IV on days 1, 3, 5, 14, and 21
:::* 1.2 '''T. b. rhodesiense, CNS involvement'''
::::* 1.2.1 '''Adult'''
:::::* Preferred regimen: [[Melarsoprol]] 2-3.6 mg/kg/day IV for 3 days. After 7 days, 3.6 mg/kg/day for 3 days. Give a 3rd series of 3.6 mg/kg/d after 7 days.
::::* 1.2.2 '''Pediatric'''
:::::* Preferred regimen: [[Melarsoprol]] 2-3.6 mg/kg/day IV for 3 days. After 7 days, 3.6 mg/kg/day for 3 days. Give a 3rd series of 3.6 mg/kg/d after 7 days 
::* 2. '''West african trypanosomiasis'''
:::* 2.1 '''T. b. gambiense, hemolymphatic stage'''
::::* 2.1.1 '''Adult'''
:::::* Preferred regimen: [[Pentamidine]] 4 mg/kg/day IM/ IV for 7-10 days
::::* 2.1.2 '''Pediatric'''
:::::* Preferred regimen: [[Pentamidine]] 4 mg/kg/day IM/IV for 7-10 days
:::::* Note (1): Pentamidine should be used during pregnancy and lacation  only if the potential benefit justifies the potential risk 
:::::* Note (2): IM/IV Pentamidine have a similar safety profile in children age 4 months and older as in adults. Pentamidine is listed as a medicine for the treatment of 1st stage African trypanosomiasis infection (Trypanosoma brucei gambiense) on the WHO Model List of Essential Medicines for Children, intended for the use of children up to 12 years of age.
:::* 2.2  '''T. b. gambiense, CNS involvement'''
::::* 2.2.1 '''Adult''' 
:::::* Preferred regimen: [[Eflornithine]] 400 mg/kg/day  IV qid for 14 days
::::* 2.2.2 '''Pediatric'''
:::::* Preferred regimen: [[Eflornithine]] 400 mg/kg/day IV  qid for 14 days
:::::* Note (1): [[Eflornithine]] should be used during pregnancy and lactation, only if the potential benefit justifies the potential risk 
:::::* Note (2): The safety of [[Eflornithine]] in children has not been established. Eflornithine is not approved by the Food and Drug Administration (FDA) for use in pediatric patients. [[Eflornithine]] is listed for the treatment of 1st stage African trypanosomiasis inTrypanosoma brucei gambiense infection on the WHO Model List of Essential Medicines for Children, intended for the use of children up to 12 years of age.

==American trypanosomiasis==
{{PBI|American trypanosomiasis}}
:* '''Chagas disease'''<ref>{{Cite web | title =  Parasites - American Trypanosomiasis (also known as Chagas Disease) | url = http://www.cdc.gov/parasites/chagas/health_professionals/tx.html }}</ref>
::* 1. Preferred regimen(1):
:::* Patients of age < 12 years- [[Benznidazole]]  5-7.5 mg/kg/ day PO  bid for 60 days
:::* Patients of age 12 years or older- [[Benznidazole]]  5-7 mg/kg/day PO bid for 60 days
::* 2. Preferred regimen(2): 
:::* Patients of age ≤ 10 years- [[Nifurtimox]] 15-20 mg/kg/day PO tid/ qid for 90 days
:::* Patients of age 11-16 years- [[Nifurtimox]] 12.5-15 mg/kg/day PO tid/ qid for 90 days
:::* Patients of age 17 years or older-  [[Nifurtimox]]  8-10 mg/kg/day PO tid/ qid for 90 days
::* Note: In the United States, [[Nifurtimox]] and [[Benznidazole]] are not FDA approved and are available only from CDC under investigational protocols.

====Parasites – Intestinal Nematodes (Roundworms)====  

{{PBI|Gnathostoma spinigerum}}
:*'''Eosinophilic Meningitis''' 
:**Preferred regimen: Supportive measures. Anthelminthic therapy might be deleterious by augmenting the inflammation due to the death of the larvae. The use of corticosteroids is generally favored for suppression of the inflammation but there are no clinical trials that prove its efficacy.<ref name="pmid19123863">{{cite journal| author=Ramirez-Avila L, Slome S, Schuster FL, Gavali S, Schantz PM, Sejvar J et al.| title=Eosinophilic meningitis due to Angiostrongylus and Gnathostoma species. | journal=Clin Infect Dis | year= 2009 | volume= 48 | issue= 3 | pages= 322-7 | pmid=19123863 | doi=10.1086/595852 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19123863  }} </ref>
:*'''Cutaneous disease:'''
::*Preferred regimen: [[Albendazole]] 400 mg bid for 21 days {{or}} [[Ivermectin]] 200 mcg/kg qd for 2 days<ref>{{Cite web | title =Gnathostomiasis| url =http://www.cdc.gov/dpdx/gnathostomiasis/tx.html }}</ref>
::*Alternative regimen: [[Albendazole]] 400 mg qd for 21 days {{or}} [[Ivermectin]] 200 mcg/kg qd single dose<ref>{{Cite web | title =Gnathostomiasis| url =http://www.cdc.gov/dpdx/gnathostomiasis/tx.html }}</ref>

{{PBI|Ancylostoma braziliense}}
::* Preferred regimen<ref>{{Cite web | title = Parasites - Zoonotic Hookworm | url = http://www.cdc.gov/parasites/zoonotichookworm/health_professionals/index.html}}</ref>
:::* Adult: [[Albendazole]] 400 mg PO qd for 3 to 7 days
:::* Pediatric: [[Albendazole]] > 2 years 400 mg PO qd for 3 days
:::* Note: This drug is contraindicated in children younger than 2 years age
::* Alternative regimen<ref>{{Cite web | title = Parasites - Zoonotic Hookworm | url = http://www.cdc.gov/parasites/zoonotichookworm/health_professionals/index.html}}</ref>
:::* Adult: [[Ivermectin]] 200 mcg/kg PO qd for one or two days
:::* Pediatric: [[Ivermectin]] >15 kg give 200 mcg/kg single dose

{{PBI|Angiostrongylus cantonensis}}
:*Preferred: Symptomatic therapy, serial lumber puncture, corticosteroids (prednisone 60 mg qd for 2 weeks) and analgesics.<ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
:*Note: [[Albendazole]] and [[Mebendazole]] are generally not recommended due to the risk of exacerbation of neurological symptoms following anthelminthic therapy.<ref name="pmid19706911">{{cite journal| author=Chotmongkol V, Kittimongkolma S, Niwattayakul K, Intapan PM, Thavornpitak Y| title=Comparison of prednisolone plus albendazole with prednisolone alone for treatment of patients with eosinophilic meningitis. | journal=Am J Trop Med Hyg | year= 2009 | volume= 81 | issue= 3 | pages= 443-5 | pmid=19706911 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19706911  }} </ref>

{{PBI|Ascaris lumbricoides}}
::* Preferred regimen: [[Albendazole]] 400 mg PO qd {{or}} [[Mebendazole]] 500 mg PO qd or 100 mg bid for 3 days<ref>{{Cite web | title = Parasites - Ascariasis| url = http://www.cdc.gov/parasites/ascariasis/health_professionals/}}</ref>
:::*Note: [[Albendazole]] dose for children of 1-2 years is 200 mg instead of 400 mg.
::* Alternative regimen (1): [[Ivermectin]] 150 to 200 µg/kg PO single dose<ref>{{Cite web | title = Parasites - Ascariasis| url = http://www.cdc.gov/parasites/ascariasis/health_professionals/}}</ref>
::* Alternative regimen (2): [[Nitazoxanide]] 500 mg bid for 3 days <ref name="pmid9580117">{{cite journal| author=Romero Cabello R, Guerrero LR, Muñóz García MR, Geyne Cruz A| title=Nitazoxanide for the treatment of intestinal protozoan and helminthic infections in Mexico. | journal=Trans R Soc Trop Med Hyg | year= 1997 | volume= 91 | issue= 6 | pages= 701-3 | pmid=9580117 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9580117  }} </ref>
::* Alternative regimen (3): [[Levamisole]] 150 mg PO single dose
::*Note: Pediatric dose: 2.5 mg/kg single dose <ref name="pmid8863040">{{cite journal| author=Khuroo MS| title=Ascariasis. | journal=Gastroenterol Clin North Am | year= 1996 | volume= 25 | issue= 3 | pages= 553-77 | pmid=8863040 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8863040  }} </ref>
::* Alternative regimen (4): [[Pyrantel]] Pamoate 11 mg/kg single dose PO - maximum 1.0 g<ref name="pmid8863040">{{cite journal| author=Khuroo MS| title=Ascariasis. | journal=Gastroenterol Clin North Am | year= 1996 | volume= 25 | issue= 3 | pages= 553-77 | pmid=8863040 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8863040  }} </ref>
::* Alternative regimen (5): [[Piperazine citrate]] 75 mg/kg qd for 2 days - maximum 3.5 g<ref name="pmid8863040">{{cite journal| author=Khuroo MS| title=Ascariasis. | journal=Gastroenterol Clin North Am | year= 1996 | volume= 25 | issue= 3 | pages= 553-77 | pmid=8863040 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8863040  }} </ref> 

{{PBI|Capillaria philippinensis}} 
::* '''1. Intestinal capillariasis'''<ref>{{Cite journal| issn = 0893-8512| volume = 5| issue = 2| pages = 120–129| last = Cross| first = J. H.| title = Intestinal capillariasis| journal = Clinical Microbiology Reviews| date = 1992-04| pmid = 1576584| pmc = PMC358231}}</ref><ref>{{Cite journal| doi = 10.4269/ajtmh.2012.11-0321| issn = 1476-1645| volume = 86| issue = 1| pages = 126–133| last1 = Attia| first1 = Rasha A. H.| last2 = Tolba| first2 = Mohammed E. M.| last3 = Yones| first3 = Doaa A.| last4 = Bakir| first4 = Hanaa Y.| last5 = Eldeek| first5 = Hanan E. M.| last6 = Kamel| first6 = Shereef| title = Capillaria philippinensis in Upper Egypt: has it become endemic?| journal = The American Journal of Tropical Medicine and Hygiene| date = 2012-01| pmid = 22232463| pmc = PMC3247121}}</ref><ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
:::* Preferred regimen: [[Albendazole]] 400 mg/day PO for 10-30 days
:::* Alternative regimen: [[Mebendazole]] 200 mg PO bid for 20-30 days

{{PBI|Enterobius vermicularis}}
::* Preferred regimen (1): [[Albendazole]] 400 mg PO single dose - repeat in 2 weeks<ref name="pmid3130234">{{cite journal| author=Wang BR, Wang HC, Li LW, Zhang XL, Yue JQ, Wang GX et al.| title=Comparative efficacy of thienpydin, pyrantel pamoate, mebendazole and albendazole in treating ascariasis and enterobiasis. | journal=Chin Med J (Engl) | year= 1987 | volume= 100 | issue= 11 | pages= 928-30 | pmid=3130234 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3130234  }} </ref>
::* Preferred regimen (2): [[Mebendazole]] 100 mg PO single dose - repeat in 2 weeks
::* Alternative regimen (1): [[Ivermectin]] 200 µg/kg PO single dose - repeat in 10 days<ref name="pmid15344847">{{cite journal| author=Heukelbach J, Wilcke T, Winter B, Sales de Oliveira FA, Sabóia Moura RC, Harms G et al.| title=Efficacy of ivermectin in a patient population concomitantly infected with intestinal helminths and ectoparasites. | journal=Arzneimittelforschung | year= 2004 | volume= 54 | issue= 7 | pages= 416-21 | pmid=15344847 | doi=10.1055/s-0031-1296993 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15344847  }} </ref> 
::* Alternative regimen (2): [[Pyrantel pamoate]] 11 mg/kg up to 1.0 g PO single dose - repeat in 2 weeks<ref>{{cite book | last = Bennett | first = John | title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases | publisher = Elsevier/Saunders | location = Philadelphia, PA | year = 2015 | isbn = 978-1455748013 }}</ref>

{{PBI|Necator americanus}}
::* Preferred regimen: [[Albendazole]] 400 mg PO single dose<ref name="pmid18430913">{{cite journal| author=Keiser J, Utzinger J| title=Efficacy of current drugs against soil-transmitted helminth infections: systematic review and meta-analysis. | journal=JAMA | year= 2008 | volume= 299 | issue= 16 | pages= 1937-48 | pmid=18430913 | doi=10.1001/jama.299.16.1937 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18430913  }} </ref>
::* Alternative regimen (1): [[Mebendazole]] 100 mg PO bid or 500 mg daily for 3 days
::* Alternative regimen (2): [[Pyrantel pamoate]] 11 mg/kg PO qd (maximum 1 g/day) for 3 days<ref>{{cite book | last = Bennett | first = John | title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases | publisher = Elsevier/Saunders | location = Philadelphia, PA | year = 2015 | isbn = 978-1455748013 }}</ref>

{{PBI|Ancylostoma duodenale}}
::* Preferred regimen: [[Albendazole]] 400 mg PO single dose<ref name="pmid18430913">{{cite journal| author=Keiser J, Utzinger J| title=Efficacy of current drugs against soil-transmitted helminth infections: systematic review and meta-analysis. | journal=JAMA | year= 2008 | volume= 299 | issue= 16 | pages= 1937-48 | pmid=18430913 | doi=10.1001/jama.299.16.1937 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18430913  }} </ref>
::* Alternative regimen (1): [[Mebendazole]] 100 mg PO bid or 500 mg daily for 3 days
::* Alternative regimen (2): [[Pyrantel pamoate]] 11 mg/kg PO qd (maximum 1 g/day) for 3 days<ref>{{cite book | last = Bennett | first = John | title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases | publisher = Elsevier/Saunders | location = Philadelphia, PA | year = 2015 | isbn = 978-1455748013 }}</ref>

{{PBI|Strongyloides stercoralis}}
::* Preferred regimen: [[Ivermectin]] 200 mcg/kg/day PO qd for 2 days or two doses 2 weeks apart from each other<ref>{{Cite web | title = WGO Practice Guideline Management of Strongyloidiasis| url = http://www.worldgastroenterology.org/assets/downloads/en/pdf/guidelines/15_management_strongyloidiasis_en.pdf}}</ref>
::* Alternative regimen: [[Albendazole]] 400 mg PO bid for 3-7 days<ref name="pmid8483992">{{cite journal| author=Archibald LK, Beeching NJ, Gill GV, Bailey JW, Bell DR| title=Albendazole is effective treatment for chronic strongyloidiasis. | journal=Q J Med | year= 1993 | volume= 86 | issue= 3 | pages= 191-5 | pmid=8483992 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8483992  }} </ref>

{{PBI|Trichuris trichiura}}
::* Preferred regimen: [[Albendazole]] 400 mg PO qd for 3 days
::* Alternatie regimen (1): [[Mebendazole]] 100 mg PO bid for 3 days
::* Alternative regimen (2): [[Ivermectin]] 200 mcg/kg/day PO qd for 3 days<ref>{{Cite web | title = Parasites - Trichuriasis| url = http://www.cdc.gov/parasites/whipworm/health_professionals/index.html#tx}}</ref>

====Parasites – Extraintestinal Nematodes (Roundworms)====  
{{PBI|Ancylostoma braziliense}}
::* Preferred regimen<ref>{{Cite web | title = Parasites - Zoonotic Hookworm | url = http://www.cdc.gov/parasites/zoonotichookworm/health_professionals/index.html}}</ref>
:::* Adult: [[Albendazole]] 400mg PO qd for 3-7 days.
:::* Pediatric: [[Albendazole]] > 2 years 400mg PO qd for 3 days
:::* Note: This drug is contraindicated in children younger than 2 years.
::* Alternative regimen<ref>{{Cite web | title = Parasites - Zoonotic Hookworm | url = http://www.cdc.gov/parasites/zoonotichookworm/health_professionals/index.html}}</ref>
:::* Adult: [[Ivermectin]] 200 mcg/kg PO qd for one or two days.
:::* Pediatric: [[Ivermectin]] >15 kg give 200mcg/kg single dose.

{{PBI|Angiostrongylus cantonensis}}
:*Preferred: Symptomatic therapy, serial lumber puncture, corticosteroids (prednisone 60mg qd for 2 weeks) and analgesics<ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
:*Note: [[Albendazole]] and [[Mebendazole]] are generally not recommended due to the risk of exacerbation of neurological symptoms following anthelminthic therapy.<ref name="pmid19706911">{{cite journal| author=Chotmongkol V, Kittimongkolma S, Niwattayakul K, Intapan PM, Thavornpitak Y| title=Comparison of prednisolone plus albendazole with prednisolone alone for treatment of patients with eosinophilic meningitis. | journal=Am J Trop Med Hyg | year= 2009 | volume= 81 | issue= 3 | pages= 443-5 | pmid=19706911 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19706911  }} </ref>

----

{{PBI|Filariasis}}
:* '''Filariasis'''<ref>{{cite web | title = Drugs for Parasitic Infections (Treatment Guidelines from The Medical Letter) | url = http://secure.medicalletter.org/para }}</ref><ref name="pmid20739055">{{cite journal| author=Taylor MJ, Hoerauf A, Bockarie M| title=Lymphatic filariasis and onchocerciasis. | journal=Lancet | year= 2010 | volume= 376 | issue= 9747 | pages= 1175-85 | pmid=20739055 | doi=10.1016/S0140-6736(10)60586-7 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20739055  }} </ref><ref name="pmid22632644">{{cite journal| author=Knopp S, Steinmann P, Hatz C, Keiser J, Utzinger J| title=Nematode infections: filariases. | journal=Infect Dis Clin North Am | year= 2012 | volume= 26 | issue= 2 | pages= 359-81 | pmid=22632644 | doi=10.1016/j.idc.2012.02.005 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22632644  }}</ref>
::* 1. '''Lymphatic filariasis caused by Wuchereria bancrofti, Brugia malayi, Brugia timori'''
:::* Preferred regimen: [[Diethylcarbamazine]] 6 mg/kd/day PO tid for 12 days (single dose if patient will continue to live in endemic area or is younger than 9 years old)
::* 2. '''Loa loa filariasis'''<ref>{{cite web | title = Parasites - Loiasis (CDC) | url = http://www.cdc.gov/parasites/loiasis/health_professionals/index.html }}</ref>
:::* 2.1 '''Symptomatic loiasis with < 8,000 microfilariae/mL'''
::::* Preferred regimen: [[Diethylcarbamazine]] 8–10 mg/kd/day PO tid for 21 days
:::* 2.2 '''Symptomatic loiasis, with < 8,000 microfilariae/mL and failed 2 rounds DEC'''
::::* Preferred regimen: [[Albendazole]] 200 mg PO bid for 21 days
:::* 2.3 '''Symptomatic loiasis, with ≥ 8,000 microfilariae/ml to suppress microfilaremia prior to treatment with DEC'''
::::* Preferred regimen: [[Albendazole]] 200 mg PO bid for 21 days
:::* 2.4 '''Symptomatic loiasis, with ≥ 8,000 microfilariae/mL'''
::::* Preferred regimen: Apheresis followed by [[Diethylcarbamazine]]
::::* Note: Apheresis should be performed at an institution with experience in using this therapeutic modality for loiasis.
::* 3. '''River blindness (onchocerciasis) caused by Onchocerca volvulus'''
:::* Preferred regimen: [[Ivermectin]] 150 μg/kg PO single dose, repeated every 6-12 mos until asymptomatic
:::* Alternative regimen: [[Doxycycline]] 100 mg PO qd for 6 weeks, alone or followed by [[Ivermectin]] 150 μg/kg PO single dose
:::* Note: Do <u>NOT</u> administer Diethylcarbamazine where onchocerciasis is endemic due to increased risk for severe local inflammation in patients with ocular microfilariae.
::* 4. '''Mansonella ozzardi'''
:::* Preferred regimen: [[Ivermectin]] 200 μg/kg PO single dose
:::* Note: Endosymbiotic Wolbachia are essential to filarial growth, development, embryogenesis and survival and represent an additional target for therapy.  [[Doxycycline]] 100–200 mg PO qd for 6–8 weeks results in loss of Wolbachia and decrease in both micro- and macrofilariae.
::* 5. '''Mansonella perstans'''
:::* Preferred regimen: [[Doxycycline]] 100–200 mg PO qd for 6–8 weeks
::* 6. '''Mansonella streptocerca'''
:::* Preferred regimen (1): [[Diethylcarbamazine]] 6 mg/kd/day PO tid for 12 days
:::* Preferred regimen (2): [[Ivermectin]] 150 μg/kg PO single dose
::* 7. '''Tropical pulmonary eosinophilia caused by Wuchereria bancrofti'''
:::* Preferred regimen: [[Diethylcarbamazine]] 6 mg/kd/day PO tid for 12–21 days

----

{{PBI|Gnathostoma spinigerum}}
:*'''Eosinophilic Meningitis'''
:**Preferred regimen: Supportive measures. Anthelminthic therapy might be deleterious by augmenting the inflammation due to the death of the larvae. The use of corticosteroids is generally favored for suppression of the inflammation but there are no clinical trials that prove its efficacy.<ref name="pmid19123863">{{cite journal| author=Ramirez-Avila L, Slome S, Schuster FL, Gavali S, Schantz PM, Sejvar J et al.| title=Eosinophilic meningitis due to Angiostrongylus and Gnathostoma species. | journal=Clin Infect Dis | year= 2009 | volume= 48 | issue= 3 | pages= 322-7 | pmid=19123863 | doi=10.1086/595852 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19123863  }} </ref>
:*'''Cutaneous disease:'''
::*Preferred regimen: [[Albendazole]] 400 mg bid for 21 days {{or}} [[Ivermectin]] 200 mcg/kg once daily for 2 days<ref>{{Cite web | title =Gnathostomiasis| url =http://www.cdc.gov/dpdx/gnathostomiasis/tx.html }}</ref>
::*Alternative regimen: [[Albendazole]] 400 mg daily for 21 days {{or}} [[Ivermectin]] 200 mcg/kg once daily for 1 day<ref>{{Cite web | title =Gnathostomiasis| url =http://www.cdc.gov/dpdx/gnathostomiasis/tx.html }}</ref>

{{PBI|Toxocariasis}}
:*'''1.1 Visceral toxocariasis'''
::*Preferred regimen: [[Albendazole]] 400 mg PO bid for five days (both adult and pediatric dosage)
::*Alternative regimen: [[Mebendazole]] 100-200 mg PO bid for five days (both adult and pediatric dosage)
::*Note: Treatment is indicated for moderate-severe cases. Patients with mild symptoms of toxocariasis may not require anthelminthic therapy as symptoms are limited.<ref name="pmid622118">{{cite journal| author=Schantz PM, Glickman LT| title=Toxocaral visceral larva migrans. | journal=N Engl J Med | year= 1978 | volume= 298 | issue= 8 | pages= 436-9 | pmid=622118 | doi=10.1056/NEJM197802232980806 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=622118  }} </ref>
:*'''1.2 Ocular toxocariasis'''
::*Preferred regimen: [[Prednisone]] 0.5-1mg/kg/day PO q24h {{and}} [[Albendazole]] 400mg PO bid for 2 to 4 weeks (pediatric dose: 400mg PO qd)<ref name="pmid11436948">{{cite journal| author=Barisani-Asenbauer T, Maca SM, Hauff W, Kaminski SL, Domanovits H, Theyer I et al.| title=Treatment of ocular toxocariasis with albendazole. | journal=J Ocul Pharmacol Ther | year= 2001 | volume= 17 | issue= 3 | pages= 287-94 | pmid=11436948 | doi=10.1089/108076801750295317 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11436948  }} </ref>
::*Note: Surgical therapy might be neeeded.

{{PBI|Trichinella spiralis}}
:* Trichinella spiralis<ref name="pmid19136437">{{cite journal| author=Gottstein B, Pozio E, Nöckler K| title=Epidemiology, diagnosis, treatment, and control of trichinellosis. | journal=Clin Microbiol Rev | year= 2009 | volume= 22 | issue= 1 | pages= 127-45, Table of Contents | pmid=19136437 | doi=10.1128/CMR.00026-08 | pmc=PMC2620635 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19136437  }} </ref>
::* Preferred regimen (1): [[Albendazole]] 400 mg PO bid for 8-14 days
::* Preferred regimen (2): [[Mebendazole]] 200-400 mg PO tid for 3 days {{then}} 400-500 mg PO tid for 10 days
::* Note (1): Both treatment schemes are suitable for adult and pediatric dosages 
::* Note (1): Albendazole and Mebendazole are contraindicated during pregnancy and not recommended in children aged 2 years.
::* Alternative regimen (1): (severe symptoms) [[Prednisone]] 30 mg/day-60 mg/day for 10-15 days
::* Alternative regimen (2): [[Pyrantel]] 10-20 mg/kg single dose for 2-3 days

====Parasites – Trematodes (Flukes)====  
{{PBI|Clonorchis sinensis}}
:*Preferred regimen: [[Praziquantel]] 75mg/kg/day PO tid for 2 days<ref>{{Cite web | title =Clonorchis | url = http://www.cdc.gov/parasites/clonorchis/health_professionals/index.html}}</ref>
:*Alternative regimen (1): [[Albendazole]] 10mg/kg/day PO qd for 7 days<ref>{{Cite web | title =Clonorchis | url = http://www.cdc.gov/parasites/clonorchis/health_professionals/index.html}}</ref>
:*Alternative regimen (2): [[Tribendimidine]] 400mg PO single dose<ref name="pmid23223597">{{cite journal| author=Qian MB, Yap P, Yang YC, Liang H, Jiang ZH, Li W et al.| title=Efficacy and safety of tribendimidine against Clonorchis sinensis. | journal=Clin Infect Dis | year= 2013 | volume= 56 | issue= 7 | pages= e76-82 | pmid=23223597 | doi=10.1093/cid/cis1011 | pmc=PMC3588115 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23223597  }} </ref>
:* This regimen is still under investigation, but it appears to be as effective as [[Praziquantel]].
:*Note: Urgent biliary decompression might be required for patients with acute cholangitis.

{{PBI|Dicrocoelium dendriticum}}
:*Preferred regimen: [[Praziquantel]] 25 mg/kg PO tid for 2 days<ref>{{Cite web | title =Dicrocoeliasis| url =http://www.cdc.gov/dpdx/dicrocoeliasis/tx.html }}</ref>
:*Note: [[Praziquantel]] is not approved for treatment of children less than 4 years old.<ref>{{Cite web | title =Dicrocoeliasis| url =http://www.cdc.gov/dpdx/dicrocoeliasis/tx.html }}</ref>
:*Alternative regimen (1): [[Myrrh]] (commiphora molmol) 12 mg/kg/day PO for 6 days<ref name="pmid17418062">{{cite journal| author=Rana SS, Bhasin DK, Nanda M, Singh K| title=Parasitic infestations of the biliary tract. | journal=Curr Gastroenterol Rep | year= 2007 | volume= 9 | issue= 2 | pages= 156-64 | pmid=17418062 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17418062  }} </ref>
:*Alternative regimen (2): [[Triclabendazole]] 10 mg/kg PO single dose<ref name="pmid17418062">{{cite journal| author=Rana SS, Bhasin DK, Nanda M, Singh K| title=Parasitic infestations of the biliary tract. | journal=Curr Gastroenterol Rep | year= 2007 | volume= 9 | issue= 2 | pages= 156-64 | pmid=17418062 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17418062  }} </ref>

{{PBI|Fasciola hepatica}}
:*Preferred regimen: [[Triclabendazole]] 10 mg/kg PO one dose<ref>{{Cite web | title =Parasites - Fascioliasis| url = http://www.cdc.gov/parasites/fasciola/health_professionals/}}</ref>
:*Note: Two-dose (double-dose) triclabendazole therapy can be given to patients who have severe or heavy Fasciola infections (many parasites) or who did not respond to single-dose therapy.
:*Alternative regimen: [[Nitazoxanide]] 500mg PO bid for 7 days

{{PBI|Paragonimus westermani}}
:*Preferred regimen (1): [[Praziquantel]] 25 mg/kg PO tid for 3 days<ref>{{Cite web | title =Parasites - Paragonimiasis| url =http://www.cdc.gov/parasites/paragonimus/health_professionals/index.html }}</ref>
:*Preferred regimen (2): [[Triclabendazole]] 10 mg/kg PO qd or bid
:*Alternative regimen (1): [[Bithinol]] 30-50mg/kg PO on alternate days for 10-15 doses
:*Alternative regimen (2): [[Niclosamide]] 2mg/kg PO single dose

{{PBI|Schistosomiasis}}
:*'''1. Schistosoma mansoni, S. haematobium, S. intercalatum'''<ref name="pmid24698483">{{cite journal| author=Colley DG, Bustinduy AL, Secor WE, King CH| title=Human schistosomiasis. | journal=Lancet | year= 2014 | volume= 383 | issue= 9936 | pages= 2253-64 | pmid=24698483 | doi=10.1016/S0140-6736(13)61949-2 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24698483  }} </ref>
::*Preferred regimen: [[Praziquantel]] 40 mg/kg per day PO in qd or bid for one day
::*Alternative regimen (1): [[Oxamniquine]] 20 mg/kg PO single dose<ref>National Center for Biotechnology Information. PubChem Compound Database; CID=4612, https://pubchem.ncbi.nlm.nih.gov/compound/4612 (accessed July 16, 2015).</ref><ref>BINA, J. C.  and  PRATA, A.. Tratamento da esquistossomose com oxamniquine (xarope) em crianças. Rev. Soc. Bras. Med. Trop.[online]. 1975, vol.9, n.4 [cited  2015-07-16], pp. 175-178 . Available from: <http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86821975000400002&lng=en&nrm=iso>. ISSN 0037-8682.  http://dx.doi.org/10.1590/S0037-86821975000400002.</ref>
::*Alternative regimen (2): [[Artemisinin]] no dose is established yet<ref name="pmid24698483">{{cite journal| author=Colley DG, Bustinduy AL, Secor WE, King CH| title=Human schistosomiasis. | journal=Lancet | year= 2014 | volume= 383 | issue= 9936 | pages= 2253-64 | pmid=24698483 | doi=10.1016/S0140-6736(13)61949-2 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24698483  }} </ref>
::*Alternative regimen (3): [[Mefloquine]] 250 mg PO single dose
::*Note: There is no benefit in associating the alternative therapies to Praziquantel.
::*Note: Praziquantel is not effective against larval/egg stages of the disease.<ref name="pmid24445340">{{cite journal| author=Paramythiotou E, Frantzeskaki F, Flevari A, Armaganidis A, Dimopoulos G| title=Invasive fungal infections in the ICU: how to approach, how to treat. | journal=Molecules | year= 2014 | volume= 19 | issue= 1 | pages= 1085-119 | pmid=24445340 | doi=10.3390/molecules19011085 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24445340  }} </ref>

:*'''2. S. japonicum, S. mekongi'''<ref name="pmid24698483">{{cite journal| author=Colley DG, Bustinduy AL, Secor WE, King CH| title=Human schistosomiasis. | journal=Lancet | year= 2014 | volume= 383 | issue= 9936 | pages= 2253-64 | pmid=24698483 | doi=10.1016/S0140-6736(13)61949-2 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24698483  }} </ref>
::*Preferred regimen: [[Praziquantel]] 60 mg/kg per day PO bid for one day
::*Alternative regimen (1): [[Artemisinin]] no dose is established yet
::*Alternative regimen (2): [[Mefloquine]] 250 mg PO single dose
::*Note: There is no benefit in associating the alternative therapies to Praziquantel.

:*'''3. Katayama Fever'''
::*Preferred regimen: Prednisone 20-40 mg/day PO for 5 days, {{then}} Praziquantel<ref name="pmid20222897">{{cite journal| author=Jauréguiberry S, Paris L, Caumes E| title=Acute schistosomiasis, a diagnostic and therapeutic challenge. | journal=Clin Microbiol Infect | year= 2010 | volume= 16 | issue= 3 | pages= 225-31 | pmid=20222897 | doi=10.1111/j.1469-0691.2009.03131.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20222897  }} </ref>
::*Note: Praziquantel should be used after 4-6 weeks of exposure, because it cannot kill the larvae stages of the Schistosoma. Praziquantel should be used after acute schistosomiasis syndrome symptoms have resolved always together with corticosteroids, only when ova are detected in stool or urine samples.<ref name="pmid19292640">{{cite journal| author=Jauréguiberry S, Paris L, Caumes E| title=Difficulties in the diagnosis and treatment of acute schistosomiasis. | journal=Clin Infect Dis | year= 2009 | volume= 48 | issue= 8 | pages= 1163-4; author reply 1164-5 | pmid=19292640 | doi=10.1086/597497 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19292640  }} </ref>
:*'''4. Neuroschistosomiasis'''
::*Preferred regimen: prednisone 1-2 mg/kg
::*Note: Praziquantel should only be introduced after a few days of the initiation of corticosteroid therapy, due to the risk of increasing the inflammatory response.

====Parasites – Cestodes (Tapeworms)====  

{{PBI|Echinococcus}}
* Echinococcus treatment<ref name="pmid8863045">{{cite journal| author=Ammann RW, Eckert J| title=Cestodes. Echinococcus. | journal=Gastroenterol Clin North Am | year= 1996 | volume= 25 | issue= 3 | pages= 655-89 | pmid=8863045 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8863045  }} </ref>
:* 1.1 '''Echinococcus granulosus (hydatid disease) treatment'''<ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy 2014 | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2014 | isbn = 978-1930808782 }}</ref>
::* Preferred regimen: [[Albendazole]] ≥ 60 kg 400 mg PO bid or < 60 kg 10-15 mg/kg/day PO bid with meals for 3-6 months
::*Alternative regimen: [[Mebendazole]] 40-50mg/kg/day PO tid for 3-6 months
::*Note: Percutaneous aspiration-injection-reaspiration (PAIR). Puncture & needle aspirate cyst content. Instill hypertonic saline (15–30%) or absolute alcohol, wait 20–30 min, then re-aspirate with final irrigation. Administer [[Albendazole]] at least 4 hours before PAIR.
::*Note: If surgery is needed, make sure to administer [[Albendazole]] for at least a week before the surgery, and to keep the medication for at least 4 weeks after the procedure.
:* 1.2 '''Echinococcus multilocularis (alveolar cyst disease) treatment'''<ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy 2014 | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2014 | isbn = 978-1930808782 }}</ref> 
::* Preferred regimen: [[Albendazole]] ≥ 60 kg 400 mg PO bid or < 60 kg 15 mg/kg/day PO bid with meals for at least 2 years. Long-term follow up needed to evaluate progression of the lesions.
::: Note: Wide surgical resection only reliable treatment; technique evolving.

==Neurocysticercosis==
{{PBI|Neurocysticercosis}}
:* '''Neurocysticercosis treatment'''
::* 1. '''Parenchymal neurocysticercosis'''
:::* 1.1 '''Single lesions'''<ref name="pmid12364377">{{cite journal| author=García HH, Evans CA, Nash TE, Takayanagui OM, White AC, Botero D et al.| title=Current consensus guidelines for treatment of neurocysticercosis. | journal=Clin Microbiol Rev | year= 2002 | volume= 15 | issue= 4 | pages= 747-56 | pmid=12364377 | doi= | pmc=PMC126865 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12364377  }} </ref>
::::* Preferred regimen:  [[Albendazole]] 15 mg/kg/day PO bid for 3-8 days {{and}} [[Prednisone]] 1 mg/kg/day PO qid for 8-10 days followed by a taper
:::* 1.2  '''Multiple cysts'''
::::* Preferred regimen: [[Albendazole]] 15 mg/kg/day PO bid for 8-15 days and high-dose steroids
::::* Preferred regimen: [[Praziquantel]] 50 mg/kg/day PO tid {{and}} [[Albendazole]] 15 mg/kg/day PO bid 
:::* 1.3 '''Cysticercal encephalitis''' <ref name="pmid12364377">{{cite journal| author=García HH, Evans CA, Nash TE, Takayanagui OM, White AC, Botero D et al.| title=Current consensus guidelines for treatment of neurocysticercosis. | journal=Clin Microbiol Rev | year= 2002 | volume= 15 | issue= 4 | pages= 747-56 | pmid=12364377 | doi= | pmc=PMC126865 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12364377  }} </ref>
::::* Cysticercal encephalitis (diffuse cerebral edema associated with multiple inflamed cysticerci) is a contraindication for antiparasitic therapy, since enhanced parasite killing can exacerbate host inflammatory response and lead to diffuse cerebral edema and potential transtentorial herniation. Most cases of cysticercal encephalitis improve with corticosteroid therapy
:::* 1.4 '''Calcified cysts ''' 
::::* Radiographic evidence of parenchymal calcifications is a significant risk factor for recurrent seizure activity; these lesions are present in about 10 percent of individuals in regions where neurocysticercosis is endemic. Seizures in these patients should be treated with antiepileptic therapy. 
::* 2. '''Extraparenchymal NCC'''
:::* 2.1 '''Subarachnoid cysts'''
::::* Preferred regimen: [[Albendazole]]  15 mg/kg/day PO bid  for  28 days {{and}} ([[Prednisone]] up to 60 mg/day PO {{or}} [[Dexamethasone]] (up to 24 mg/day)) along with the antiparasitic therapy. The dose can often be tapered after a few weeks. However, in cases for which more prolonged steroid therapy is required, methotrexate can be used as a steroid-sparing agent 
:::*  2.2 '''Giant cysts'''
::::* Giant cysticerci are usually accompanied by cerebral edema and mass effect, which should be managed with high-dose corticosteroids (with or without mannitol).
:::* 2.3 ''' Intraventricular cysts''' 
::::* Emergent management with CSF diversion via a ventriculostomy or placement of a ventriculo-peritoneal shunt
::::* Treatment of residual hydrocephalus may be managed with endoscopic foraminotomy and endoscopic third ventriculostomy; this approach may also allow debulking of cisternal cysticerci
:::* 2.4 ''' Ocular cysticercosis'''
::::* Surgical excision is warranted in the setting of intraocular cysts
::::* Cysticercal involvement of the extraocular muscles should be managed with albendazole and corticosteroids.
:::* 2.5 '''Spinal cysticercosis'''
::::* Medical therapy with corticosteroids and antiparasitic drugs

{{PBI|Sparganosis}}
:* '''Sparganosis (Spirometra mansonoides) treatment''' <ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy 2014 | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2014 | isbn = 978-1930808782 }}</ref>
::* Preferred treatment: Surgical resection or ethanol injection of subcutaneous masses
::*Note: [[Praziquantel]] 75 mg/kg/day PO qd for 3 days is controversial. It's been innefective in some cases, but has had some results in patients when surgical therapy wasn't an option.<ref name="pmid21359068">{{cite journal| author=Lee JH, Kim GH, Kim SM, Lee SY, Lee WY, Bae JW et al.| title=A case of sparganosis that presented as a recurrent pericardial effusion. | journal=Korean Circ J | year= 2011 | volume= 41 | issue= 1 | pages= 38-42 | pmid=21359068 | doi=10.4070/kcj.2011.41.1.38 | pmc=PMC3040402 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21359068  }} </ref>


====Parasites – Ectoparasites====  

{{PBI|Body lice}}
:* '''Pediculus humanus, corporis treatment'''<ref>{{Cite web | title = body lice | url =http://www.cdc.gov/parasites/lice/body/treatment.html }} </ref>
::*  A body lice infestation is treated by improving the personal hygiene of the infested person, including assuring a regular (at least weekly) change of clean clothes.
::*  Clothing, bedding, and towels used by the infested person should be laundered using hot water (at least 130°F) and machine dried using the hot cycle.
::*  Sometimes the infested person also is treated with a pediculicide [[Ivermectin]] Lotion; however, a pediculicide  [[Ivermectin]] generally is not necessary if hygiene is maintained and items are laundered appropriately at least once a week. A pediculicide [[Ivermectin]] should be applied exactly as directed on the bottle or by your physician.

{{PBI|Head lice}}
:* '''Pediculus humanus, capitis treatment'''<ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
::* Preferred regimen (1): [[Permethrin]] 1% lotion apply to shampooed dried hair for 10 min.; repeat in 9-10 days 
::* Preferred regimen (2):  [[Malathion]] 0.5% lotion (Ovide) apply to dry hair for 8–12hrs, then shampoo (2 doses 7-9 days apart)
::* Alternative regimen: [[Ivermectin]] 200 μg/kg PO once; 3 doses at 7 day intervals reported effective. 

{{PBI|Pubic lice}}
:* '''Phthirus pubis treatment'''<ref>{{Cite journal| issn = 1545-8601| volume = 64| issue = RR-03| pages = 1–137| last1 = Workowski| first1 = Kimberly A.| last2 = Bolan| first2 = Gail A.| title = Sexually transmitted diseases treatment guidelines, 2015| journal = MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control| date = 2015-06-05| pmid = 26042815}}</ref>
::* Preferred regimen (1): [[Permethrin]] 1% cream rinse applied to affected areas and washed off after 10 minutes
::* Preferred regimen (2): Pyrethrins with piperonyl butoxide applied to the affected area and washed off after 10 minutes 
::* Alternative regimen (1): [[Malathion]] 0.5% lotion applied to affected areas and washed off after 8–12 hours
::* Alternative regimen (2): [[Ivermectin]] 250 ug/kg  PO, repeated in 2 weeks

{{PBI|Myiasis}}
:*Preferred regimen: No medications approved by the FDA are available for treatment<ref>{{Cite web | title =Parasites - Myiasis | url =http://www.cdc.gov/parasites/myiasis/health_professionals/index.html }}</ref>
:*Note: Fly larvae need to be surgically removed.
::* '''Fly larvae treatment''' <ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy 2014 | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2014 | isbn = 978-1930808782 }}</ref>
::* Preferred treatment (1): Occlude punctum to prevent gas exchange with petrolatum, fingernail polish, makeup cream or bacon.
::* Preferred treatment (2): When larva migrates, manually remove.  
::*Note (1): Myiasis is due to larvae of flies.
::*Note (2): Usually cutaneous/subcutaneous nodule with central punctum.

{{PBI|Scabies}}
:* '''Sarcoptes scabiei treatment'''<ref>{{Cite journal| issn = 1545-8601| volume = 64| issue = RR-03| pages = 1–137| last1 = Workowski| first1 = Kimberly A.| last2 = Bolan| first2 = Gail A.| title = Sexually transmitted diseases treatment guidelines, 2015| journal = MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control| date = 2015-06-05| pmid = 26042815}}</ref>
::* 1. '''Adult'''
:::* Preferred regimen (1): [[Permethrin]] 5% cream applied to all areas of the body from the neck down and washed off after 8–14 hours
:::* Preferred regimen (2): [[Ivermectin]]  200 ug/kg PO qd and repeated in 2 weeks
:::* Alternative regimen: [[Lindane]] (1%) 1 oz of lotion or 30 g of cream applied in a thin layer to all areas of the body from the neck down and thoroughly washed off after 8 hours
::*  2. '''Infants and young children'''
:::* Preferred regimen: [[Permethrin]] 5% cream applied to all areas of the body from the neck down and washed off after 8–14 hours
:::* Note: Infants and young children aged< 10 years should not be treated with lindane.
::*  3. '''Crusted Scabies'''
:::* Crusted scabies (i.e., Norwegian scabies) is an aggressive infestation that usually occurs in immunodeficient, debilitated, or malnourished persons, including persons receiving systemic or potent topical glucocorticoids, organ transplant recipients, persons with HIV infection or human T-lymphotrophic virus-1-infection, and persons with hematologic malignancies.
::::* Preferred regimen:   (Topical scabicide  5% topical [[Benzyl benzoate]] 5% {{or}}  topical [[Permethrin]]  5% cream (full-body application to be repeated daily for 7 days then twice weekly until discharge or cure) {{and}} treatment with [[Ivermectin]] 200 ug/kg  PO on days 1,2,8,9, and 15. Additional [[Ivermectin]] treatment on days 22 and 29 might be required for severe cases
::*  4.'''Pregnant or Lactating Women'''
:::* Preferred regimen: [[Permethrin]] 5% cream applied to all areas of the body from the neck down and washed off after 8–14 hours

====Viruses====

{{PBI|Adenovirus}}
:* '''Adenovirus'''<ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy 2014 | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2014 | isbn = 978-1930808782 }}</ref>
::* 1. '''In severe cases of pneumonia or post hematopoietic stem cell transplantation'''
:::* Preferred regimen (1): [[Cidofovir]] 5 mg/kg/week IV for 2 weeks, then every 2 weeks {{and}} [[Probenecid]] 1.25 g/M<sup>2</sup> PO given 3 hours before [[Cidofovir]] and 3 & 9 hours after each infusion 
:::* Preferred regimen (2): [[Cidofovir]] 1 mg/kg IV 3 times per week
:::*Note: [[Ganciclovir]], [[Foscarnet]] and [[Ribavirin]] are not recommended for use on adenovirus infection.<ref name="pmid24982316">{{cite journal| author=Lion T| title=Adenovirus infections in immunocompetent and immunocompromised patients. | journal=Clin Microbiol Rev | year= 2014 | volume= 27 | issue= 3 | pages= 441-62 | pmid=24982316 | doi=10.1128/CMR.00116-13 | pmc=PMC4135893 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24982316  }} </ref>
::* 2. '''For hemorrhagic cystitis'''
:::* Preferred regimen: [[Cidofovir]] (5 mg/kg in 100 mL saline instilled into bladder) intravesical<ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy 2014 | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2014 | isbn = 978-1930808782 }}</ref>
::* 3. '''Pink eye (viral conjunctivitis)'''
:::*Preferred regimen: No specific treatment available. If symptomatic, cold artificial tears may help. 
::* 4.'''Bronchitis'''
:::*Preferred regimen: No specific therapy recommended, treatment is symptomatic.


{{PBI|SARS}}
:* '''Severe acute respiratory distress syndrome- coronavirus'''<ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy 2014 | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2014 | isbn = 978-1930808782 }}</ref><ref name="pmid16968120">{{cite journal| author=Stockman LJ, Bellamy R, Garner P| title=SARS: systematic review of treatment effects. | journal=PLoS Med | year= 2006 | volume= 3 | issue= 9 | pages= e343 | pmid=16968120 | doi=10.1371/journal.pmed.0030343 | pmc=PMC1564166 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16968120  }} </ref><ref name="pmid15766649">{{cite journal| author=Groneberg DA, Poutanen SM, Low DE, Lode H, Welte T, Zabel P| title=Treatment and vaccines for severe acute respiratory syndrome. | journal=Lancet Infect Dis | year= 2005 | volume= 5 | issue= 3 | pages= 147-55 | pmid=15766649 | doi=10.1016/S1473-3099(05)01307-1 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15766649  }} </ref>
:*Preferred regimen: supportive therapy
:*Note: New therapies were studied for SARS during the last outbreaks which concluded:
::* [[Ribavirin]] ineffective and probably harmful due to haemolytic anaemia
::* [[Lopinavir]] {{plus}} [[Ritonavir]] is still controversial and need further investigation
::* Interferon has no benefit and its studies are inconclusive
::* [[Corticosteroids]] increases risk of fungal infections, some studies showed a higher incidence of psychosis, diabetes, avascular necrosis and osteoporosis 
::* Inhaled [[Nitric oxide]] potent mediator of airway inflammation, its has improved oxygenation in some studies


{{PBI|Cytomegalovirus}}
:* '''Cytomegalovirus treatment'''<ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy 2014 | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2014 | isbn = 978-1930808782 }}</ref>
::*1. '''Immunocompetent patients'''
:::*1.1 '''Mononucleosis syndrome'''
::::*Preferred regimen: supportive therapy
:::*1.2 '''CMV in pregnancy'''
::::*Preferred regimen: Hyperimmune 200 IU/kg of maternal weight as single-dose during pregnancy
::*2. '''Immunocompromised patients'''
:::*2.1 '''Retinitis'''
::::*Preferred regimen (1): [[Ganciclovir]] intraocular implant {{plus}} [[Valganciclovir]] 900 mg PO bid for 14-21 days {{then}} [[Valganciclovir]] 900mg PO qq for maintenance therapy - for immediate sight-threatening lesions
::::*Preferred regimen (2): [[Valganciclovir]] 900 mg PO bid for 14-21 days {{then}} [[Valganciclovir]] 900 mg PO qq for maintenance therapy - for peripheral lesions
::::*Alternative regimen (1): [[Foscarnet]] 60 mg/kg IV q8h {{or}} [[Foscarnet]] 90 mg/kg IV q12h for 14-21 days {{then}} [[Foscarnet]] 90-120 mg/kg IV q24h 
::::*Alternative regimen (2): [[Cidofovir]] 5 mg/kg IV for 2 weeks {{then}} [[Cidofovir]] 5 mg/kg IV every other week - each dose should be admnistered with IV saline hydration and probenecid
::::*Alternative regimen (3): [[Ganciclovir]] 5 mg/kg IV q12h for 14-21 days {{then}} [[Valganciclovir]] 900 mg PO bid
::::*Alternative regimen (4): [[Fomivirsen]] intravitreal injection - for relapses
::::*Note: keep a maintenance dose of [[Valganciclovir]] 900 mg PO qd until CD4 >100/mm³
:::* 2.2 '''Transplant patients'''
::::*Preferred regimen: [[Valganciclovir]] 900 mg PO bid {{or}} [[Ganciclovir]] 5 mg/kg IV q12h for at least 2-3 weeek
::::*Note: Use [[Valganciclovir]] 900 mg PO qd for 1-3 months if high dose of immunosuppression. 
:::* 2.3 '''Colitis, esophagitis, gastritis'''
::::*Preferred regimen: [[Ganciclovir]] 5 mg/kg/dose IV q12h for 3-6 weeks weeks for induction. There is no agreement on the use of maintenance.
::::*Alternative regimen: [[Cidofovir]] 5 mg/kg IV for 2 weeks, then 5 mg/kg every other week; each dose should be administered with IV saline hydration and oral probenecid 2 g PO 3h before each dose and further 1 g doses after 2h and 8h.
::::*Note: Switch to oral [[Valganciclovir]] when PO tolerated & when symptoms not severe enough to interfere with absorption. 
:::* 2.4 '''Pneumonia'''
::::*Preferred regimen: [[Valganciclovir]] 900 mg PO bid for 14–21 days, then 900 mg PO qd for maintenance therapy
::::*Alternative regimen for retinitis: [[Ganciclovir]] 5 mg/kg IV q12h for 14–21 days, then [[Valganciclovir]] 900 mg PO qd
::::*Note: In bone marrow transplant patients, combine therapy with CMV immune globulin.
:::* 2.5 '''Encephalitis, ventriculitis'''
::::*Note: Treatment not defined, but should be considered the same as retinitis. Disease may develop while taking [[Ganciclovir]] as suppressive therapy. 
:::* 2.6 '''Lumbosacral polyradiculopathy'''
::::*Preferred regimen: [[Ganciclovir]], as with retinitis
::::*Alternative regimen: [[Foscarnet]] 40 mg/kg IV q12h another option
::::*Alternative regimen: [[Cidofovir]] 5 mg/kg IV for 2 weeks, then 5 mg/kg every other week; each dose should be administered with IV saline hydration and oral probenecid 2 g PO 3h before each dose and further 1 g doses after 2h and 8h.
::::*Note (1): Switch to [[Valganciclovir]] when possible.
::::*Note (2): Suppression continued until CD4 remains >100/mm³ for 6 months. 
:::*2.7 '''Peri/postnatal severe CMV infection in very low birth weight infants'''
::::*Preferred regimen: [[Ganciclovir]] 6 mg/kg/dose IV q12h for 3 weeks<ref name="pmid25243446">{{cite journal| author=Josephson CD, Caliendo AM, Easley KA, Knezevic A, Shenvi N, Hinkes MT et al.| title=Blood transfusion and breast milk transmission of cytomegalovirus in very low-birth-weight infants: a prospective cohort study. | journal=JAMA Pediatr | year= 2014 | volume= 168 | issue= 11 | pages= 1054-62 | pmid=25243446 | doi=10.1001/jamapediatrics.2014.1360 | pmc=PMC4392178 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25243446  }} </ref>


{{PBI|Enterovirus D68}}
:* '''Enterovirus treatment'''<ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy 2014 | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2014 | isbn = 978-1930808782 }}</ref>
:::*Preferred regimen: supportive therapy
:::*Note: A new drug [[Pleconaril]] designed to affect Rhinovirus is being suggested to be effective against Enterovirus D68 but further investigation is required<ref name="pmid25554786">{{cite journal| author=Liu Y, Sheng J, Fokine A, Meng G, Shin WH, Long F et al.| title=Structure and inhibition of EV-D68, a virus that causes respiratory illness in children. | journal=Science | year= 2015 | volume= 347 | issue= 6217 | pages= 71-4 | pmid=25554786 | doi=10.1126/science.1261962 | pmc=PMC4307789 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25554786  }} </ref>


{{PBI|Ebola virus}}
:*'''Ebola virus treatment'''<ref>{{cite web|title=Ebola virus treatment|url=http://www.cdc.gov/vhf/ebola/treatment/index.html}}</ref><ref name="pmid21084112">{{cite journal| author=Feldmann H, Geisbert TW| title=Ebola haemorrhagic fever. | journal=Lancet | year= 2011 | volume= 377 | issue= 9768 | pages= 849-62 | pmid=21084112 | doi=10.1016/S0140-6736(10)60667-8 | pmc=PMC3406178 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21084112  }} </ref>
::*Preferred regimen: supportive therapy. There is no specific antiviral drug available for Ebola thus far. For information of investigational therapies including Favipiravir, Brincidofovir, ZMapp, TKM-Ebola, AVI-6002, and BCX4430, see [[Ebola future or investigational therapies|here]].
:::*Isolate patient
:::*Provide intravenous fluids (IV) (patients need large volumes in some cases) and maintain electrolytes at normal levels
:::*Maintain oxygen saturation and blood pressure
:::*Administer blood products if coagulopathy or bleeding, antiemetics if vomiting , antipyretics if fever, analgesics, anti-motility if severe diarrhea, total parenteral nutrition if patient has poor oral intake and dialysis if there's renal failure
:::*Treat other infections if they occur. Provide adequate Gram-negative coverage and gram-positive if the patient has any catheter or hospital-acquired pneumonia.
:::*If there's respiratory failure, invasive mechanical ventilation may be the best option to offer respiratory support
::*Note (1): Recovery from Ebola depends on good supportive care and the patient’s immune response.
::*Note (2): While there is no proven treatment available for Ebola virus disease, human convalescent whole blood has been used as an empirical treatment with promising results in a small group of EVD cases.<ref>[http://apps.who.int/iris/bitstream/10665/135591/1/WHO_HIS_SDS_2014.8_eng.pdf interim]</ref><ref name="pmid9988160">{{cite journal| author=Mupapa K, Massamba M, Kibadi K, Kuvula K, Bwaka A, Kipasa M et al.| title=Treatment of Ebola hemorrhagic fever with blood transfusions from convalescent patients. International Scientific and Technical Committee. | journal=J Infect Dis | year= 1999 | volume= 179 Suppl 1 | issue=  | pages= S18-23 | pmid=9988160 | doi=10.1086/514298 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9988160  }} </ref>
::*Note (3): People who recover from Ebola infection develop antibodies that last for at least 10 years, possibly longer. It is not known if people who recover are immune for life or if they can become infected with a different species of Ebola.
::*Note (4): Some people who have recovered from Ebola have developed long-term complications, such as joint and vision problems.


{{PBI|Marburg virus}}
:*Marburg virus treatment
::*Preferred regimen: supportive therapy including maintenance of blood volume and electrolyte balance, as well as analgesics and standard nursing care<ref>http://www.cfsph.iastate.edu/Factsheets/pdfs/viral_hemorrhagic_fever_filovirus.pdf</ref><ref>http://www.cdc.gov/vhf/marburg/treatment/index.html</ref>


{{PBI|Hantavirus}}
:*'''Hantavirus cardiopulmonary syndrome treatment'''<ref>{{citeweb|title=Hanta virus|url=http://www.cdc.gov/hantavirus/technical/hps/treatment.html}}</ref>
::*Preferred regimen: Supportive therapy, there is no specific treatment for hantavirus cardiopulmonary syndrome
::*Note (1): ICU management should include careful assessment, monitoring and adjustment of volume status and cardiac function, including inotropic and vasopressor support if needed
::*Note (2): Fluids should be administered carefully due to the potential for capillary leakage
::*Note (3): Supplemental oxygen should be administered if patients become hypoxic
::*Note (4): Equipment and materials for intubation and mechanical ventilation should be readily available since onset of respiratory failure may be precipitous
::*Note (5): Extracorporeal membrane oxygenation was used with survival rates of 50% in some studies in patients with cardiac index output <2.5L/min/m²<ref name="pmid9468181">{{cite journal| author=Crowley MR, Katz RW, Kessler R, Simpson SQ, Levy H, Hallin GW et al.| title=Successful treatment of adults with severe Hantavirus pulmonary syndrome with extracorporeal membrane oxygenation. | journal=Crit Care Med | year= 1998 | volume= 26 | issue= 2 | pages= 409-14 | pmid=9468181 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9468181  }} </ref>


{{PBI|Dengue virus}}
:* [[Dengue virus]] <ref>{{cite book | last = LastName | first = FirstName | title = Dengue guidelines for diagnosis, treatment, prevention, and control | publisher = TDR World Health Organization | location = Geneva | year = 2009 | isbn = 9789241547871 }}</ref>
::* 1. '''Patients who may be sent home'''
:::* These are patients who are able to tolerate adequate volumes of oral fluids and pass urine at least once every six hours, and do not have any of the warning signs, particularly when fever subsides
:::* Patients who are sent home should be monitored daily by health care providers for temperature pattern, volume of fluid intake and losses, urine output (volume and frequency), warning signs, signs of plasma leakage and bleeding, haematocrit, and white blood cell and platelet counts

::* 2. '''Ambulatory patients  with stable haematocrit can be sent home '''
:::* Encourage oral intake of oral rehydration solution (ORS), fruit juice and other fluids containing electrolytes and sugar to replace losses from fever and vomiting
:::* Give [[Paracetamol]] for high fever if the patient is uncomfortable. The interval of paracetamol dosing should not be less than six hours. Tepid sponge if the patient still has high fever
:::* Should be brought to hospital immediately if any of the following occur: no clinical improvement, deterioration around the time of defervescence, severe abdominal pain, persistent vomiting, cold and clammy extremities, lethargy or irritability/restlessness, bleeding (e.g. black stools or coffee-ground vomiting), not passing urine for more than 4–6 hours

::* 3. '''Patients who should be referred for in-hospital management'''
:::* Patients may need to be admitted to a secondary health care centre for close observation, particularly as they approach the critical phase. These include patients with warning signs (Abdominal pain or tenderness, Persistent vomiting, Clinical fluid accumulation, Mucosal bleed, Lethargy, restlessness, Liver enlargment >2cm, Laboratory:increase in HCT concurrent with rapid decrease in platelet count), those with co-existing conditions that may make dengue or its management more complicated (such as pregnancy, infancy, old age, obesity, diabetes mellitus, renal failure, chronic haemolytic diseases), and those with certain social circumstances (such as living alone, or living far from a health facility without reliable means of transport)

::::* 3.1 '''With warning signs'''
:::::* Obtain a reference haematocrit before fluid therapy. Give only isotonic solutions such as 0.9% saline, Ringer’s lactate, or Hartmann’s solution. Start with 5–7 ml/ kg/hour for 1–2 hours, then reduce to 3–5 ml/kg/hr for 2–4 hours, and then reduce to 2–3 ml/kg/hr or less according to the clinical response
:::::* Reassess the clinical status and repeat the haematocrit. If the haematocrit remains the same or rises only minimally, continue with the same rate (2–3 ml/kg/hr) for another 2–4 hours. If the vital signs are worsening and haematocrit is rising rapidly, increase the rate to 5–10 ml/kg/hour for 1–2 hours. Reassess the clinical status, repeat the haematocrit and review fluid infusion rates accordingly
:::::* Give the minimum intravenous fluid volume required to maintain good perfusion and urine output of about 0.5 ml/kg/hr. Intravenous fluids are usually needed for only 24–48 hours. Reduce intravenous fluids gradually when the rate of plasma leakage decreases towards the end of the critical phase. This is indicated by urine output and/or oral fluid intake that is/are adequate, or haematocrit decreasing below the baseline value in a stable patient
:::::* Patients with warning signs should be monitored by health care providers until the period of risk is over. A detailed fluid balance should be maintained. Parameters that should be monitored include vital signs and peripheral perfusion (1–4 hourly until the patient is out of the critical phase), urine output (4–6 hourly), haematocrit (before and after fluid replacement, then 6–12 hourly), blood glucose, and other organ functions (such as renal profile, liver profile, coagulation profile, as indicated)
::::* 3.2 '''Without warning signs'''
:::::* Encourage oral fluids. If not tolerated, start intravenous fluid therapy of 0.9% saline or Ringer’s lactate with or without dextrose at maintenance rate. For obese and overweight patients, use the ideal body weight for calculation of fluid infusion. Patients may be able to take oral fluids after a few hours of intravenous fluid therapy. Thus, it is necessary to revise the fluid infusion frequently. Give the minimum volume required to maintain good perfusion and urine output. Intravenous fluids are usually needed only for 24–48 hours
:::::* Patients should be monitored by health care providers for temperature pattern, volume of fluid intake and losses, urine output (volume and frequency), warning signs, haematocrit, and white blood cell and platelet counts. Other laboratory tests (such as liver and renal functions tests) can be done, depending on the clinical picture and the facilities of the hospital or health centre

::* 4. '''Severe dengue'''
:::* Severe dengue: Severe plasma leakage leading to dengue shock and/or fluid accumulation with respiratory distress; severe haemorrhages; severe organ impairment (hepatic damage, renal impairment, cardiomyopathy, encephalopathy or encephalitis)
:::* 4.1 '''Treatment of shock'''
::::* 4.1.1 '''Compensated shock'''
:::::* Start intravenous fluid resuscitation with isotonic crystalloid solutions at 5–10 ml/kg/hour over one hour. Then reassess the patient’s condition (vital signs, capillary refill time, haematocrit, urine output). The next steps depend on the situation
:::::* If the patient’s condition improves, intravenous fluids should be gradually reduced to 5–7 ml/kg/hr for 1–2 hours, then to 3–5 ml/kg/hr for 2–4 hours, then to 2–3 ml/kg/hr, and then further depending on haemodynamic status, which can be maintained for up to 24–48 hours
:::::* If vital signs are still unstable (i.e. shock persists), check the haematocrit after the first bolus. If the haematocrit increases or is still high (>50%), repeat a second bolus of crystalloid solution at 10–20 ml/kg/hr for one hour. After this second bolus, if there is improvement, reduce the rate to 7–10 ml/ kg/hr for 1–2 hours, and then continue to reduce as above. If haematocrit decreases compared to the initial reference haematocrit (<40% in children and adult females, <45% in adult males), this indicates bleeding and the need to cross-match and transfuse blood as soon as possible
:::::* Further boluses of crystalloid or colloidal solutions may need to be given during the next 24–48 hours

::::* 4.1.2 '''Hypotensive shock'''
:::::* Initiate intravenous fluid resuscitation with crystalloid or colloid solution (if available) at 20 ml/kg as a bolus given over 15 minutes to bring the patient out of shock as quickly as possible
:::::* If the patient’s condition improves, give a crystalloid/colloid infusion of 10 ml/kg/hr for one hour. Then continue with crystalloid infusion and gradually reduce to 5–7 ml/kg/hr for 1–2 hours, then to 3–5 ml/kg/hr for 2–4 hours, and then to 2–3 ml/kg/hr or less, which can be maintained for up to 24–48 hours
:::::* If vital signs are still unstable (i.e. shock persists), review the haematocrit obtained before the first bolus. If the haematocrit was low (<40% in children and adult females, <45% in adult males), this indicates bleeding and the need to cross- match and transfuse blood as soon as possible (see treatment for haemorrhagic complications)
:::::* If the haematocrit was high compared to the baseline value (if not available, use population baseline), change intravenous fluids to colloid solutions at 10–20 ml/kg as a second bolus over 30 minutes to one hour. After the second bolus, reassess the patient. If the condition improves, reduce the rate to 7–10 ml/kg/hr for 1–2 hours, then change back to crystalloid solution and reduce the rate of infusion as mentioned above. If the condition is still unstable, repeat the haematocrit after the second bolus
:::::* If the haematocrit decreases compared to the previous value (<40% in children and adult females, less than 45% in adult males), this indicates bleeding and the need to cross-match and transfuse blood as soon as possible (see treatment for haemorrhagic complications). If the haematocrit increases compared to the previous value or remains very high ( more than 50%), continue colloid solutions at 10–20 ml/kg as a third bolus over one hour. After this dose, reduce the rate to 7–10 ml/kg/hr for 1–2 hours, then change back to crystalloid solution and reduce the rate of infusion as mentioned above when the patient’s condition improves
:::::* Further boluses of fluids may need to be given during the next 24 hours. The rate and volume of each bolus infusion should be titrated to the clinical response. Patients with severe dengue should be admitted to the high-dependency or intensive care area

:::* 4.2 '''Treatment of haemorrhagic complications'''
::::* Blood transfusion required
:::::* Give 5–10ml/kg of fresh-packed red cells or 10–20 ml/kg of fresh whole blood at an appropriate rate and observe the clinical response. It is important that fresh whole blood or fresh red cells are given. Oxygen delivery at tissue level is optimal with high levels of 2,3 di-phosphoglycerate (2,3 DPG). Stored blood loses 2,3 DPG, low levels of which impede the oxygen-releasing capacity of haemoglobin, resulting in functional tissue hypoxia. A good clinical response includes improving haemodynamic status and acid-base balance
:::::* Consider repeating the blood transfusion if there is further blood loss or no appropriate rise in haematocrit after blood transfusion. There is little evidence to support the practice of transfusing platelet concentrates and/or fresh-frozen plasma for severe bleeding. It is being practised when massive bleeding can not be managed with just fresh whole blood/fresh-packed cells, but it may exacerbate the fluid overload
:::::* Great care should be taken when inserting a naso-gastric tube which may cause severe haemorrhage and may block the airway. A lubricated oro-gastric tube may minimize the trauma during insertion. Insertion of central venous catheters should be done with ultra-sound guidance or by a very experienced person

::* 5. '''Treatment of complications and other areas of treatment'''
:::* 5.1 '''Fluid overload'''
::::* Oxygen therapy should be given immediately
::::* When the following signs are present, intravenous fluids should be discontinued or reduced to the minimum rate necessary to maintain euglycaemia
:::::* signs of cessation of plasma leakage; stable blood pressure, pulse and peripheral perfusion; haematocrit decreases in the presence of a good pulse volume; afebrile for more than 24–48 days (without the use of antipyretics); resolving bowel/abdominal symptoms; improving urine output
::::* The management of fluid overload varies according to the phase of the disease and the patient’s haemodynamic status. If the patient has stable haemodynamic status and is out of the critical phase (more than 24–48 hours of defervescence), stop intravenous fluids but continue close monitoring. If necessary, give oral or intravenous furosemide 0.1–0.5 mg/kg/dose once or twice daily, or a continuous infusion of furosemide 0.1 mg/kg/hour. Monitor serum potassium and correct the ensuing hypokalaemia
::::* If the patient has stable haemodynamic status but is still within the critical phase, reduce the intravenous fluid accordingly. Avoid diuretics during the plasma leakage phase because they may lead to intravascular volume depletion
::::* Patients who remain in shock with low or normal haematocrit levels but show signs of fluid overload may have occult haemorrhage. Further infusion of large volumes of intravenous fluids will lead only to a poor outcome. Careful fresh whole blood transfusion should be initiated as soon as possible. If the patient remains in shock and the haematocrit is elevated, repeated small boluses of a colloid solution may help

:::* 5.2 '''Other complications of dengue'''
::::* Both hyperglycaemia and hypoglycaemia may occur, even in the absence of diabetes mellitus and/or hypoglycaemic agents. Electrolyte and acid-base imbalances are also common observations in severe dengue and are probably related to gastrointestinal losses through vomiting and diarrhoea or to the use of hypotonic solutions for resuscitation and correction of dehydration. Hyponatraemia, hypokalaemia, hyperkalaemia, serum calcium imbalances and metabolic acidosis (sodium bicarbonate for metabolic acidosis is not recommended for pH ≥ 7.15) can occur. One should also be alert for co-infections and nosocomial infections.
:::* 5.3 '''Supportive care and adjuvant therapy'''
::::* renal replacement therapy, with a preference to continuous veno-venous haemodialysis (CWH), since peritoneal dialysis has a risk of bleeding; 
::::* vasopressor and inotropic therapies as temporary measures to prevent life- threatening hypotension in dengue shock and during induction for intubation, while correction of intravascular volume is being vigorously carried out; 
::::* further treatment of organ impairment, such as severe hepatic involvement or encephalopathy or encephalitis; 
::::* further treatment of cardiac abnormalities, such as conduction abnormalities, may occur (the latter usually not requiring interventions)

{{PBI|West Nile virus}}
:* '''West nile virus<ref name=CDC West nile virus>{{cite web | title = CDC West nile virus | url =http://www.cdc.gov/westnile/symptoms/index.html }}</ref>'''
::* 1.1. '''Prevention'''
:::* No WNV vaccines are licensed for use in humans. In the absence of a vaccine, prevention of WNV disease depends on community-level mosquito control programs to reduce vector densities, personal protective measures to decrease exposure to infected mosquitoes, and screening of blood and organ donors. 
:::* Personal protective measures include use of mosquito repellents, wearing long-sleeved shirts and long pants, and limiting outdoor exposure from dusk to dawn. Using air conditioning, installing window and door screens, and reducing peridomestic mosquito breeding sites, can further decrease the risk for WNV exposure.
:::* Blood and some organ donations in the United States are screened for WNV infection; health care professionals should remain vigilant for the possible transmission of WNV through blood transfusion or organ transplantation. Any suspected WNV infections temporally associated with blood transfusion or organ transplantation should be reported promptly to the appropriate state health department.
::* 1.2. '''Treatment'''
:::* There is no specific treatment for WNV disease; clinical management is supportive. Patients with severe meningeal symptoms often require pain control for headaches and antiemetic therapy and rehydration for associated nausea and vomiting. Patients with encephalitis require close monitoring for the development of elevated intracranial pressure and seizures. Patients with encephalitis or poliomyelitis should be monitored for inability to protect their airway. Acute neuromuscular respiratory failure may develop rapidly and prolonged ventilatory support may be required.

{{PBI|Yellow Fever}}
:* Yellow fever<ref>{{cite web | title = District guidelines for yellow fever surveillance | url = http://www.who.int/csr/resources/publications/yellowfev/whoepigen9809.pdf?ua=1 }}</ref><ref> name="pmid3547569">{{cite journal| author=Monath TP| title=Yellow fever: a medically neglected disease. Report on a seminar. | journal=Rev Infect Dis | year= 1987 | volume= 9 | issue= 1 | pages= 165-75 |pmid=3547569 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3547569  }} </ref>
::* Preferred regimen: No specific treatment is available for yellow fever. In the toxic phase, supportive treatment includes therapies for treating dehydration and fever. Ribavirin has failed in several studies in the monkey model.
:::* Note: An international seminar held by WHO in 1984 recommended maintenance of nutrition, prevention of hypoglycemia, maintenance of the blood pressure with fluids and vasoactive drugs, prevention of bleeding with fresh-frozen plasma, dialysis if renal failure, correction of metabolic acidosis, administration of cimetidine IV to avoid gastric bleeding and oxygen if needed.

{{PBI|Chikungunya virus}}
::'''Chikungunya Fever''' <ref name="pmid25806915">{{cite journal| author=Weaver SC, Lecuit M| title=Chikungunya virus and the global spread of a mosquito-borne disease. | journal=N Engl J Med | year= 2015 | volume= 372 | issue= 13 | pages= 1231-9 | pmid=25806915 | doi=10.1056/NEJMra1406035 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25806915  }} </ref>
::*Preferred regimen: no specific therapeutics agents are available and there are no licensed vaccines to prevent Chikungunya Fever.
:::* Note: Anti inflammatory drugs can be used to control joint swelling and arthritis. 

{{PBI|Hepatitis A virus}}
:*Preferred regimen: No therapy recommended. If within 2 wks of exposure, IVIG 0.02 mL per kg IM times 1 protective. 


{{PBI|Hepatitis B virus}}
*'''Acute Hepatitis B'''

*'''Chronic Hepatitis B'''
:*'''1. Patients with HBeAg-positive chronic hepatitis B'''<ref name="pmid19714720">{{cite journal| author=Lok AS, McMahon BJ| title=Chronic hepatitis B: update 2009. | journal=Hepatology | year= 2009 | volume= 50 | issue= 3 | pages= 661-2 | pmid=19714720 | doi=10.1002/hep.23190 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19714720  }} </ref>
::*'''1.1. HBV DNA >20,000, ALT <2 times upper limit normal (ULN)'''<ref name="pmid19714720">{{cite journal| author=Lok AS, McMahon BJ| title=Chronic hepatitis B: update 2009. | journal=Hepatology | year= 2009 | volume= 50 | issue= 3 | pages= 661-2 | pmid=19714720 | doi=10.1002/hep.23190 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19714720  }} </ref>
:::*Observe; consider treatment when ALT becomes elevated. 
:::*Consider biopsy in persons 40 years, ALT persistently high normal >2 times upper limit normal (ULN), or with family history of HCC. 
:::*Consider treatment if HBV DNA >20,000 IU/mL and biopsy shows moderate/severe inflammation or significant fibrosis.

::*'''1.2. HBV DNA >20,000, ALT >2 times upper limit normal (ULN)'''<ref name="pmid19714720">{{cite journal| author=Lok AS, McMahon BJ| title=Chronic hepatitis B: update 2009. | journal=Hepatology | year= 2009 | volume= 50 | issue= 3 | pages= 661-2 | pmid=19714720 | doi=10.1002/hep.23190 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19714720  }} </ref>
:::*Preferred regimen (1): Pegylated IFN-alpha 180 mcg weekly SC for 48 weeks
:::*Preferred regimen (2): [[Tenofovir]] (TDF) Adjustment of Adult Dosage in Accordance with Creatinine Clearance:
::::*If creatinine clearance >50 or normal renal function give 300 mg q24 hrs
::::*If creatinine clearance 30–49 give 300 mg q48 hrs
::::*If creatinine clearance 10–29 give 300 mg q72-96 hrs
::::*If creatinine clearance <10 with dialysis give 300 mg once a week or after a total of approximately 12 hours of dialysis
::::*If creatinine clearance <10 without dialysis there is no recommendation
::::*Note: duration of treatment is minimum 1 year, continue for at least 6 months after HBeAg seroconversion
:::*Preferred regimen (3): [[Entecavir]] (ETV) Adjustment of Adult Dosage in Accordance with Creatinine Clearance:
::::*If creatinine clearance >50 give 0.5 mg PO daily for patients with no prior [[Lamivudine]] treatment, and 1 mg PO daily for patients who are refractory/resistant to lamivudine for minimum 1 year, continue for at least 6 months after HBeAg seroconversion.
::::*If creatinine clearance 30–49 give 0.25 mg PO qd {{or}} 0.5 mg PO q48 hr for patients with no prior [[Lamivudine]] treatment, and 0.5 mg PO qd {{or}} 1 mg PO q 48 hr for patients who are refractory/resistant to lamivudine for minimum 1 year, continue for at least 6 months after HBeAg seroconversion.
::::*If creatinine clearance 10–29 give 0.15 mg PO qd {{or}} 0.5 mg PO q 72 hr for patients with no prior [[Lamivudine]] treatment, and 0.3 mg PO qd {{or}} 1 mg PO q 72 hr for patients who are refractory/resistant to lamivudine for minimum 1 year, continue for at least 6 months after HBeAg seroconversion.
::::*If creatinine clearance <10 or hemodialysis or continuous ambulatory peritoneal dialysis give 0.05 mg PO qd {{or}} 0.5 mg PO q7 days for patients with no prior [[Lamivudine]] treatment, and 0.1 mg PO qd {{or}} 1 mg PO q 7 days for patients who are refractory/resistant to lamivudine for minimum 1 year, continue for at least 6 months after HBeAg seroconversion.
::::*Note: duration of treatment is minimum 1 year, continue for at least 6 months after HBeAg seroconversion
:::*Alternative regimen (1): [[Interferon alpha]] (IFNα) 5 MU daily or 10 MU thrice weekly SC for 16 weeks
:::*Alternative regimen (2): [[Lamivudine]] (LAM) Adjustment of Adult Dosage in Accordance with Creatinine Clearance:
::::*If creatinine clearance >50 or normal renal function give 100 mg PO qd
::::*If creatinine clearance 30–49 give 100 mg PO first dose, then 50 mg PO qd
::::*If creatinine clearance 15–29 give 100 mg PO first dose, then 25 mg PO qd
::::*If creatinine clearance 5-14 give 35 mg PO first dose, then 15 mg PO qd
::::*If creatinine clearance <5 give 35 mg PO first dose, then 10 mg PO qd
::::*The recommended dose of lamivudine for persons coinfected with HIV is 150mg PO twice daily.
::::*Note: duration of treatment is minimum 1 year, continue for at least 6 months after HBeAg seroconversion
:::*Alternative regimen (3): [[Adefovir]] (ADV) Adjustment of Adult Dosage in Accordance with Creatinine Clearance:
::::*If creatinine clearance >50 or normal renal function give 10 mg PO daily
::::*If creatinine clearance 30–49 give 10 mg PO every other day
::::*If creatinine clearance 10–19 10 mg PO every third day
::::*If hemodialysis patients give 10 mg PO every week following dialysis
::::*Note: duration of treatment is minimum 1 year, continue for at least 6 months after HBeAg seroconversion
:::*Alternative regimen (4): [[Telbivudine]] (LdT) Adjustment of Adult Dosage in Accordance with Creatinine Clearance:
::::*If creatinine clearance >50 or normal renal function give 600 mg PO once daily
::::*If creatinine clearance 30–49 600 give mg PO once every 48 hours
::::*If creatinine clearance <30 (not requiring dialysis) give 600 mg PO once every 72 hours
::::*If End-stage renal disease give 600 mg PO once every 96 hours after hemodialysis
:::*Note (1): duration of treatment is minimum 1 year, continue for at least 6 months after HBeAg seroconversion 
:::*Note (2): Observe for 3-6 months and treat if no spontaneous HBeAg loss.
:::*Note (3): Consider liver biopsy prior to treatment if compensated. 
:::*Note (4): Immediate treatment if icteric or clinical decompensation.
:::*Note (5): [[Interferon alpha]] (IFNα)/ pegylated interferon-alpha (peg-IFNα), [[Lamivudine]] (LAM), [[Adefovir]] (ADV), [[Entecavir]] (ETV), tenofovir disoproxil fumarate (TDF) or [[telbivudine]] (LdT) may be used as initial therapy. 
:::*Note (6): Adefovir (ADV) not preferred due to weak antiviral activity and high rate of resistance after 1st year.
:::*Note (7): Lamivudine (LAM) and Telbivudine (LdT) not preferred due to high rate of drug resistance. 
:::*Note (8): End-point of treatment – Seroconversion from HBeAg to anti-HBe.
:::*Note (9): [[Interferon alpha]] (IFNα)  non-responders / contraindications to IFNα change to [[Tenofovir]] (TDF)/[[Entecavir]] (ETV).

::*'''1.3. Children with elevated ALT greater than 2 times normal'''<ref name="pmid19714720">{{cite journal| author=Lok AS, McMahon BJ| title=Chronic hepatitis B: update 2009. | journal=Hepatology | year= 2009 | volume= 50 | issue= 3 | pages= 661-2 | pmid=19714720 | doi=10.1002/hep.23190 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19714720  }} </ref>
:::*Preferred regimen(1): [[Interferon alpha]] (IFNα) 6 MU/m2  SC thrice weekly with a maximum of 10 MU
:::*Preferred regimen(2): [[Lamivudine]] (LAM) 3 mg/kg/d PO with a maximum of 100 mg/d.

:*'''2. Patients with HBeAg-negative chronic hepatitis B'''<ref name="pmid19714720">{{cite journal| author=Lok AS, McMahon BJ| title=Chronic hepatitis B: update 2009. | journal=Hepatology | year= 2009 | volume= 50 | issue= 3 | pages= 661-2 | pmid=19714720 | doi=10.1002/hep.23190 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19714720  }} </ref>
::*'''2.1. HBV DNA >2,000 IU/mL and elevated ALT >2 times normal'''
:::*Preferred regimen (1): Pegylated IFN-alpha 180 mcg weekly SC for 1 year
:::*Preferred regimen (2): [[Tenofovir]] (TDF) Adjustment of Adult Dosage in Accordance with Creatinine Clearance:
::::*If creatinine clearance >50 or normal renal function give 300 mg q24 hrs
::::*If creatinine clearance 30–49 give 300 mg q48 hrs
::::*If creatinine clearance 10–29 give 300 mg q72-96 hrs
::::*If creatinine clearance <10 with dialysis give 300 mg once a week or after a total of approximately 12 hours of dialysis
::::*If creatinine clearance <10 without dialysis there is no recommendation
::::*Note: duration of treatment is more than 1 year
:::*Preferred regimen (3): [[Entecavir]] (ETV) Adjustment of Adult Dosage in Accordance with Creatinine Clearance:
::::*If creatinine clearance >50 give 0.5 mg PO daily for patients with no prior [[Lamivudine]] treatment, and 1 mg PO daily for patients who are refractory/resistant to lamivudine
::::*If creatinine clearance 30–49 give 0.25 mg PO qd {{or}} 0.5 mg PO q48 hr for patients with no prior [[Lamivudine]] treatment, and 0.5 mg PO qd {{or}} 1 mg PO q 48 hr for patients who are refractory/resistant to lamivudine
::::*If creatinine clearance 10–29 give 0.15 mg PO qd {{or}} 0.5 mg PO q 72 hr for patients with no prior [[Lamivudine]] treatment, and 0.3 mg PO qd {{or}} 1 mg PO q 72 hr for patients who are refractory/resistant to lamivudine
::::*If creatinine clearance <10 or hemodialysis or continuous ambulatory peritoneal dialysis give 0.05 mg PO qd {{or}} 0.5 mg PO q7 days for patients with no prior [[Lamivudine]] treatment, and 0.1 mg PO qd {{or}} 1 mg PO q 7 days for patients who are refractory/resistant to lamivudine.
::::*Note: duration of treatment is more than 1 year
:::*Alternative regimen (1): [[Interferon alpha]] (IFNα) 5 MU daily or 10 MU thrice weekly SC for 1 year
:::*Alternative regimen (2): [[Lamivudine]] (LAM) Adjustment of Adult Dosage in Accordance with Creatinine Clearance:
::::*If creatinine clearance >50 or normal renal function give 100 mg PO qd
::::*If creatinine clearance 30–49 give 100 mg PO first dose, then 50 mg PO qd
::::*If creatinine clearance 15–29 give 100 mg PO first dose, then 25 mg PO qd
::::*If creatinine clearance 5-14 give 35 mg PO first dose, then 15 mg PO qd
::::*If creatinine clearance <5 give 35 mg PO first dose, then 10 mg PO qd
::::*The recommended dose of lamivudine for persons coinfected with HIV is 150mg PO twice daily.
::::*Note: duration of treatment is more than 1 year
:::*Alternative regimen (3): [[Adefovir]] (ADV) Adjustment of Adult Dosage in Accordance with Creatinine Clearance:
::::*If creatinine clearance >50 or normal renal function give 10 mg PO daily
::::*If creatinine clearance 30–49 give 10 mg PO every other day
::::*If creatinine clearance 10–19 10 mg PO every third day
::::*If hemodialysis patients give 10 mg PO every week following dialysis
::::*Note: duration of treatment is more than 1 year
:::*Alternative regimen (4): [[Telbivudine]] (LdT)Adjustment of Adult Dosage in Accordance with Creatinine Clearance:
::::*If creatinine clearance >50 or normal renal function give 600 mg PO once daily
::::*If creatinine clearance 30–49 600 give mg PO once every 48 hours
::::*If creatinine clearance <30 (not requiring dialysis) give 600 mg PO once every 72 hours
::::*If End-stage renal disease give 600 mg PO once every 96 hours after hemodialysis
:::*Note (1): duration of treatment is more than 1 year
:::*Note (2): [[Interferon alpha]] (IFNα)/ pegylated interferon-alpha (peg-IFNα), [[Lamivudine]] (LAM), [[Adefovir]] (ADV), [[Entecavir]] (ETV), tenofovir disoproxil fumarate (TDF) or [[telbivudine]] (LdT) may be used as initial therapy. 
:::*Note (3): Adefovir (ADV) not preferred due to weak antiviral activity and high rate of resistance after 1st year.
:::*Note (4): [[Lamivudine]] (LAM) and [[Telbivudine]] (LdT) not preferred due to high rate of drug resistance.
:::*Note (5): End-point of treatment – not defined
:::*Note (6): [[Interferon alpha]] (IFNα)  non-responders / contraindications to IFNα change to [[Tenofovir]] (TDF)/[[Entecavir]] (ETV).

:*'''3. HBV DNA >2,000 IU/mL and elevated ALT 1->2 times normal'''<ref name="pmid19714720">{{cite journal| author=Lok AS, McMahon BJ| title=Chronic hepatitis B: update 2009. | journal=Hepatology | year= 2009 | volume= 50 | issue= 3 | pages= 661-2 | pmid=19714720 | doi=10.1002/hep.23190 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19714720  }} </ref>
::*Consider liver biopsy and treat if liver biopsy shows moderate/severe necroinflammation or significant fibrosis.

:*'''4. HBV DNA <2,000 IU/mL and ALT < upper limit normal (ULN)'''<ref name="pmid19714720">{{cite journal| author=Lok AS, McMahon BJ| title=Chronic hepatitis B: update 2009. | journal=Hepatology | year= 2009 | volume= 50 | issue= 3 | pages= 661-2 | pmid=19714720 | doi=10.1002/hep.23190 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19714720  }} </ref>
::*Observe, treat if HBV DNA or ALT becomes higher.

:*'''5. +/- HBeAg and detectable HBV DNA with Cirrhosis'''<ref name="pmid19714720">{{cite journal| author=Lok AS, McMahon BJ| title=Chronic hepatitis B: update 2009. | journal=Hepatology | year= 2009 | volume= 50 | issue= 3 | pages= 661-2 | pmid=19714720 | doi=10.1002/hep.23190 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19714720  }} </ref>
::*'''5.1. Compensated Cirrhosis and HBV DNA >2,000''' 
:::*Preferred regimen (1): [[Entecavir]] (ETV) Adjustment of Adult Dosage in Accordance with Creatinine Clearance:
::::*If creatinine clearance >50 give 0.5 mg PO daily for patients with no prior [[Lamivudine]] treatment, and 1 mg PO daily for patients who are refractory/resistant to lamivudine.
::::*If creatinine clearance 30–49 give 0.25 mg PO qd {{or}} 0.5 mg PO q48 hr for patients with no prior [[Lamivudine]] treatment, and 0.5 mg PO qd {{or}} 1 mg PO q 48 hr for patients who are refractory/resistant to lamivudine.
::::*If creatinine clearance 10–29 give 0.15 mg PO qd {{or}} 0.5 mg PO q 72 hr for patients with no prior [[Lamivudine]] treatment, and 0.3 mg PO qd {{or}} 1 mg PO q 72 hr for patients who are refractory/resistant to lamivudine.
::::*If creatinine clearance <10 or hemodialysis or continuous ambulatory peritoneal dialysis give 0.05 mg PO qd {{or}} 0.5 mg PO q7 days for patients with no prior [[Lamivudine]] treatment, and 0.1 mg PO qd {{or}} 1 mg PO q 7 days for patients who are refractory/resistant to lamivudine.
:::*Preferred regimen (2): [[Tenofovir]] (TDF) Adjustment of Adult Dosage in Accordance with Creatinine Clearance:
::::*If creatinine clearance >50 or normal renal function give 300 mg q24 hrs
::::*If creatinine clearance 30–49 give 300 mg q48 hrs
::::*If creatinine clearance 10–29 give 300 mg q72-96 hrs
::::*If creatinine clearance <10 with dialysis give 300 mg once a week or after a total of approximately 12 hours of dialysis
::::*If creatinine clearance <10 without dialysis there is no recommendation
:::*Alternative regimen (1): [[Lamivudine]] (LAM) Adjustment of Adult Dosage in Accordance with Creatinine Clearance:
::::*If creatinine clearance >50 or normal renal function give 100 mg PO qd
::::*If creatinine clearance 30–49 give 100 mg PO first dose, then 50 mg PO qd
::::*If creatinine clearance 15–29 give 100 mg PO first dose, then 25 mg PO qd
::::*If creatinine clearance 5-14 give 35 mg PO first dose, then 15 mg PO qd
::::*If creatinine clearance <5 give 35 mg PO first dose, then 10 mg PO qd
::::*The recommended dose of lamivudine for persons coinfected with HIV is 150mg PO twice daily.
:::*Alternative regimen (2): [[Adefovir]] (ADV) Adjustment of Adult Dosage in Accordance with Creatinine Clearance:
::::*If creatinine clearance >50 or normal renal function give 10 mg PO daily
::::*If creatinine clearance 30–49 give 10 mg PO every other day
::::*If creatinine clearance 10–19 give 10 mg PO every third day
::::*If hemodialysis patients give 10 mg PO every week following dialysis
:::*Alternative regimen (3): [[Telbivudine]] (LdT) Adjustment of Adult Dosage in Accordance with Creatinine Clearance:
::::*If creatinine clearance >50 or normal renal function give 600 mg PO once daily
::::*If creatinine clearance 30–49 600 give mg PO once every 48 hours
::::*If creatinine clearance <30 (not requiring dialysis) give 600 mg PO once every 72 hours
::::*If End-stage renal disease give 600 mg PO once every 96 hours after hemodialysis
:::*Note (1): LAM and LdT not preferred due to high rate of drug resistance.
:::*Note (2): ADV not preferred due to weak antiviral activity and high risk of resistance after 1st year.
:::*Note (3): These patients should receive long-term treatment. However, treatment may be stopped in HBeAg-positive patients if they have confirmed HBeAg seroconversion and have completed at least 6 months of consolidation therapy and in HBeAg-negative patients if they have confirmed HBsAg clearance.

::*'''5.2. Compensated Cirrhosis and HBV DNA <2,000''' 
:::*Consider treatment if ALT elevated.

::*'''5.3. Decompensated Cirrhosis'''
:::*Preferred regimen (1): [[Tenofovir]] (TDF) Adjustment of Adult Dosage in Accordance with Creatinine Clearance:
::::*If creatinine clearance >50 or normal renal function give 300 mg q24 hrs
::::*If creatinine clearance 30–49 give 300 mg q48 hrs
::::*If creatinine clearance 10–29 give 300 mg q72-96 hrs
::::*If creatinine clearance <10 with dialysis give 300 mg once a week or after a total of approximately 12 hours of dialysis
::::*If creatinine clearance <10 without dialysis there is no recommendation
:::*Preferred regimen (2): [[Entecavir]] (ETV) Adjustment of Adult Dosage in Accordance with Creatinine Clearance:
::::*If creatinine clearance >50 give 0.5 mg PO daily for patients with no prior [[Lamivudine]] treatment, and 1 mg PO daily for patients who are refractory/resistant to lamivudine.
::::*If creatinine clearance 30–49 give 0.25 mg PO qd {{or}} 0.5 mg PO q48 hr for patients with no prior [[Lamivudine]] treatment, and 0.5 mg PO qd {{or}} 1 mg PO q 48 hr for patients who are refractory/resistant to lamivudine.
::::*If creatinine clearance 10–29 give 0.15 mg PO qd {{or}} 0.5 mg PO q 72 hr for patients with no prior [[Lamivudine]] treatment, and 0.3 mg PO qd {{or}} 1 mg PO q 72 hr for patients who are refractory/resistant to lamivudine.
::::*If creatinine clearance <10 or hemodialysis or continuous ambulatory peritoneal dialysis give 0.05 mg PO qd {{or}} 0.5 mg PO q7 days for patients with no prior [[Lamivudine]] treatment, and 0.1 mg PO qd {{or}} 1 mg PO q 7 days for patients who are refractory/resistant to lamivudine.
:::*Preferred regimen (3): [[Lamivudine]] (LAM) {{and}} [[Adefovir]] (ADV)
::::*[[Lamivudine]] (LAM) Adjustment of Adult Dosage in Accordance with Creatinine Clearance:
:::::*If creatinine clearance >50 or normal renal function give 100 mg PO qd
:::::*If creatinine clearance 30–49 give 100 mg PO first dose, then 50 mg PO qd
:::::*If creatinine clearance 15–29 give 100 mg PO first dose, then 25 mg PO qd
:::::*If creatinine clearance 5-14 give 35 mg PO first dose, then 15 mg PO qd
:::::*If creatinine clearance <5 give 35 mg PO first dose, then 10 mg PO qd
:::::*The recommended dose of lamivudine for persons coinfected with HIV is 150mg PO twice daily.
::::*[[Adefovir]] (ADV) Adjustment of Adult Dosage in Accordance with Creatinine Clearance:
:::::*If creatinine clearance >50 or normal renal function give 10 mg PO daily
:::::*If creatinine clearance 30–49 give 10 mg PO every other day
:::::*If creatinine clearance 10–19 give 10 mg PO every third day
:::::*If hemodialysis patients give 10 mg PO every week following dialysis
:::*Preferred regimen (4): [[Telbivudine]] (LdT) {{and}} [[Adefovir]] (ADV)
::::*[[Telbivudine]] (LdT) Adjustment of Adult Dosage in Accordance with Creatinine Clearance:
:::::*If creatinine clearance >50 or normal renal function give 600 mg PO once daily
:::::*If creatinine clearance 30–49 600 give mg PO once every 48 hours
:::::*If creatinine clearance <30 (not requiring dialysis) give 600 mg PO once every 72 hours
:::::*If End-stage renal disease give 600 mg PO once every 96 hours after hemodialysis
::::*[[Adefovir]] (ADV) Adjustment of Adult Dosage in Accordance with Creatinine Clearance:
:::::*If creatinine clearance >50 or normal renal function give 10 mg PO daily
:::::*If creatinine clearance 30–49 give 10 mg PO every other day
:::::*If creatinine clearance 10–19 give 10 mg PO every third day
:::::*If hemodialysis patients give 10 mg PO every week following dialysis
:::*Note: coordinate treatment with transplant center and refer for liver transplant.
:::*Life-long treatment is recommended.

:* '''6. +/- HBeAg and undetectable HBV DNA  with Cirrhosis'''<ref name="pmid19714720">{{cite journal| author=Lok AS, McMahon BJ| title=Chronic hepatitis B: update 2009. | journal=Hepatology | year= 2009 | volume= 50 | issue= 3 | pages= 661-2 | pmid=19714720 | doi=10.1002/hep.23190 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19714720  }} </ref>
::*Compensated Cirrhosis: Observe
::*Uncompensated Cirrhosis: Refer for liver transplant

{{PBI|Hepatitis C virus}}
'''Chronic Hepatitis C'''
*'''1. Treatment regimens for chronic hepatitis C virus genotype 1'''<ref> {{Cite web | title = INITIAL TREATMENT OF HCV INFECTION
| url = http://www.hcvguidelines.org/full-report/initial-treatment-hcv-infection}}</ref>
:*'''1.1. Treatment regimens for genotype 1a''':
::*Preferred regimen (1): [[Ledipasvir]] 90 mg PO qd {{and}} [[Sofosbuvir]] 400 mg PO qd for 12 weeks 
::*Preferred regimen (2): [[Paritaprevir]] 150 mg PO qd {{and}} [[Ritonavir]] 100 mg PO qd {{and}} [[Ombitasvir]] 25 mg PO qd {{and}} Dasabuvir 250 mg PO bid {{and}} weight-based [[Ribavirin]] PO qd ([1000 mg <75 kg] to [1200 mg >75 kg]) for 12 weeks (no cirrhosis) {{or}} 24 weeks (cirrhosis) 
::*Preferred regimen (3): [[Sofosbuvir]] 400 mg PO qd {{and}} [[Simeprevir]] 150 mg PO qd {{withorwithout}} weight-based [[Ribavirin]] PO qd ([1000 mg <75 kg] to [1200 mg >75 kg]) for 12 weeks (no cirrhosis) or 24 weeks (cirrhosis)
::*Note: these regimens are recommended for treatment-naive patients with HCV genotype 1a infection.

:*'''1.2. Treatment regimens for genotype 1b''':
::*Preferred regimen (1): [[Ledipasvir]] 90 mg PO qd {{and}} [[Sofosbuvir]] 400 mg PO qd for 12 weeks
::*Preferred regimen (2): [[Paritaprevir]] PO 150 mg qd {{and}} [[Ritonavir]] 100 mg PO qd {{and}} Ombitasvir 25 mg PO qd {{and}} Dasabuvir 250 mg PO bid for 12 weeks. The addition of weight-based [[Ribavirin]] PO qd (1000 mg [<75kg] to 1200 mg [>75 kg]) is recommended in patients with cirrhosis
::*Preferred regimen (3): [[Sofosbuvir]] 400 mg PO qd {{and}} [[Simeprevir]] 150 mg PO qd for 12 weeks (no cirrhosis) or 24 weeks (cirrhosis) 
::*Note: these regimens are recommended for treatment-naive patients with HCV genotype 1b infection.

*'''2. Treatment regimens for chronic hepatitis C virus genotype 2'''<ref> {{Cite web | title = INITIAL TREATMENT OF HCV INFECTION
| url = http://www.hcvguidelines.org/full-report/initial-treatment-hcv-infection}}</ref>
:*Preferred regimen: [[Sofosbuvir]] 400 mg PO qd {{and}} weight-based RBV (1000 mg [<75 kg] to 1200 mg [>75 kg]) for 12 weeks 
:*Note (1): This regimen are recommended for treatment-naive patients with HCV genotype 2 infection.
:*Note (2): Extending treatment to 16 weeks is recommended in patients with cirrhosis.

*'''3. Treatment regimens for chronic hepatitis C virus genotype 3'''<ref> {{Cite web | title = INITIAL TREATMENT OF HCV INFECTION
| url = http://www.hcvguidelines.org/full-report/initial-treatment-hcv-infection}}</ref>
:*Preferred regimen: [[Sofosbuvir]] 400 mg PO qd and weight-based [[Ribavirin]] PO qd (1000 mg [<75 kg] to 1200 mg [>75 kg]) PO qd for 24 weeks 
:*Alternative regimen: [[Sofosbuvir]] 400 mg and weight-based [[Ribavirin]] PO qd (1000 mg [<75 kg] to 1200 mg [>75 kg]) PO qd {{and}} weekly [[PEG-IFN]] for 12 weeks is an acceptable regimen for IFN-eligible, treatment-naive patients with HCV genotype 3 infection.
:*Note: These regimens are recommended for treatment-naive patients with HCV genotype 3 infection.

*'''4. Treatment regimens for chronic hepatitis C virus genotype 4'''
:*Preferred regimen (1): [[Ledipasvir 90 mg]] PO qd {{and}} [[Sofosbuvir]] 400 mg PO qd for 12 weeks 
:*Preferred regimen (2): [[Paritaprevir 150 mg]] PO qd {{and}} [[Ritonavir]] 100 mg PO qd {{and}} Ombitasvir 25 mg PO qd {{and}} weight-based [[Ribavirin]] PO qd (1000 mg [<75 kg] to 1200 mg [>75 kg]) for 12 weeks
:*Preferred regimen (3): [[Sofosbuvir]] 400 mg PO qd {{and}} weight-based [[Ribavirin]] PO qd (1000 mg [<75 kg] to 1200 mg [>75 kg]) for 24 weeks
:*Alternative regimen (1): [[Sofosbuvir]] 400 mg PO qd {{and}} weight-based [[Ribavirin]] PO qd (1000 mg [<75 kg] to 1200 mg [>75 kg]) {{and}} weekly PEG-IFN for 12 weeks 
:*Alternative regimen (2): [[Sofosbuvir]] 400 mg PO qd {{and}} [[Simeprevir]] 150 mg PO qd {{withorwithout}} weight-based [[Ribavirin]] PO qd (1000 mg [<75 kg] to 1200 mg [>75 kg]) for 12 weeks
:*Note: These regimens are accpetable for treatment-naive patients with HCV genotype 3 infection.

*'''5. Treatment regimens for chronic hepatitis C virus genotype 5'''<ref> {{Cite web | title = INITIAL TREATMENT OF HCV INFECTION
| url = http://www.hcvguidelines.org/full-report/initial-treatment-hcv-infection}}</ref>
:*Preferred regimen: [[Sofosbuvir]] 400 mg PO qd {{and}} weight-based [[Ribavirin]] PO qd(1000 mg [<75 kg] to 1200 mg [>75 kg]) {{and}} weekly [[PEG-IFN]] for 12 weeks is recommended for treatment-naive patients with HCV genotype 5 infection.
:*Alternative regimen: Weekly [[PEG-IFN]] {{and}} weight-based [[Ribavirin]] PO qd (1000 mg [<75 kg] to 1200 mg [>75 kg]) for 48 weeks is an alternative regimen for IFN-eligible, treatment-naive patients with HCV genotype 5 infection.

*'''6. Treatment regimens for chronic hepatitis C virus genotype 6'''<ref> {{Cite web | title = INITIAL TREATMENT OF HCV INFECTION
| url = http://www.hcvguidelines.org/full-report/initial-treatment-hcv-infection}}</ref>
:*Preferred regimen: [[Ledipasvir]] 90 mg PO qd {{and}} [[Sofosbuvir]] PO qd 400 mg for 12 weeks is recommended for treatment-naive patients with HCV genotype 6 infection.
:*Alternative regimen: [[Sofosbuvir]] 400 mg PO qd {{and}} weight-based [[Ribavirin]] PO qd (1000 mg [<75 kg] to 1200 mg [>75 kg]) {{and}} weekly PEG-IFN for 12 weeks is an alternative regimen for IFN-eligible, treatment-naive patients with HCV genotype 6 infection.

{{PBI|Hepatitis D virus}}
*Preferred regimen: [[Interferon alpha]](IFNα) 5 MU daily {{or}} 9 MU three times a week for 6–12 months <ref name="pmid23286865">{{cite journal| author=Rizzetto M| title=Current management of delta hepatitis. | journal=Liver Int | year= 2013 | volume= 33 Suppl 1 | issue=  | pages= 195-7 | pmid=23286865 | doi=10.1111/liv.12058 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23286865  }} </ref>

{{PBI|Hepatitis E virus}} 
* '''Hepatitis E treatment'''<ref>{{citeweb|title=Hepatitis E virus|url=http://www.who.int/mediacentre/factsheets/fs280/en/}}</ref>
:*Preferred regimen: supportive therapy. There is no specific treatment available.
::*Note (1): Hepatitis E is usually self-limiting, hospitalization is generally not required.
::*Note (2): Hospitalization is required for people with fulminant hepatitis and should also be considered for symptomatic pregnant women.

{{PBI|Epstein-Barr virus}}
:* [[Epstein-Barr Virus]] (EBV) <ref name=CDC>{{cite web | title = Epstein-Barr Virus (EBV) center for disease control and prevention| url =http://www.cdc.gov/epstein-barr/about-ebv.html }}</ref>
::* There is no vaccine to protect against EBV infection. You can help protect yourself by not kissing or sharing drinks, food, or personal items, like toothbrushes, with people who have EBV infection.
::* There is no specific treatment for EBV. However, some things can be done to help relieve symptoms, including
:::* drinking fluids to stay hydrated
:::* getting plenty of rest
:::* taking over-the-counter medications for pain and fever

{{PBI|Human herpesvirus 6}}
:* '''Human herpesvirus 6 treatment'''<ref name="pmid25582535">{{cite journal| author=Tong LX, Worswick SD| title=Viral infections in acute graft-versus-host disease: a review of diagnostic and therapeutic approaches. | journal=J Am Acad Dermatol | year= 2015 | volume= 72 | issue= 4 | pages= 696-702 | pmid=25582535 | doi=10.1016/j.jaad.2014.12.002 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25582535  }} </ref><ref name="pmid15653828">{{cite journal| author=De Bolle L, Naesens L, De Clercq E| title=Update on human herpesvirus 6 biology, clinical features, and therapy. | journal=Clin Microbiol Rev | year= 2005 | volume= 18 | issue= 1 | pages= 217-45 | pmid=15653828 | doi=10.1128/CMR.18.1.217-245.2005 | pmc=PMC544175 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15653828  }} </ref>
::* Preferred regimen: supportive therapy
::* Note: If patient is immunocompromised, there are no antiviral regimens stablished as there are no clinical trials to validate their use on these cases. Consider administering [[Ganciclovir]], [[Acyclovir]], [[Foscarnet]] {{or}} [[Cidofovir]].<ref name="pmid22819486">{{cite journal| author=Wolz MM, Sciallis GF, Pittelkow MR| title=Human herpesviruses 6, 7, and 8 from a dermatologic perspective. | journal=Mayo Clin Proc | year= 2012 | volume= 87 | issue= 10 | pages= 1004-14 | pmid=22819486 | doi=10.1016/j.mayocp.2012.04.010 | pmc=PMC3538396 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22819486  }} </ref><ref name="pmid15653828">{{cite journal| author=De Bolle L, Naesens L, De Clercq E| title=Update on human herpesvirus 6 biology, clinical features, and therapy. | journal=Clin Microbiol Rev | year= 2005 | volume= 18 | issue= 1 | pages= 217-45 | pmid=15653828 | doi=10.1128/CMR.18.1.217-245.2005 | pmc=PMC544175 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15653828  }} </ref>
 

{{PBI|Roseola|Human herpesvirus 7}}
:* '''Human herpesvirus 7 (roseola virus) treatment'''
::* Preferred regimen: Supportive therapy
::* Note (1): Immunocompetent hosts with uncomplicated skin manifestations associated with HHV-7, particularly roseola infantum and pityriasis rosea, need only symptomatic management<ref name="pmid22819486">{{cite journal| author=Wolz MM, Sciallis GF, Pittelkow MR| title=Human herpesviruses 6, 7, and 8 from a dermatologic perspective. | journal=Mayo Clin Proc | year= 2012 | volume= 87 | issue= 10 | pages= 1004-14 | pmid=22819486 | doi=10.1016/j.mayocp.2012.04.010 | pmc=PMC3538396 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22819486  }}</ref>
::* Note (2): For HIV-positive patients, antiretroviral therapy may be advisable<ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
::* Note (3): The most active antiviral compounds against HHV-7 are [[Cidofovir]] and [[Foscarnet]]<ref name="pmid11747000">{{cite journal| author=De Clercq E, Naesens L, De Bolle L, Schols D, Zhang Y, Neyts J|title=Antiviral agents active against human herpesviruses HHV-6, HHV-7 and HHV-8. | journal=Rev Med Virol | year= 2001 | volume= 11 | issue= 6 | pages= 381-95 | pmid=11747000 | doi= | pmc= |url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11747000  }} </ref><ref name="pmid22819486">{{cite journal| author=Wolz MM, Sciallis GF, Pittelkow MR| title=Human herpesviruses 6, 7, and 8 from a dermatologic perspective. | journal=Mayo Clin Proc | year= 2012 | volume= 87 | issue= 10 | pages= 1004-14 | pmid=22819486 | doi=10.1016/j.mayocp.2012.04.010 | pmc=PMC3538396 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22819486  }} </ref>

----

{{PBI|Human herpesvirus 8 (KSHV)}}
:* 1. '''Mild to moderate Kaposi sarcoma'''<ref>{{ cite web | title = Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents | url = https://aidsinfo.nih.gov/contentfiles/lvguidelines/AdultOITablesOnly.pdf }}</ref>
::* Preferred regimen: initiate or optimize ART

:* 2. '''Advanced Kaposi sarcoma (ACTG Stage T1, including disseminated cutaneous or visceral Kaposi sarcoma)'''
::* Preferred regimen: chemotherapy (per oncology consult) {{and}} ART

:* 3. '''Primary effusion lymphoma'''
::* Preferred regimen: chemotherapy (per oncology consult) {{and}} ART
::* Note: [[Valganciclovir]] PO or [[Ganciclovir]] IV can be used as adjunctive therapy.

:* 4. '''Multicentric Castleman's disease'''
::* Preferred regimen (1): [[Valganciclovir]] 900 mg PO bid for 3 weeks
::* Preferred regimen (2): [[Ganciclovir]] 5 mg/kg IV q12h for 3 weeks
::* Preferred regimen (3): [[Valganciclovir]] 900 mg PO BID {{and}} [[Zidovudine]] 600 mg PO q6h for 7–21 days
::* Alternative regimen: [[Rituximab]] 375 mg/m2 given weekly for 4–8 weeks (may be an alternative to or used adjunctively with antiviral therapy)


{{PBI|Herpes simplex virus}}
:* '''Genital Herpes'''<ref>{{Cite journal| issn = 1545-8601| volume = 64| issue = RR-03| pages = 1–137| last1 = Workowski| first1 = Kimberly A.| last2 = Bolan| first2 = Gail A.| title = Sexually transmitted diseases treatment guidelines, 2015| journal = MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control| date = 2015-06-05| pmid = 26042815}}</ref>
::* 1.'''First Clinical Episode of Genital Herpes'''
:::* Preferred Regimen (1): [[Acyclovir]] 400 mg PO tid for 7–10 days 
:::* Preferred Regimen (2): [[Acyclovir]] 200 mg PO five times a day for 7–10 days
:::* Preferred Regimen (3): [[Valacyclovir]] 1 g PO bid for 7–10 days
:::* Preferred Regimen (4): [[Famciclovir]] 250 mg PO tid  for 7–10 days
:::* Note:Treatment can be extended if healing is incomplete after 10 days of therapy.
::* 2.'''Established HSV-2 Infection ''' 
:::* 2.1 '''Suppressive Therapy for Recurrent Genital Herpes'''
::::* Preferred Regimen (1): [[Acyclovir]] 400 mg PO bid 
::::* Preferred Regimen (2): [[Valacyclovir]] 500 mg PO qd 
::::* Preferred Regimen (3): [[Valacyclovir]] 1 g PO qd
::::* Preferred Regimen (4): [[Famciclovir]] 250 mg PO bid
::::* Note(1):Daily therapy with [[Acyclovir]] for as long as 6 years and with [[Valacyclovir]]  {{or}} [[Famciclovir]] for 1 year
::::* Note(2):[[Valacyclovir]] 500 mg qd might be less effective than other [[Valacyclovir]] {{or}} [[Acyclovir]] dosing regimens in persons who have very frequent recurrences (i.e., ≥10 episodes per year). 
:::* 2.2 '''Episodic Therapy for Recurrent Genital Herpes'''
::::* Preferred Regimen (1): [[Acyclovir]] 400 mg PO tid for 5 days
::::* Preferred Regimen (2): [[Acyclovir]] 800 mg PO bid for 5 days
::::* Preferred Regimen (3): [[Acyclovir]] 800 mg  PO tid for 2 days
::::* Preferred Regimen (4): [[Valacyclovir]] 500 mg PO bid for 3 days
::::* Preferred Regimen (5): [[Valacyclovir]] 1 g PO qd for 5 days 
::::* Preferred Regimen (6): [[Famciclovir]] 125 mg  PO bid  for 5 days
::::* Preferred Regimen (7): [[ Famciclovir]] 1 g PO bid  for 1 day 
::::* Preferred Regimen (8): [[Famciclovir]] 500 mg once, followed by 250 mg  PO bid  for 2 days
::* 3. '''Severe Disease''' (disseminated infection, pneumonitis, or hepatitis) or CNS complications (e.g., meningoencephalitis).
:::* Preferred Regimen: [[ Acyclovir]] 5–10 mg/kg IV q8h  for 2–7 days or until clinical improvement is observed, followed by oral antiviral therapy to complete at least 10 days of total therapy. HSV encephalitis requires 21 days of intravenous therapy. Impaired renal function warrants an adjustment in acyclovir dosage.
::* 4. '''Special Considerations'''
:::* 4.1 '''HIV Infection'''
::::* 4.1.1 '''Daily Suppressive Therapy in Persons with HIV'''
:::::* Preferred Regimen (1): [[Acyclovir]] 400–800 mg PO bid /tid  
:::::* Preferred Regimen (2): [[Valacyclovir]] 500 mg  PO bid 
:::::* Preferred Regimen (3): [[Famciclovir]] 500 mg PO bid
::::* 4.1.2 '''Episodic Infection in Persons with HIV'''
:::::* Preferred Regimen (1): [[Acyclovir]] 400 mg  PO tid  for 5–10 days 
:::::* Preferred Regimen (2): [[Valacyclovir]] 1 g PO bid for 5–10 days 
:::::* Preferred Regimen (3): [[Famciclovir]] 500 mg  PO bid for 5–10 days 
:::::* Note: For severe HSV disease, initiating therapy with [[Acyclovir]] 5–10 mg/kg IV q8 h might be necessary.
:::* 4.2 '''Genital Herpes in Pregnancy'''
::::* Suppressive therapy of pregnant women with recurrent genital herpes
::::* Preferred Regimen (1): [[Acyclovir]] 400–800 mg PO bid /tid 
::::* Preferred Regimen (2): [[Valacyclovir]] 500 mg  PO bid
::::* Note:Treatment recommended starting at 36 weeks of gestation. 
:::* 4.3 '''Neonatal Herpes '''
::::* Known or suspected neonatal herpes

::::* Preferred Regimen: [[Acyclovir]] 20 mg/kg IV q 8 h
::::* Note (1): Treatment for 14 days if disease is limited to the skin and mucous membranes, or 
::::* Note (2): Treatment for 21 days for disseminated disease and that involving the central nervous system.
:::* 4.4 '''Acyclovir-resistant genital herpes'''
::::* Preferred Regimens: [[Foscarnet ]] 40–80 mg/kg IV q8 h until clinical resolution is attained
::::* Alternative Regimen (1): [[Cidofovir]] 5 mg/kg  IV once weekly might also be effective.
::::* Alternative Regimen (2): Imiquimod topical preparations should be applied to the lesions qd for 5 consecutive days.
:::* 4.5 '''Management of Sex Partners''' 
::::* Preferred Regimen (1): [[Acyclovir]] 400 mg PO tid for 7–10 days
::::* Preferred Regimen (2): [[Acyclovir]] 200 mg PO five times a day for 7–10 days
::::* Preferred Regimen (3): [[Valacyclovir]] 1 g PO bid for 7–10 days
::::* Preferred Regimen (4): [[Famciclovir]] 250 mg PO tid  for 7–10 days
::::* Note:The sex partners of persons who have genital herpes can benefit from evaluation and counseling. Symptomatic sex partners should be evaluated and treated
:::* 4.6 '''Allergy, Intolerance, and Adverse Reactions'''
::::* Allergic and other adverse reactions to oral [[Acyclovir]], [[Valacyclovir]], and [[Famciclovir]] are rare. Desensitization to acyclovir has been described.

----

==vzv==
{{PBI|Varicella-zoster virus}}
::* 1. '''Varicella zoster treatment'''<ref name="pmid23863052">{{cite journal| author=Cohen JI| title=Clinical practice: Herpes zoster. | journal=N Engl J Med | year= 2013 | volume= 369 | issue= 3 | pages= 255-63 | pmid=23863052 | doi=10.1056/NEJMcp1302674 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23863052  }} </ref>
:::* 1.1 '''Non Immunocompromised person'''
::::* Preferred regimen (1): [[Acyclovir]] 500 mg PO five times a dayfor 7-10 days
::::* Preferred regimen (2): [[Famciclovir]] 500 mg PO tid  for 7 days
::::* Preferred regimen (3): [[Valacyclovir]] 1 g PO tid for 7 days
::::* Preferred regimen (4): Brivudin 125 mg PO qd for 7 days
:::* 1.2 '''Immunocompromised person requiring hospitalization or persons with sever neurologic complications'''
::::* Preferred regimen (1): [[Acyclovir]] 10 mg/ kg IV q8h for 7-10 days
::::* Preferred regimen (2): [[Foscarnet]] 40 mg/ kg IV q8h until lesions are healed
::::* Note: Brivudin is not available in USA and has not been approved by FDA. [[Foscarnet]] is not approve by FDA
::* 2. '''Treatment of VZV complications'''<ref name="pmid17143845">{{cite journal| author=Dworkin RH, Johnson RW, Breuer J, Gnann JW, Levin MJ, Backonja M et al.| title=Recommendations for the management of herpes zoster. | journal=Clin Infect Dis | year= 2007 | volume= 44 Suppl 1 | issue=  | pages= S1-26 | pmid=17143845 | doi=10.1086/510206 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17143845  }} </ref>
:::* 2.1 '''VZV ophthalmicus'''
::::* Treatment includes the following 
:::::* (1) [[Famciclovir]] {{or}} [[Valacyclovir]] for 7–10 days, preferably started within 72 h of rash onset (with [[Acyclovir]] IV given as needed for retinitis), to resolve acute disease and inhibit late inflammatory recurrences, {{and}} [[Prednisone]] 20 mg PO tid for 4 days or bid for 6 days, and then qd for 4 day
:::::* (2) Bacitracin-Polymyxin ophthalmic ointment administered bid ,to protect the ocular surface;
:::::* (3) Topical  [[Prednisolone]] 0.125%–1% 2–6 times daily prescribed and managed only by an ophthalmologist for corneal immune disease, episcleritis, scleritis, or iritis; 
:::::* (4) [[Homatropine]] 5% bid as needed for iritis 
:::::* (5) Latanaprost qd and/or Timolol maleate ophthalmic gel forming solution every morning)ocular pressure–lowering drugs given as needed for glaucoma
:::::* Note (1): Systemic steroids are indicated in the presence of moderate to severe pain or rash, particularly if there is significant edema, which may cause orbital apex syndrome through pressure on the nerves entering the orbit. 
:::::* Note (2): pain medications and cool to tepid wet compresses (if tolerated) and no topical antivirals, because they are ineffective
:::* 2.2 '''VZV retinitis'''
::::* Preferred regimen: [[Acyclovir]] IV  10–15 mg/kg q8h for 10–14 days followed by [[Valacyclovir]] PO 1 g tid  daily for 4–6 weeks
::* 3 '''Recommendations for treating varicella zoster virus (VZV) Infections in HIV-Infected adults and adolescents'''<ref>{{Cite web | title =VZV |https://aidsinfo.nih.gov/guidelines/html/4/adult-and-adolescent-oi-prevention-and-treatment-guidelines/341/vzv }} </ref>
:::* 3.1 '''Primary Varicella Infection (Chickenpox)'''
::::* 3.1.1 '''Uncomplicated Cases'''
:::::* Preferred regimen (1):[[Valacyclovir]] 1 g PO tid for 5–7 days 
:::::* Preferred regimen (2): [[Famciclovir]] 500 mg PO tid  for 5–7 days 
:::::* Alternative regimen: [[Acyclovir]] 800 mg PO 5 times daily for 5–7 days
::::* 3.1.2 '''Severe or Complicated Cases'''
:::::* Preferred regimen: [[Acyclovir]] 10–15 mg/kg IV q8h for 7–10 days 
:::::* Note: May switch to oral [[Famciclovir]], [[Valacyclovir]], or [[Acyclovir]] after defervescence if no evidence of visceral involvement is evident
:::* 3.2 '''Herpes Zoster (Shingles)'''
::::* 3.2.1 '''Acute Localized Dermatomal'''
:::::* Preferred regimen (1): [[Valacyclovir]] 1000 mg PO tid for 7–10 days
:::::* Preferred regimen (2): [[Famciclovir]] 500 mg PO tid for 7–10 days
:::::* Alternative Therapy: [[Acyclovir]] 800 mg PO 5 times daily for 7–10 days
:::::* Note: Longer duration should be considered if lesions resolve slowly
::::* 3.2.2 '''Extensive Cutaneous Lesion or Visceral Involvement'''
:::::* Preferred regimen: [[Acyclovir]] 10–15 mg/kg IV q8h until clinical improvement is evident, then switch to ([[Valacyclovir]] 1 g PO tid, [[Famciclovir]] 500 mg PO tid, or [[Acyclovir]] 800 mg PO 5 times daily)—to complete a 10–14 day course, when formation of new lesions has ceased  and signs and symptoms of visceral VZV infection are improving 
:::* 3.3 '''PORN (Progressive outer retinal necrosis)'''
::::* Preferred regimen: [[Ganciclovir]] 5 mg/kg and/or [[Foscarnet]] 90 mg/kg IV q12h {{and}} [[Ganciclovir]] 2 mg/0.05mL and/or foscarnet 1.2 mg/0.05mL intravitreal twice weekly.
::::* Note: Duration of therapy is not well defined and should be determined based on clinical, virologic, and immunologic response in consultation with experienced ophthalmologist and optimize ART regimen.
::::* Note: [[Ganciclovir]] ocular implants are no longer commercially available
:::* 3.4 '''ARN (Acute retinal necrosis)'''
::::* Preferred regimen: [[Acyclovir]] 10-15 mg/kg IV q8h for 10–14 days, followed by [[Valacyclovir]] 1 g PO tid for 6 weeks {{and}} [[Ganciclovir]] 2 mg/0.05mL intravitreal qd/bid twice weekly 
::::* Note: Duration of therapy is not well defined and should be determined based on clinical, virologic, and immunologic response in consultation with experienced ophthalmologist
::* 4 '''Prevention  of  varicella zoster virus (VZV) Infections in HIV-Infected Adults and Adolescents'''
:::* 4.1 '''Pre-Exposure Prevention of VZV Primary Infection'''
::::* '''Indications'''
:::::* Adult and adolescent patients with CD4 count ≥200 cells/mm3 without documentation of vaccination, health-care provider diagnosis or verification of a history of varicella or herpes zoster, laboratory confirmation of disease, or persons who are seronegative for VZV. Routine VZV serologic testing in HIV-infected adults and adolescents is not recommended.
:::::* '''Vaccination'''
:::::* Primary varicella vaccination (Varivax™), 2 doses (0.5 mL SQ) administered 3 months apart 
:::::* If vaccination results in disease because of vaccine virus, treatment with acyclovir is recommended.
:::::* VZV-susceptible household contacts of susceptible HIV-infected persons should be vaccinated to prevent potential transmission of VZV to their HIV-infected contacts.
:::::* If post-exposure VariZIG has been administered, wait at least 5 months before varicella vaccination.
:::::* If post-exposure acyclovir has been administered, wait at least 3 days before varicella vaccine.
:::* 4.2 '''Post-Exposure Prophylaxis'''
::::* '''Indication'''
:::::* Close contact with a person who has active varicella or herpes zoster, and
:::::* Is susceptible to VZV (i.e., has no history of vaccination or of either condition, or is known to be VZV seronegative)
::::* Preferred regimen: VariZIG 125 IU /10 kg (maximum of 625 IU) IM, administered as soon as possible and within 10 days after exposure to a person with active varicella or herpes zoster
::::* Alternative regimen (Begin 7–10 Days After Exposure): [[Acyclovir]] 800 mg PO 5 times/day for 5–7 days {{or}} [[Valacyclovir]] 1 g PO tid for 5–7 days  
::::* If post-exposure VariZIG has been administered, wait at least 5 months before varicella vaccination.
::::* Note: Patients receiving monthly high dose IVIG (i.e., >400 mg/kg) are likely to be protected against VZV and probably do not require VariZIG if the last dose of IVIG was administered <3 weeks before VZV exposure. 
::::* Note: Neither these pre-emptive interventions nor post-exposure varicella vaccination have been studied in HIV-infected adults and adolescents.
::::* If acyclovir or valacyclovir is used, varicella vaccines should not be given until at least 72 hours after the last dose of the antiviral drug.

==hpv==
{{PBI|Human papillomavirus}}
:* ''' Anogenital Warts'''<ref>{{Cite journal| issn = 1545-8601| volume = 64| issue = RR-03| pages = 1–137| last1 = Workowski| first1 = Kimberly A.| last2 = Bolan| first2 = Gail A.| title = Sexually transmitted diseases treatment guidelines, 2015| journal = MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control| date = 2015-06-05| pmid = 26042815}}</ref>
::* 1.'''Preferred regimen for External Anogenital Warts'''(i.e., penis, groin, scrotum, vulva, perineum, external anus, and perianus)
:::* 1.1 '''Patient-Applied''': [[Imiquimod]] 3.75% or 5% cream {{or}} [[Podofilox]] 0.5% solution or gel {{or}} [[Sinecatechins]] 15% ointment
:::* 1.2 '''Provider-Administered''': Cryotherapy with liquid nitrogen or cryoprobe  {{or}} Surgical removal either by tangential scissor excision, tangential shave excision, curettage, laser,or electrosurgery {{or}} [[Trichloroacetic acid]] (TCA) {{or}} Bichloroacetic acid (BCA) 80%-90% solution
:::* Note (1): Many persons with external anal warts also have intra-anal warts. Thus, persons with external anal warts might benefit from an inspection of the anal canal by digital examination, standard anoscopy, or high-resolution anoscopy.
:::* Note (2): Might weaken condoms and vaginal diaphragms.
::* 2.'''Alternative Regimens for External Genital Warts'''
:::* 2.1 '''Urethral Meatus Warts'''
::::* Preferred regimen: Cryotherapy with liquid nitrogen {{or}} Surgical removal 
:::* 2.2 '''Vaginal Warts'''
::::* Preferred regimen: Cryotherapy with liquid nitrogen {{or}} Surgical removal  {{or}}  (TCA {{or}} BCA 80%–90% solution)
::::* Note: The use of a cryoprobe in the vagina is not recommended because of the risk for vaginal perforation and fistula formation
:::* 2.3 '''Cervical Warts'''
::::* Preferred regimen: Cryotherapy with liquid nitrogen {{or}} Surgical removal {{or}} (TCA {{or}} BCA 80%–90% solution)
::::* Note: Management of cervical warts should include consultation with a specialist.For women who have exophytic cervical warts, a biopsy evaluation to exclude high-grade SIL must be performed before treatment is initiated.
:::* 2.4 '''Intra-anal Warts'''
::::* Preferred regimen: Cryotherapy with liquid nitrogen {{or}} Surgical removal {{or}} (TCA {{or}} BCA 80%–90% solution)
::::* Note: Management of intra-anal warts should include consultation with a specialist.

::* 3. '''Specific considerations'''
:::* 3.1 '''Follow-up'''
::::* Most anogenital warts respond within 3 months of therapy. Factors that might affect response to therapy include immunosuppression and treatment compliance. In general, warts located on moist surfaces or in intertriginous areas respond best to topical treatment. A new treatment modality should be selected when no substantial improvement is observed after a complete course of treatment or in the event of severe side effects; treatment response and therapy-associated side effects should be evaluated throughout the course of therapy.

:::* 3.2 '''Management of sex partners'''
::::* Persons should inform current partner(s) about having genital warts because the types of HPV that cause warts can be passed on to partners. Partners should receive counseling messages that partners might already have HPV despite no visible signs of warts, so HPV testing of sex partners of persons with genital warts is not recommended.

:::* 3.3 '''Pregnancy'''
::::* [[Podofilox]] (podophyllotoxin), [[Podophyllin]], and [[Sinecatechins]] should not be used during pregnancy. Imiquimod appears to pose low risk but should be avoided until more data are available.
::::* Cesarean delivery is indicated for women with anogenital warts if the pelvic outlet is obstructed or if vaginal delivery would result in excessive bleeding. 
::::* Pregnant women with anogenital warts should be counseled concerning the low risk for warts on the larynx of their infants or children (recurrent respiratory papillomatosis).

:::* 3.4 '''HIV infection'''
::::* Data do not support altered approaches to treatment for persons with HIV infection.
::::* Squamous cell carcinomas arising in or resembling anogenital warts might occur more frequently among immunosuppressed persons, therefore requiring biopsy for confirmation of diagnosis for suspicious cases

:::* 3.5 '''High-grade squamous intraepithelial lesions'''
::::* Biopsy of an atypical wart might reveal HSIL or cancer of the anogenital tract. In this instance, referral to a specialist for treatment is recommended.

----

==influenza A& B==
{{PBI|Influenza A & B}}
:* '''Antiviral Medications Recommended for Treatment of Influenza'''
::* 1. '''Adults'''
:::* Preferred regimen (1): [[Oseltamivir]] (Tamiflu®) 75 mg PO bid for 5 days
:::* Preferred regimen (2): [[Zanamivir]] (Relenza®) 10 mg (two 5-mg inhalations) bid for 5 days
:::* Preferred regimen (3): [[Peramivir]] (Rapivab®) 600 mg IV for 15-30 minutes (single dose)
:::* Note: FDA approved and recommended Peramivir (Rapivab®) for use in adults ≥18 yrs 
::* 2. '''Children'''
:::* 2.1 '''Children < 1 yr'''
::::* Preferred regimen: [[Oseltamivir]] (Tamiflu®) 3 mg/kg/dose PO bid for 5 days
:::* 2.2 '''Children > 1 yr''' 
::::* 2.2.1 '''Children ≤ 15 kg'''
:::::* Preferred regimen: [[Oseltamivir]] (Tamiflu®) 30 mg PO bid for 5 days
::::* 2.2.2 '''Children > 15 to 23 kg'''
:::::* Preferred regimen: [[Oseltamivir]] (Tamiflu®) 45 mg PO bid for 5 days
::::* 2.2.3 '''Children > 23 to 40 kg'''
:::::* Preferred regimen: [[Oseltamivir]] (Tamiflu®) 60 mg PO bid for 5 days
::::* 2.2.4 '''Children > 40 kg'''
:::::* Preferred regimen (1): [[Oseltamivir]] (Tamiflu®) 75 mg PO bid for 5 days
:::::* Preferred regimen (2): [[Zanamivir]] (Relenza®) 10 mg (two 5-mg inhalations)  bid  for 5 days, may be considered for children > 7 yrs old
::* 3. '''Adult Patients with Renal Impairment or End Stage Renal Disease (ESRD) on Dialysis'''
:::* 3.1 '''[[Oseltamivir]] '''
::::* Creatinine clearance 61 to 90 mL/min-75 mg PO bid for 5 days
::::* Creatinine clearance 31 to 60 mL/min-30 mg PO bid for 5 days
::::* Creatinine clearance 10 to 30 mL/min-30 mg PO qd  for 5 days
::::* ESRD Patients on Hemodialysis
::::* Creatinine clearance ≤10 mL/min-30 mg after every hemodialysis cycle. Treatment duration not to exceed 5 days
::::* ESRD Patients on Continuous Ambulatory Peritoneal Dialysis-A single 30 mg dose administered immediately after a dialysis exchange
:::* 3.2 '''[[Peramivir]]'''
::::* Creatinine clearance >50 mL/min-600mg IV single dose
::::* Creatinine clearance 30 to 49 mL/min-200mg IV single dose
::::* Creatinine clearance 10 to 29 mL/min-100mg IV single dose
::::* ESRD Patients on Hemodialysis-Dose administered after dialysis at a dose adjusted based on creatinine clearance 
::::* Note: No dose adjustment is recommended for inhaled zanamivir for a 5-day course of treatment for patients with renal impairment.
::* 4. '''Antiviral Medications Recommended for Chemoprophylaxis of Influenza'''
:::* 4.1. '''Adults'''
::::* Preferred regimen (1): [[Oseltamivir]] (Tamiflu®) 75 mg PO qd for 7days
::::* Preferred regimen (2): [[Zanamivir]] (Relenza®) 10 mg (two 5-mg inhalations) qd for 7 days
:::* 4.2. '''Children'''
::::* 4.2.1 '''Children < 1 yr'''
:::::* Preferred regimen: [[Oseltamivir]] (Tamiflu®) 3 mg/kg/dose PO qd for 7 days
::::* 4.2.2 '''Children > 1 yr''' 
:::::* 4.2.2.1 '''Children ≤ 15 kg'''
::::::* Preferred regimen: [[Oseltamivir]] (Tamiflu®) 30 mg PO qd for 7 days
:::::* 4.2.2.2 '''Children > 15 to 23 kg'''
::::::* Preferred regimen: [[Oseltamivir]] (Tamiflu®) 45 mg PO qd for 7 days
:::::* 4.2.2.3 '''Children > 23 to 40 kg'''
::::::* Preferred regimen: [[Oseltamivir]] (Tamiflu®) 60 mg PO qd for 7 days
:::::* 4.2.2.4 '''Children > 40 kg'''
::::::* Preferred regimen (1): [[Oseltamivir]] (Tamiflu®) 75 mg PO qd for 7 days
::::::* Preferred regimen (2):  [[Zanamivir]] (Relenza®) 10 mg (two 5-mg inhalations) qd  for 7 days, may be considered for children > 7 yrs older
::::::* Note: If child is < 3 months old, use of [[Oseltamivir]] for chemoprophylaxis is not recommended unless situation is judged critical due to limited data in this age group.

==Avian influenza==
{{PBI|Avian influenza}}
::*1. Preferred regimen:[[Oseltamivir]] 75 mg PO qd for a minimum 10 days <ref name=":1">Avian Influenza Factsheet. World Health Organization. http://www.who.int/mediacentre/factsheets/avian_influenza/en/ Accessed on April 22, 2015</ref><ref>{{Cite web| title= avian influenza| url=http://www.cdc.gov/flu/avianflu/avian-in-humans.htm}} </ref>
:::*Note:Patients with severe disease may have diarrhea and may not absorb oseltamivir efficiently
::*2. Patients with Avian Influenza who have diarrhea and  malabsorption
:::* Preferred regimen (1): [[Zanamivir]] 10 mg inhaled bid for minimum 5 days 
:::* Preferred regimen (2): [[Peramivir] ]600 mg IV as a single dose for 1 day
:::* Note(1): Preliminary evidence demonstrates that [[Neuraminidase inhibitor]] can reduce the duration of viral replication and improve survival among patients with avian influenza. In cases of suspected avian influenza, one of the following 3 neuraminidase inhibitors should be administered as soon possible, preferably within 48 hours of symptom onset. 
:::* Note(2): The use of [[Corticosteroids]] is not recommended.
:::* Note(3): Physicians may consider increasing either the recommended daily dose and/or the duration of treatment in cases of severe disease.
:::* Note(4): The use of [[Amantadine]] is not recommended as most H5N1 and H7N9 avian influenza viruses are resistant to it.<ref>WHO guidelines for pharmacological management of pandemic (H1N1) 2009 influenza and other influenza viruses. http://www.who.int/csr/resources/publications/swineflu/h1n1_use_antivirals_20090820/en/ Accessed on April 22, 2015
</ref>
:::* Note(5): Supportive care is also an important cornerstone of the care of patients with avian influenza. Considering the severity of the illness and the possible complications, patients may require fluid resuscitation, vasopressors, intubation and ventilation, paracentesis, hemodialysis or hemofiltration, and parentral nutrition.

----

{{PBI|Swine influenza}}
:* [[Swine influenza]] <ref>{{Cite book| publisher = World Health Organization| title = WHO Guidelines for Pharmacological Management of Pandemic Influenza A(H1N1) 2009 and Other Influenza Viruses| location = Geneva| series = WHO Guidelines Approved by the Guidelines Review Committee| accessdate = 2015-07-14| date = 2010| url = http://www.ncbi.nlm.nih.gov/books/NBK138515/| pmid = 23741777}}</ref>
::* 1. '''Condition1: Patients who have severe or progressive clinical illness'''
:::* Preferred regimen: [[Oseltamivir]] 150 mg PO bid 
:::* Note (1): Treatment duration depends on clinical response
:::* Note (2): Where the clinical course remains severe or progressive, despite 5 or more days of antiviral treatment, monitoring of virus replication and shedding, and antiviral drug susceptibility testing is desirable
:::* Note (3): Antiviral treatment should be maintained without a break until virus infection is resolved or there is satisfactory clinical improvement
:::* Note (4): Patients who have severe or progressive clinical illness, but who are unable to take oral medication may be treated with oseltamivir administered by nasogastric or orogastric tube

::* 2. '''Condition2: In situations where oseltamivir is not available, or not possible to use, patients who have severe or progressive clinical illness'''
:::* Preferred regimen: [[Zanamivir]] inhaled
:::* Note: [[Zanamivir]] IV should be considered where available and is recommended for those with serious or progressive illness. If not available, [[Peramivir]] IV may be considered

::* 3. '''Condition3: Severely immunosuppressed patients'''
:::* Preferred regimen: Antiviral chemoprophylaxis by using [[Oseltamivir]] {{or}} [[Zanamivir]]

----

{{PBI|Measles}}
:* '''Measles<ref name=CDC Measles treatment>{{cite web | title = CDC Measles treatment | url =http://www.cdc.gov/measles/hcp/index.html }}</ref>''' 
::* 1.1. '''Prevention'''
:::* 1.1.1. '''Vaccines'''
::::* Note (1): Measles can be prevented with measles-containing vaccine, which is primarily administered as the combination measles-mumps-rubella (MMR) vaccine. The combination measles-mumps-rubella-varicella (MMRV) vaccine can be used for children aged 12 months through 12 years for protection against measles, mumps, rubella and varicella. Single-antigen measles vaccine is not available.
::::* Note (2): Vaccination recommendations
:::::* Children: CDC recommends routine childhood immunization for MMR vaccine starting with the first dose at 12 through 15 months of age, and the second dose at 4 through 6 years of age or at least 28 days following the first dose.
:::::* Students at post-high school educational institutions: Students at post-high school educational institutions without evidence of measles immunity need two doses of MMR vaccine, with the second dose administered no earlier than 28 days after the first dose.
:::::* Adults: People who are born during or after 1957 who do not have evidence of immunity against measles should get at least one dose of MMR vaccine.
:::::* International travelers: People 6 months of age or older who will be traveling internationally should be protected against measles. Before travelling internationally,
::::::* Infants 6 through 11 months of age should receive one dose of MMR vaccine
::::::* Children 12 months of age or older should have documentation of two doses of MMR vaccine (the first dose of MMR vaccine should be administered at age 12 months or older; the second dose no earlier than 28 days after the first dose)
::::::* Teenagers and adults born during or after 1957 without evidence of immunity against measles should have documentation of two doses of MMR vaccine, with the second dose administered no earlier than 28 days after the first dose
:::* 1.1.2. '''Post-exposure Prophylaxis'''
::::* 1.1.2.1. '''Indication'''
:::::* People exposed to measles who cannot readily show that they have evidence of immunity against measles should be offered post-exposure prophylaxis (PEP) or be excluded from the setting (school, hospital, childcare). MMR vaccine, if administered within 72 hours of initial measles exposure, or immunoglobulin (IG), if administered within six days of exposure, may provide some protection or modify the clinical course of disease.
::::* Note (1): If MMR vaccine is not administered within 72 hours of exposure as PEP, MMR vaccine should still be offered at any interval following exposure to the disease in order to offer protection from future exposures. People who receive MMR vaccine or IG as PEP should be monitored for signs and symptoms consistent with measles for at least one incubation period.
::::* Note (2): If many measles cases are occurring among infants younger than 12 months of age, measles vaccination of infants as young as 6 months of age may be used as an outbreak control measure. Note that children vaccinated before their first birthday should be revaccinated when they are 12 through 15 months old and again when they are 4 through 6 years of age.
::::* Note (3): People who are at risk for severe illness and complications from measles, such as infants younger than 12 months of age, pregnant women without evidence of measles immunity, and people with severely compromised immune systems, should receive IG. Intramuscular IG (IGIM) should be given to all infants younger than 12 months of age who have been exposed to measles.
::::* Note (4):  For infants aged 6 through 11 months, MMR vaccine can be given in place of IG, if administered within 72 hours of exposure. Because pregnant women might be at higher risk for severe measles and complications, intravenous IG (IGIV) should be administered to pregnant women without evidence of measles immunity who have been exposed to measles. People with severely compromised immune systems who are exposed to measles should receive IGIV regardless of immunologic or vaccination status because they might not be protected by MMR vaccine.
::::* Preferred regimen: The recommended dose of IGIM is 0.5 mL/kg of body weight (maximum dose = 15 mL) and the recommended dose of IGIV is 400 mg/kg.
::::* Note (5): If a healthcare provider without evidence of immunity is exposed to measles, MMR vaccine should be given within 72 hours, or IG should be given within 6 days when available. Exclude healthcare personnel without evidence of immunity from duty from day 5 after first exposure to day 21 after last exposure, regardless of post-exposure vaccine. 
::* 1.2. '''Treatment'''
:::* Note (1): There is no specific antiviral therapy for measles. Medical care is supportive and to help relieve symptoms and address complications such as bacterial infections.
:::* Note (2): Severe measles cases among children, such as those who are hospitalized, should be treated with vitamin A. Vitamin A should be administered immediately on diagnosis and repeated the next day. The recommended age-specific daily doses are
::::* 50,000 IU for infants younger than 6 months of age
::::* 100,000 IU for infants 6–11 months of age
::::* 200,000 IU for children 12 months of age and older


{{PBI|Middle East respiratory syndrome}}
:*'''Middle East Respiratory Syndrome treatment'''
::* Preferred regimen: supportive care. There is no antiviral recommended for this infection at this moment, even though experimental therapies are at research (IFNs, [[Ribavirin]], [[Lopinavir]], [[Mycophenolic acid]], [[Cyclosporine]], [[Chloroquine]], [[Chlorpromazine]], [[Loperamide]], [[6-mercaptopurine]] and [[6-thioguanine]]). Supportive care include: administer oxygen to patients with severe acute pulmonary infection with signs of respiratory distress, hypoxaemia or shock; use conservative fluids management, avoid administering high-dose systemic glucocorticoids, use non-invasive ventilation, but, if its nor effective, do not delay endotracheal intubation; use lung-protective strategy for intubated patients, recognize sepsis as early as possible and treat it accordingly.<ref>http://apps.who.int/iris/bitstream/10665/178529/1/WHO_MERS_Clinical_15.1_eng.pdf?ua=1</ref>

==Parainfluenza virus==
{{PBI|Parainfluenza virus}}
:*Parainfluenza virus<ref name="pmid23024295">{{cite journal| author=Hirsch HH, Martino R, Ward KN, Boeckh M, Einsele H, Ljungman P| title=Fourth European Conference on Infections in Leukaemia (ECIL-4): guidelines for diagnosis and treatment of human respiratory syncytial virus, parainfluenza virus, metapneumovirus, rhinovirus, and coronavirus. | journal=Clin Infect Dis | year= 2013 | volume= 56 | issue= 2 | pages= 258-66 | pmid=23024295 | doi=10.1093/cid/cis844 | pmc=PMC3526251 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23024295  }} </ref>
::* 1. '''Adults'''
:::* Preferred regimen: [[Ribavirin]] PO/IV 10 mg/kg q8h 
::::* Day 1: Start with 600 mg loading dose,then 200 mg  q8h
::::* Day 2: 400 mg q8h
::::* Day 3: Increase the dose to a maximum of 10 mg/kg q8h
:::* 1.1 '''In case of adverse events'''
::::* Preferred regimen: Decrease dose or discontinue [[Ribavirin]]
:::* 1.2 '''Creatinine clearance'''
::::* 30–50 mL/min: [[Ribavirin]] PO/IV maximal 200 mg  q8h 
::::* 10–30 mL/ min: No recommendation can be given


{{PBI|Parvovirus B19}}
:* Parvovirus B19<ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy 2014 | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2014 | isbn = 978-1930808782 }}</ref>
::* 1. '''Erythema infectiosum'''
:::* Supportive therapy: Symptomatic treatment only 
::* 2. '''Arthritis/arthalgia ''' 
:::* Preferred regimen: Nonsteroidal anti-inflammatory drugs (NSAID) 
::* 3.'''Transient aplastic crisis''' 
:::* Supportive therapy: Transfusions and oxygen
::* 4. '''Fetal hydrops'''
:::* Supportive therapy: Intrauterine blood transfusion
::* 5. '''Chronic infection with anemia'''
:::* Preferred regimen: IVIG and transfusion
::* 6.'''Chronic infection without anemia''' 
:::* Preferred regimen: IVIG
:::: Note (1): Diagnostic tools are IgM and Igb antibody titers.Perhaps better is blood Parvovirus PCR.
:::: Note (2): Dose of IVIG not standardized; suggest 400 mg/kg IV of commercial IVIG for 5 or 10 days or 1000 mg/kg IV for 3 days. 
:::: Note (3): Most dramatic anemias in pts with pre-existing hemolytic anemia. 
:::: Note (4): Bone marrow shown erythrocyte maturation arrest with giant pronormoblasts.

{{PBI|BK virus}}
:* '''Human polyomavirus (BK virus) treatment'''
::* '''Maintenance regimen consisting of triple immunosuppression therapy''': [[Calcineurin]] inhibitor ([[Cyclosporine]] or [[Tacrolimus]]) {{and}} an antimetabolite ([[Azathioprine]], [[Mycophenolate mofetil]], or [[Mycophenolate sodium]]), {{and}} [[Prednisone]] is to discontinue completely the antimetabolite (usually [[Mycophenolate]]) and decrease the dose of the [[Calcineurin]] inhibitor.
::* '''Alternative regimen (1)''': Decrease the [[Mycophenolate]] dose by 50 percent, followed by a 50 percent decrease in the [[Calcineurin]] inhibitor at three months if decoy cells persist. If using this approach, the target serum [[Tacrolimus]] trough level is 4 to 6, and the target serum [[Cyclosporine]] trough level is 60 to 100 ng/mL. [[Mycophenolate]] may be discontinued completely if viral activation persists. Maintenance immunosuppression then consists of [[Tacrolimus]] and low-dose [[Prednisone]].
::* '''Alternative regimen (2)''': Reduce both the [[Calcineurin]] inhibitor and the [[Mycophenolate]], which allows both the targeting of two pathways and lower total immunosuppression.
:::* Note (1): For those who are hypogammaglobulinemic, we administer intravenous immunoglobulins (IV IG) in replacement doses of 500 mg/kg. Quantitative immunoglobulins should be checked two to three months later to determine whether hypogammaglobulinemia has recurred. Intravenous immunoglobulins (IV IG) is also an option in certain settings, based upon polymerase chain reaction (PCR) and kidney biopsy results. IVIG may contain antibodies against BK and JC virus since these viruses are ubiquitous in the general population.
:::* Note (2): The goals of decreased immunosuppressive therapy are to restrain viral replication without triggering rejection.
:::* Note (3): Reduced immunosuppression (defined as lowering mean doses of [[Mycophenolate]] and [[Tacrolimus]]) resulted in the successful elimination of viremia (mean period of six months) and allograft survival.
:::* Note (4): Alternative approaches to reducing immunosuppression have also been effective
::::* 4.1 Changing from [[Tacrolimus]] to low-dose [[Cyclosporine]] not only reduces the effect of the [[Calcineurin]] inhibitor, but also reduces [[Mycophenolate]] concentrations.
::::* 4.2 Replacing the [[Calcineurin]] inhibitor with [[Sirolimus]], with or without discontinuation of the antimetabolite, has the advantage of avoiding the long-term [[Calcineurin]] inhibitor-related nephrotoxic effects.
::::* 4.3 Lowering the dose of [[Calcineurin]] inhibitors may slow the loss of renal function.

:* '''Primary Regimens'''
::* Decrease immunosuppression if possible. (Cornerstone of Treatment)
::* Suggested antiviral therapy is based on anecdotal data. If progressive renal dysfunction:
::* Fluoroquinolone {{and}} IVIG 500 mg/kg IV {{and}} Leflunomide 100 mg for daily for 3 days, then 10-20 mg PO daily
::* If refractory to all of the above, add [[Cidofovir]] 5 mg/kg once per week for 2 weeks, then once every other week  if refractory to all of the above

:* '''Ancillary Therapies in BK Virus Nephropathy'''
::* [[Cidofovir]] 0.25-1.0 mg/kg IV biweekly for 8 wk without [[Probenecid]], prehydration recommended 
::* [[Leflunomide]] 100 mg loading dose for 3 days, 20-60 mg/day, goal [[Leflunomide]] trough 50-100 ng/mL (consider lower trough goals of 20-40 ng/mL given hemolysis risk)
::* IV Ig 1-2 g/kg IV for 1-2 doses or 150 mg/kg  IV biweekly for 8 wk 
::* [[Fluoroquinolones]]-[[Ciproflaxacin]] 500 mg/day, duration dependent on virological response. 

{{PBI|JC virus}}
:* '''Progressive Multifocal Leukoencephalopathy (PML) caused by JC Virus ( John Cunningham virus) infections'''<ref>{{citeweb|title=JCvirus|url=https://aidsinfo.nih.gov/contentfiles/lvguidelines/adultandadolescentgl.pdf}}</ref>

::* There is no specific antiviral therapy for JC virus infection. 

::* The main treatment approach is to reverse the immunosuppression caused by HIV.

::* Initiate anti retroviral therapy (ART) immediately in ART-naive patients .

::* Optimize ART in patients who develop Progressive Multifocal Leukoencephalopathy in phase of HIV viremia on ART .

::* [[Corticosteroids]] may be used for Progressive Multifocal Leukoencephalopathy- immune reconstitution inflammatory syndrome (IRIS) characterized by contrast enhancement, edema or mass effect, and with clinical deterioration 
{{PBI|Rabies}}
::*Preferred regimen: no specific therapeutics agents are available once the disease is established. 
:::* Note: There are vaccines and immune globulins available for postexposure prophylaxis:
::::* Postexposure Prophylaxis for non immunized individuals: Wound cleansing, human rabies immune globulin - administer full dose infiltrated around any wound. Administer any remaining volume IM at other site anatomically distant from the wound. Administer vaccine 1,0ml, IM at deltoid area one each on days 0, 3, 7 and 14.
::::* Postexposure Prophylaxis for immunized individuals: Wound cleansing, do not administer human rabies immune globulin. Administer vaccine 1,0ml, IM at deltoid area one each on days 0 and 3.

{{PBI|Respiratory Syncytial Virus}}
* Respiratory syncytial virus treatment
:* Supportive therapy
::* Hydration and supplemental oxygen.
::* Routine use of [[Ribavirin]] not recommended. [[Ribavirin]] therapy associated with small increases in O2 saturation. 
::* No consistent decrease in need for mechanical ventilation or ICU stays. High cost, aerosol administration and potential toxicity<ref name="pmid19736258">{{cite journal| author=Committee on Infectious Diseases| title=From the American Academy of Pediatrics: Policy statements--Modified recommendations for use of palivizumab for prevention of respiratory syncytial virus infections. | journal=Pediatrics | year= 2009 | volume= 124 | issue= 6 | pages= 1694-701 | pmid=19736258 | doi=10.1542/peds.2009-2345 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19736258  }} </ref>

::: Note (1) In adults, Respiratory syncytial virus accounted for 10.6% of hospitalizations for pneumonia, 11.4% for COPD, 7.2% for asthma & 5.4% for CHF in pts >65 yrs of age <ref name="pmid15858184">{{cite journal| author=Falsey AR, Hennessey PA, Formica MA, Cox C, Walsh EE| title=Respiratory syncytial virus infection in elderly and high-risk adults. | journal=N Engl J Med | year= 2005 | volume= 352 | issue= 17 | pages= 1749-59 | pmid=15858184 | doi=10.1056/NEJMoa043951 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15858184  }} </ref>. Respiratory syncytial virus caused 11% of clinically important respiratory illnesses in military recruits<ref name="pmid16007526">{{cite journal| author=O'Shea MK, Ryan MA, Hawksworth AW, Alsip BJ, Gray GC| title=Symptomatic respiratory syncytial virus infection in previously healthy young adults living in a crowded military environment. | journal=Clin Infect Dis | year= 2005 | volume= 41 | issue= 3 | pages= 311-7 | pmid=16007526 | doi=10.1086/431591 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16007526  }} </ref>

::: Note (2) Respiratory Syncytial Virus major cause of morbidity in neonates/infants.
::: Note (3) Nucleic acid test now approved to detect 12 respiratory viruses (xTAG Respiratory Viral Panel, Luminex Molecular Diagnostics). 
:* '''Prevention of Respiratory syncytial virus'''

::* 1. In children <24 months old with chronic lung disease of prematurity (formerly broncho-pulmonary dysplasia) requiring supplemental oxygen or 
::* 2. In premature infants (<32 wks gestation) and <6 months old at start of Respiratory syncytial virus season or 
::* 3. In children with selected congenital heart diseases.
:::* Preferred regimen for prevention of Respiratory syncytial virus: [[Palivizumab]] (Synagis) 15 mg per kg IM q month Nov.-April<ref name="pmid19736258">{{cite journal| author=Committee on Infectious Diseases| title=From the American Academy of Pediatrics: Policy statements--Modified recommendations for use of palivizumab for prevention of respiratory syncytial virus infections. | journal=Pediatrics | year= 2009 | volume= 124 | issue= 6 | pages= 1694-701 | pmid=19736258 | doi=10.1542/peds.2009-2345 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19736258  }} </ref>

:::: Note : Significant reduction in Respiratory syncytial virus hospitalization among children with congenital heart disease<ref name="pmid17727335">{{cite journal| author=Feltes TF, Sondheimer HM| title=Palivizumab and the prevention of respiratory syncytial virus illness in pediatric patients with congenital heart disease. | journal=Expert Opin Biol Ther | year= 2007 | volume= 7 | issue= 9 | pages= 1471-80 | pmid=17727335 | doi=10.1517/14712598.7.9.1471 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17727335  }} </ref>

{{PBI|Rhinovirus}}
*'''Rhinovirus treatment (commom cold)'''
:* '''Supportive therapy'''

::* Symptomatic treatment-[[Ipratropium bromide]] intranasal (2 sprays tid) {{and}} [[Clemastine]] 1.34 mg 1–2 tab PO bid–tid (over the counter) 
::* Symptomatic relief by [[Ipratropium]] nasal spray decreases rhinorrhea and sneezing vs placebo.<ref name="pmid9880472">{{cite journal| author=Gern JE, Busse WW| title=Association of rhinovirus infections with asthma. | journal=Clin Microbiol Rev | year= 1999 | volume= 12 | issue= 1 | pages= 9-18 | pmid=9880472 | doi= | pmc=PMC88904 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9880472}}</ref> {{and}} Clemastine (an antihistamine) decreases sneezing, rhinorrhea but associated with dry nose, mouth & throat in 6–19%.<ref name="pmid8729205">{{cite journal| author=Gwaltney JM, Park J, Paul RA, Edelman DA, O'Connor RR, Turner RB| title=Randomized controlled trial of clemastine fumarate for treatment of experimental rhinovirus colds. | journal=Clin Infect Dis | year= 1996 | volume= 22 | issue= 4 | pages= 656-62 | pmid=8729205 | doi= | pmc= url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8729205  }} </ref>{{or}} Oral pleconaril given within 24 hrs of onset reduced duration (1 day) & severity of “cold symptoms” in DBPCT (p < .001).<ref name="pmid12802751">{{cite journal| author=Hayden FG, Herrington DT, Coats TL, Kim K, Cooper EC, Villano SA et al.| title=Efficacy and safety of oral pleconaril for treatment of colds due to picornaviruses in adults: results of 2 double-blind, randomized, placebo-controlled trials. | journal=Clin Infect Dis | year= 2003 | volume= 36 | issue= 12 | pages= 1523-32 | pmid=12802751 | doi=10.1086/375069 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12802751  }} </ref>
:::* Note (1)No antiviral rx indicated . <ref name="pmid15693216">{{cite journal| author=Turner RB| title=New considerations in the treatment and prevention of rhinovirus infections. | journal=Pediatr Ann | year= 2005 | volume= 34 | issue= 1 | pages= 53-7 | pmid=15693216 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15693216  }} </ref>

:::* Note (2) Found in 1/2 of children with community-acquired pneumonia; role in pathogenesis unclear (CID 39:681, 2004). <ref name="pmid12517470">{{cite journal| author=Heikkinen T, Järvinen A| title=The common cold. | journal=Lancet | year= 2003 | volume= 361 | issue= 9351 | pages= 51-9 | pmid=12517470 | doi=10.1016/S0140-6736(03)12162-9 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12517470  }} </ref>
:::* Note (3) High rate of rhinovirus identified in children with significant lower resp tract infections <ref name="pmid19258921">{{cite journal| author=Louie JK, Roy-Burman A, Guardia-Labar L, Boston EJ, Kiang D, Padilla T et al.| title=Rhinovirus associated with severe lower respiratory tract infections in children. | journal=Pediatr Infect Dis J | year= 2009 | volume= 28 | issue= 4 | pages= 337-9 | pmid=19258921 | doi=10.1097/INF.0b013e31818ffc1b | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19258921  }} </ref>

{{PBI|Rotavirus}}
* Rotavirus treatment<ref>{{citeweb|title=Rotavirus|url=http://www.who.int/mediacentre/factsheets/fs330/en/}}</ref>, <ref>{{citeweb|title=Rotavirus|url=http://www.cdc.gov/rotavirus/about/treatment.html}}</ref>

:* '''Treatment of diarrhoea caused by rotavirus '''

::* Rehydration with oral rehydration salts (ORS) solution. oral rehydration salts (ORS) solution is a mixture of clean water, salt and sugar. It costs a few cents per treatment. oral rehydration salts (ORS) solution is absorbed in the small intestine and replaces the water and electrolytes lost in the faeces.

::* Zinc supplements-with zinc supplements reduce the duration of a diarrhoea episode by 25% and are associated with a 30% reduction in stool volume.
::* Rehydration with intravenous fluids in case of severe dehydration or shock.
::* Nutrient-rich foods the vicious circle of malnutrition and diarrhoea can be broken by continuing to give nutrient-rich foods  including breast milk during an episode, and by giving a nutritious diet  including exclusive breastfeeding for the first six months of life  to children when they are well.
::* Consulting a health professional , in particular for management of persistent diarrhoea or when there is blood in stool or if there are signs of dehydration.

::: Note (1): Rotavirus and Escherichia coli are the two most common etiological agents of diarrhoea in developing countries.

::: Note (2): There is no antiviral drug to treat rotavirus infection. Antibiotic drugs will not help because antibiotics fight against bacteria not viruses.

::: Note (3): Rotavirus infection can cause severe vomiting and diarrhea. This can lead to dehydration (loss of body fluids). During rotavirus infection, infants and young children, older adults, and people with other illnesses are most at risk becoming dehydrated.

::: Note (4): Symptoms of dehydration include decrease in urination, dry mouth and throat, feeling dizzy when standing up. A dehydrated child may also cry with few or no tears and be unusually sleepy or fussy.
:* Prevention
::* Access to safe drinking-water
::* Use of improved sanitation
::* Hand washing with soap

::* Exclusive breastfeeding for the first six months of life

::* Good personal and food hygiene
::* Health education about how infections spread; and Rotavirus vaccination.

==Smallpox==
{{PBI|Smallpox}}
:* '''Smallpox''' <ref>{{Cite web | title = DIAGNOSIS AND MANAGEMENT OF SMALLPOX | url = http://www.nejm.org/doi/pdf/10.1056/NEJMra020025 }}</ref>
::* Supportive care is the mainstay of therapy.
::* Currently, there are no anti-viral drugs of proven efficacy. 
::* Recently, animal studies suggest that [[cidofovir]] and its cyclic analogues, given at the time of or immediately after exposure, have promise for the prevention of cowpox, vaccinia, and monkeypox.
::* Patients need adequate hydration and nutrition, because substantial amounts of fluid and protein can be lost by febrile persons with dense, often weeping lesions.
:::* 1. '''Secondary bacterial infection'''
::::* Penicillinase-resistant antimicrobial agents should be used 

:::::* If smallpox lesions are secondarily infected, 

:::::* If bacterial infection endangers the eyes 

::::::* Daily eye rinsing is required in severe cases. 

::::::* Topical [[idoxuridine]] should be considered for the treatment of corneal lesions, although its efficacy is unproved for smallpox.
:::::* If the eruption is very dense and widespread.

==HIV/AIDS==
{{PBI|HIV/AIDS}}
]* 1. '''Antiretroviral regimen options for treatment-naive patients<ref name=AIDSinfoNIH>{{cite web | title = AIDSinfoNIH | url =https://aidsinfo.nih.gov/guidelines/html/1/adult-and-adolescent-arv-guidelines/11/what-to-start }}</ref>'''
:* 1.1. '''Integrase strand transfer inhibitor-based regimens'''
::* Preferred regimen (1): [[Dolutegravir]] 50 mg PO qd {{and}} [[Abacavir]] 600 mg-[[Lamivudine]] 300 mg PO qd in patients who are HLA-B*5701-negative
::* Preferred regimen (2): [[Dolutegravir]] 50 mg PO qd {{and}} [[Tenofovir]] 300 mg-[[Emtricitabine]] 200 mg PO qd
::* Preferred regimen (3): [[Elvitegravir]] 150 mg-[[Cobicistat]] 150 mg-[[Tenofovir]] 300 mg-[[Emtricitabine]] 200 mg PO qd in patients with estimated CrCl ≥ 70 mL/min/1.73
::* Preferred regimen (4): [[Raltegravir]] 400 mg PO bid {{and}} [[Tenofovir]] 300 mg-[[Emtricitabine]] 200 mg PO qd 
::* Alternative regimen (1): [[Efavirenz]] 600 mg PO qd {{or}} [[Tenofovir]] 300 mg-[[Emtricitabine]] 200 mg PO qd
::* Alternative regimen (2): [[Rilpivirine]] 25 mg PO qd {{and}} ([[Tenofovir]] 300 mg PO qd {{or}} [[Emtricitabine]] 200 mg PO qd) for patients with CD4 count >200 cells/microL
::* Alternative regimen (3): [[Raltegravir]] 400 mg PO bid  {{and}} ([[Abacavir]] 600 mg PO qd {{or}} [[Lamivudine]] 300 mg PO qd) in patients who are HLA-B*5701-negative

:* 1.2. '''Protease inhibitor-based regimen'''
::* Preferred regimen: [[Darunavir]] 800 mg-[[Ritonavir]] 100 mg PO qd {{and}} [[Tenofovir]] 300 mg-[[Emtricitabine]] 200 mg PO qd
::* Alternative regimen (1): [[Atazanavir]] 300 mg-[[Cobicistat]] 150 mg PO qd {{and}} [[Tenofovir]] disoproxil fumarate 300 mg-[[Emtricitabine]] 200 mg PO qd only for patients with pre-treatment estimated CrCl ≥70 mL/min
::* Alternative regimen (2): [[Atazanavir]] 300 mg-[[Ritonavir]] 100 mg PO qd {{and}} [[Tenofovir]] 300 mg-[[Emtricitabine]] 200 mg PO qd
::* Alternative regimen (3): ([[Darunavir]] 800 mg-[[Cobicistat]] 150 mg PO qd {{or}} [[Darunavir]] 800 mg-[[Ritonavir]] 100 mg PO qd) {{and}} [[Abacavir]] 600 mg-[[Lamivudine]] 300 mg PO qd only for patients who are HLA-B*5701 negative
::* Alternative regimen (4): [[Darunavir]] 800 mg-[[Cobicistat]] 150 mg PO qd {{and}} [[Tenofovir]] disoproxil fumarate 300 mg-[[Emtricitabine]] 200 mg PO qd only for patients with pre-treatment estimated CrCl ≥70 mL/min
::* Alternative regimen (5): [[Atazanavir]] 300 mg-[[Ritonavir]] 100 mg PO qd {{and}} [[Abacavir]] 600 mg-[[Lamivudine]] 300 mg PO qd in patients who are HLA-B*5701-negative and with pre-treatment HIV RNA <100,000 copies/mL
::* Alternative regimen (6): [[Lopinavir]] 400 mg-[[Ritonavir]] 100 mg PO qd or bid {{and}} [[Abacavir]] 600 mg-[[Lamivudine]] 300 mg PO qd only for patients who are HLA-B*5701 negative
::* Alternative regimen (7): [[Lopinavir]] 400 mg-[[Ritonavir]] 100 mg PO qd or bid {{and}} [[Tenofovir]] disoproxil fumarate 300 mg-[[Emtricitabine]] 200 mg PO qd

:* 1.3. '''A non-nucleoside reverse transcriptase inhibitor (NNRTI) based regimen'''
::* Alternative regimen (1): [[Efavirenz]] 600 mg-[[Tenofovir]] 300 mg-[[Emtricitabine]] 200 mg PO qd
::* Alternative regimen (2): [[Rilpivirine]] 25 mg-[[Tenofovir]] 300 mg-[[Emtricitabine]] 200 mg PO qd

:* 1.4. '''Other regimen options'''
::* 1.4.1. '''A non-nucleoside reverse transcriptase inhibitor (NNRTI) based regimen'''
:::* Preferred regimen (1):  [[Efavirenz]] 600 mg PO qd {{and}} [[Abacavir]] 600 mg-[[Lamivudine]] 300 mg PO qd only for patients who are HLA-B*5701 negative and with pre-treatment HIV RNA <100,000 copies/mL.
::* 1.4.2. '''Other regimens when tenofovir or abacavir cannot be used'''
:::* Preferred regimen (1): [[Darunavir]] 800 mg-[[Ritonavir]] 100 mg PO qd {{and}} [[Raltegravir]] 400 mg PO qd only for patients with pre-treatment HIV RNA <100,000 copies/mL and CD4 cell count >200 cells/mm3. 
:::* Preferred regimen (2): [[Lopinavir]] 400 mg-[[Ritonavir]] 100 mg PO bid {{and}} [[Lamivudine]] 300 mg PO bid

:* 1.5. '''Pediatric doses<ref name=AIDSinfoNIH pediatric doses>{{cite web | title = AIDSinfoNIH pediatric doses | url =https://aidsinfo.nih.gov/contentfiles/lvguidelines/PediatricGuidelines.pdf }}</ref>'''
::* [[Abacavir]] 300 mg PO bid
::* [[Lamivudine]] 4 mg/kg/dose PO bid; maximum 150 mg PO bid
::* [[Stavudine]] 1 mg/kg/dose PO bid
::* [[Tenofovir]] 8 mg/kg/dose PO bid
::* [[Zidovudine]] 180-240 mg/m<sup>2</sup>/dose PO bid or 160 mg/m<sup>2</sup>/dose PO tid (range 90 mg/m<sup>2</sup>/dose-180 mg/m<sup>2</sup>/dose)
::* [[Lopinavir]] 400 mg PO bid
::* [[Nelfinavir]] 50 mg/kg/dose PO bid
::* [[Raltegravir]] 300 mg PO bid
::* [[Didanosine]] 
:::* 20 to < 25 kg: 200 mg PO qd
:::* 25 to < 60 kg: 250 mg PO qd 
:::* ≥60 kg: 400 mg PO qd
::* [[Efavirenz]] 
:::* 10 to < 15 kg: 200 mg PO qd
:::* 15 to <20 kg: 250 mg PO qd
:::* 20 to < 25 kg: 300 mg PO qd
:::* 25 to < 32.5 kg: 350 mg PO qd
:::* 32.5 to <40 kg: 400 mg PO qd
:::* ≥ 40 kg: 600 mg PO qd
::* [[Nevirapine]] maximum 200 mg per dose
:::* Between 1 day and 8 years: 200 mg/m<sup>2</sup>/dose PO qd for 14 days, then 200 mg/m<sup>2</sup>/dose PO bid
:::* 8 years and above: 120-150 mg/m<sup>2</sup>/dose PO qd for 14 days, then 120-150 mg/m<sup>2</sup>/dose PO bid 
::* Note (1): Anti retroviral therapy for treatment naive patients is a life long therapy.
::* Note (2): [[Tenofovir]] disoproxil fumarate should be avoided in patients with a creatinine clearance <50 mL/min.
::* Note (3): [[Rilpivirine]] should be used in patients with a CD4 cell count >200 copies/mL and should not be used with proton pump inhibitors.
::* Note (4): [[Efavirenz]] should not be used in pregnant women.
  
* 2. '''Pre-exposure prophylaxis (PrEP)<ref name=CDC Pre-Exposure Prophylaxis>{{cite web | title = CDC Pre-Exposure Prophylaxis | url =http://www.cdc.gov/hiv/pdf/PrEP_fact_sheet_final.pdf }}</ref>'''
:* Preferred regimen: [[Tenofovir]] disoproxil fumarate 300 mg-[[Emtricitabine]] 200 mg PO qd for ≤90-days
:* Note (1): People with high risk behavior such as men who have sex with men, intravenous drug abusers, HIV-positive sexual partner, recent bacterial STI, high number of sex partners, history of inconsistent or no condom use, commercial sex work, people in high-prevalence area or network are advised to take pre-exposure prophylaxis of drugs.
:* Note (2): Follow-up visits at least every 3 months to provide the following: HIV test, medication adherence counseling, behavioral risk reduction support, side effect assessment, STI symptom assessment, pregnancy testing.
:* Note (3): At 3 months and every 6 months thereafter, assess renal function.
:* Note (4): Every 6 months, test for bacterial STIs.

* 3. '''Post- exposure prophylaxis<ref name=WHO post exposure prophylaxis>{{cite web | title = WHO postexposureprophylaxis | url =http://www.who.int/hiv/topics/prophylaxis/en/ }}</ref>'''
:* Preferred regimen: [[Raltegravir]] 400 mg PO bid {{and}} [[Tenofovir]] disoproxil fumarate 300 mg-[[Emtricitabine]] 200 mg PO qd
:* Preferred basic regimen for low-risk exposures (Eg: mucus membrane):
:** [[Zidovudine]] 100 mg PO qd {{and}} [[Lamivudine]] 300 mg PO qd
:** [[Zidovudine]] 100 mg PO qd {{and}} [[Emtricitabine]] 200 mg PO qd
:** [[Tenofovir]] 300 mg PO qd {{and}} [[Lamivudine]] 300 mg PO qd
:** [[Tenofovir]] 300 mg PO qd {{and}} [[Emtricitabine]] 200 mg PO qd
:* Preferred expanded regimen for high-risk exposure (Eg: percutaneous needle stick)
:** [[Zidovudine]] 100 mg PO qd {{and}} [[Lamivudine]] 300 mg PO qd {{and}} [[Lopinavir]] 400 mg-[[Ritonavir]] 100 mg PO qd
:** [[Zidovudine]] 100 mg PO qd {{and}} [[Emtricitabine]] 200 mg PO qd {{and}} [[Lopinavir]] 400 mg-[[Ritonavir]] 100 mg PO qd
:** [[Tenofovir]] 300 mg PO qd {{and}} [[Lamivudine]] 300 mg PO qd {{and}} [[Lopinavir]] 400 mg-[[Ritonavir]] 100 mg PO qd
:** [[Tenofovir]] 300 mg PO qd {{and}} [[Emtricitabine]] 200 mg PO qd{{and}} [[Lopinavir]] 400 mg-[[Ritonavir]] 100 mg PO qd
:* Note: Ideally therapy should be started within hours of exposure and continued for 28 days. 

* 4. '''Perinatal antiretroviral regimen<ref name=AIDSinfoNIH Intrapartum car>{{cite web | title = AIDSinfoNIH intrapartum care | url =https://aidsinfo.nih.gov/guidelines/html/3/perinatal-guidelines/180/intrapartum-antiretroviral-therapy-prophylaxis }}</ref>''' 
:* 4.1. '''Antepartum'''
::* 4.1.1. '''Protease inhibitor-based regimen'''
:::* Preferred regimen: ([[Tenofovir]] 300 mg-[[Emtricitabine]] 200 mg PO qd (fixed dose combination) {{or}} [[Tenofovir]] 300 mg-[[Lamivudine]] 300 mg PO qd {{or}} [[Abacavir]] 600 mg-[[Lamivudine]] 300 mg PO qd {{or}} [[Zidovudine]] 100 mg-[[Lamivudine]] 300 mg PO qd) {{and}} ([[Atazanavir]] 300 mg-[[Ritonavir]] 100 mg PO qd {{or}} [[Lopinavir]] 400 mg-[[Ritonavir]] 100 mg PO qd)
::* 4.1.2. '''A non-nucleoside reverse transcriptase inhibitor (NNRTI) based regimen:'''
:::* Preferred regimen (1): [[Efavirenz]] 600 mg-[[Tenofovir]] 300 mg-[[Emtricitabine]] 200 mg (fixed dose combination) PO qd 
:::* Preferred regimen (2): [[Efavirenz]] 600 mg-[[Tenofovir]] 300 mg-[[Lamivudine]] 300 mg PO qd
:::* Alternative regimen: ([[Abacavir]] 600 mg-[[Lamivudine]] 300 mg PO qd {{or}} [[Zidovudine]] 100 mg-[[Lamivudine]] 300 mg PO qd) {{and}} [[Efavirenz]] 600 mg PO qd

:* 4.2. '''Intrapartum'''
::* Note (1): HIV RNA <1000 copies/mL and good adherance-Continue the regimen during delivery or cessarean section.
::* Note (2): HIV RNA >1000 copies/mL near delivery, possible poor adherence, or unknown HIV RNA levels- Intravenous [[Zidovudine]] 2 mg/kg IV over 1 hr should be given three hours before cesarean section or delivery and then 1 mg/kg/hr IV continuous infusion until umbilical cord clamping.

:* 4.3. '''Postpartum'''
::* Note: Initiate anti retroviral therapy (ART) and continue after delivery and cessation of breastfeeding.

* 5. '''Infant antiretroviral prophylaxis for prevention of mother-to-child transmission of HIV<ref name=AIDSinfoNIH postpartum care>{{cite web | title = AIDSinfoNIH postpartumcare | url =https://aidsinfo.nih.gov/contentfiles/lvguidelines/PerinatalGL.pdf }}</ref>''' 
:* 5.1 '''Prophylaxis for HIV-exposed infants of women who received antepartum antiretroviral prophylaxis'''
::* Preferred regimen: [[Zidovudine]] (ZDV) 100 mg PO given at birth and continued till six weeks
::* Note (1): Dose based on gestational age at birth and weight, initiated as soon after birth as possible and preferably within 6 to 12 hours of delivery.
::* Note (2): ≥35 weeks gestation at birth: 4 mg/kg/dose orally (or, if unable to tolerate oral agents, 3 mg/kg/dose IV) every 12 hours.
::* Note (3): ≥30 to <35 weeks gestation at birth: 2 mg/kg/dose orally (or 1.5 mg/kg/dose IV) every 12 hours, advanced to 3 mg/kg/dose orally (or 2.3 mg/kg/dose IV) every 12 hours at age 15 days.
::* Note (4): <30 weeks gestation at birth: 2 mg/kg/dose orally (or 1.5 mg/kg/dose IV) every 12 hours, advanced to 3 mg/kg/dose orally (or 2.3 mg/kg/dose IV) every 12 hours after age four weeks.
:* 5.2. '''Prophylaxis for HIV-exposed infants of women who received no antepartum antiretroviral prophylaxis'''
::: [[Nevirapine]] 
:::* Dose based on birth weight, initiated as soon after birth as possible.
:::* Birth weight 1.5 to 2 kg: 8 mg/dose orally.
:::* Birth weight >2 kg: 12 mg/dose orally.
::: {{and}} 
::: [[Zidovudine]] (ZDV) 
:::* Dose based on gestational age at birth and weight, initiated as soon after birth as possible and preferably within 6 to 12 hours of delivery.
::::* ≥35 weeks gestation at birth: 4 mg/kg/dose orally (or, if unable to tolerate oral agents, 3 mg/kg/dose IV) every 12 hours.
::::* ≥30 to <35 weeks gestation at birth: 2 mg/kg/dose orally (or 1.5 mg/kg/dose IV) every 12 hours, advanced to 3 mg/kg/dose orally (or 2.3 mg/kg/dose IV) every 12 hours at age 15 days.
::::* <30 weeks gestation at birth: 2 mg/kg/dose orally (or 1.5 mg/kg/dose IV) every 12 hours, advanced to 3 mg/kg/dose orally (or 2.3 mg/kg/dose IV) every 12 hours after age four weeks.
:::* Note (1): Three doses in the first week of life.
:::* Note (2): First dose within 48 hours of birth (birth to 48 hrs).
:::* Note (3): Second dose 48 hours after first.
:::* Note (4): Third dose 96 hours after second.

:* 6. '''Treatment and prevention of opportunistic infections<ref name=AIDSinfoNIH opportunistic infectons>{{cite web | title = AIDSinfoNIH opportunistic infections | url =https://aidsinfo.nih.gov/contentfiles/lvguidelines/adult_oi.pdf }}</ref>'''
::* 6.1. '''Pneumocystis pneumonia (PCP)'''
:::* 6.1.1. '''Prevention'''
::::* Indication
:::::* CD4 count <200 cells/mm3 
:::::* Oropharyngeal candidiasis 
:::::* CD4 <14% 
:::::* History of AIDS-defining illness
:::::* CD4 count >200 but <250 cells/mm3 if monitoring CD4 cell count every 3 months is not possible.
::::* Preferred regimen: [[Trimethoprim/sulfamethoxazole]] 160 mg/800 mg PO qd or 80 mg/400 mg PO qd
::::* Alternative regimen (1): [[Trimethoprim/sulfamethoxazole]] 160 mg/800 mg PO three times weekly 
::::* Alternative regimen (2): [[Dapsone]] 100 mg PO qd or 50 mg PO bid
::::* Alternative regimen (3): [[Dapsone]] 50 mg PO qd {{and}} ([[Pyrimethamine]] 50 mg-[[Leucovorin]] 25 mg) PO weekly 
::::* Alternative regimen (4): [[Dapsone]] 200 mg PO qd {{and}} ([[Pyrimethamine]] 75 mg-[[Leucovorin]] 25 mg) PO weekly 
::::* Alternative regimen (5): Aerosolized [[Pentamidine]] 300 mg via [[Respigard]] nebulizer every month 
::::* Alternative regimen (6): [[Atovaquone]] 1500 mg PO qd
::::* Alternative regimen (7): [[Atovaquone]] 1500 mg {{and}} ([[Pyrimethamine]] 25 mg {{and}} [[Leucovorin]] 10 mg) PO qd
:::* 6.1.2. '''Treatment'''
::::* 6.1.2.1. '''For Moderate-to-Severe PCP''''
:::::* Preferred regimen:  [[Trimethoprim]] 15–20 mg {{and}} [[Sulfamethoxazole]] 75–100 mg/kg/day IV given q6h or q8h, may switch to PO after clinical improvement
:::::* Alternative regimen (1): [[Pentamidine]] 4 mg/kg IV daily infused over ≥60 minutes
:::::* Note: Reduce dose to 3 mg/kg IV daily if toxic.
:::::* Alternative regimen (2): [[Primaquine]] 30 mg (base) PO qd {{and}} ([[Clindamycin]] 600 mg q6h IV {{or}} 900 mg IV q8h {{or}} [[Clindamycin]] 450 mg PO qid or 600 mg PO tid)
::::* 6.1.2.2. '''For Mild-to-Moderate PCP'''
:::::* Preferred regimen: [[Trimethoprim]] 15–20 mg {{and}} [[Sulfamethoxazole]] 75–100 mg/kg/day PO in TID {{or}} [[Trimethoprim/sulfamethoxazole]] 160 mg/800 mg 2 tablets PO tid
:::::* Alternative regimen (1): [[Dapsone]] 100 mg PO qd {{and}} TMP 5 mg/kg PO tid
:::::* Alternative regimen (2): [[Primaquine]] 30 mg (base) PO qd {{and}} ([[Clindamycin]] 450 mg PO qid or 600 mg PO tid {{or}} [[Atovaquone]] 750 mg PO bid with food)
::::* 6.1.3. '''Secondary prophylaxis, after completion of PCP treatment'''
:::::* Preferred regimen (1): [[Trimethoprim/Sulfamethoxazole]] 160 mg/800 mg  PO qd {{or}} [[Trimethoprim/Sulfamethoxazole]] 80 mg/400 mg PO qd
:::::* Alternative regimen (1): [[Trimethoprim/sulfamethoxazole]] 160 mg/800 mg PO three times weekly
:::::* Alternative regimen (2): [[Dapsone]] 100 mg PO qd
:::::* Alternative regimen (3): [[Dapsone]] 50 mg PO qd {{and}} [[Pyrimethamine]] 50 mg PO {{and}} [[Leucovorin]] 25 mg PO weekly
:::::* Alternative regimen (4): [[Dapsone]] 200 mg PO {{and}} [[Pyrimethamine]] 75 mg PO {{and}} [[Leucovorin]] 25 mg PO weekly
:::::* Alternative regimen (5): [[Dapsone]] 100 mg PO qd
:::::* Alternative regimen (6): [[Dapsone]] 50 mg PO qd {{and}} [[Pyrimethamine]] 50 mg PO {{and}} [[Leucovorin]] 25 mg PO weekly
:::::* Alternative regimen (7): [[Dapsone]] 200 mg PO {{and}} [[Pyrimethamine]] 75 mg PO {{and}} [[Leucovorin]] 25 mg PO weekly
:::::* Alternative regimen (8): Aerosolized [[Pentamidine]] 300 mg monthly via [[Respirgard]] nebulizer
:::::* Alternative regimen (9): [[Atovaquone]] 1500 mg PO qd
:::::* Alternative regimen (10): [[Atovaquone]] 1500 mg PO {{and}} [[Pyrimethamine]] 25 mg PO {{and}} [[Leucovorin]] 10 mg PO qd
::::* 6.1.4. '''Adjunctive corticosteroids'''
:::::* Indications- PaO2 <70 mmHg at room air {{or}} Alveolar-arterial O2 gradient >35 mmHg.
:::::* Preferred regimen: 
::::::* Days 1–5: 40 mg PO bid
::::::* Days 6–10: 40 mg PO qd 
::::::* Days 11–21: 20 mg PO qd
:::::* Note (1): [[Trimethoprim/sulfamethoxazole]] should be permanently discontinued in patients with possible or definite stevens johnson syndrome or toxic epidermal necrosis.
:::::* Note (2): Whenever possible, patients should be tested for G6PD before use of [[Dapsone]] or [[Primaquine]]. Alternative regimen should be used in patients found to have G6PD deficiency.

::* 6.2. '''Toxoplasma gondii encephalitis'''
:::* 6.2.1. '''Prevention'''
::::* 6.2.1.1. '''Indication'''
:::::* Toxoplasma IgG-positive patients with CD4 count <100 cells/µL.
:::::* Seronegative patients receiving PCP prophylaxis not active against toxoplasmosis should have toxoplasma serology retested if CD4 count decline to <100 cellsµL. 
:::::* Prophylaxis should be initiated if seroconversion occurred.
::::* Preferred regimen: [[Trimethoprim/sulfamethoxazole]] 160 mg/800 mg PO qd
::::* Alternative regimen (1): [[Trimethoprim/sulfamethoxazole]] 160 mg/800 mg PO three times weekly
::::* Alternative regimen (2): [[Trimethoprim/sulfamethoxazole]] 80 mg/400 mg PO qd
::::* Alternative regimen (3): [[Dapsone]] 50 mg PO qd {{and}} [[Pyrimethamine]] 50 mg PO weekly {{and}} [[Leucovorin]] 25 mg PO weekly
::::* Alternative regimen (4): [[Dapsone]] 200 mg PO weekly {{and}} [[Pyrimethamine]] 75 mg PO weekly {{and}} [[Leucovorin]] 25 mg PO weekly
::::* Alternative regimen (5): [[Atovaquone]] 1500 mg PO qd
::::* Alternative regimen (6): [[Atovaquone]] 1500 mg PO qd {{and}} [[Pyrimethamine]] 25 mg PO qd {{and}} [[Leucovorin]] 10 mg PO qd
:::* 6.2.2. '''Treatment'''
::::* 6.2.2.1. '''Treatment of acute infection'''
:::::* Preferred regimen: [[Pyrimethamine]] 200 mg PO single dose, followed by weight-based therapy:
::::::* If <60 kg, [[Pyrimethamine]] 50 mg PO qd {{and}} [[Sulfadiazine]] 1000 mg PO qid {{and}} [[Leucovorin]] 10–25 mg PO qd
::::::* If ≥60 kg, [[Pyrimethamine]] 75 mg PO qd {{and}} [[Sulfadiazine]] 1500 mg PO qid {{and}} [[Leucovorin]] 10–25 mg PO qd
::::::* Note: At least 6 weeks; longer duration if clinical or radiologic disease is extensive or response is incomplete at 6 weeks.
:::::* Alternative regimen (1): [[Pyrimethamine]] 50 mg  PO qd{{and}} [[Leucovorin]] 10–25 mg PO qd {{and}} [[Clindamycin]] 600 mg IV or PO q6h
:::::* Alternative regimen (2): [[Trimethoprim]] 5 mg/kg-[[Sulfamethoxazole]] 25 mg/kg  IV or PO bid
:::::* Alternative regimen (3): [[Atovaquone]] 1500 mg PO bid with food {{and}} [[Pyrimethamine]] 50 mg PO qd {{and}} [[Leucovorin]] 10–25 mg PO qd
:::::* Alternative regimen (4): [[Atovaquone]] 1500 mg PO bid with food {{and}} [[Sulfadiazine]] 1000–1500 mg PO qid (weight-based dosing, as in preferred therapy)
:::::* Alternative regimen (5): [[Atovaquone]] 1500 mg PO bid with food
:::::* Alternative regimen (6): [[Pyrimethamine]] 50 mg-[[Leucovorin]] 10–25 mg PO qd {{and}} [[Azithromycin]] 900–1200 mg PO qd
::::* 6.2.2.2. '''Chronic maintenance therapy'''
:::::* Preferred regimen: [[Pyrimethamine]] 25–50 mg PO qd {{and}} [[Sulfadiazine]] 2000–4000 mg PO qd (in 2–4 divided doses) {{and}} [[Leucovorin]] 10–25 mg PO qd
:::::* Alternative regimen (1): [[Clindamycin]] 600 mg PO tid {{and}} [[Pyrimethamine]] 25–50 mg-[[Leucovorin]] 10–25 mg PO qd
:::::* Alternative regimen (2): [[Trimethoprim/sulfamethoxazole]] 160 mg/800 mg bid
:::::* Alternative regimen (3): [[Atovaquone]] 750–1500 mg PO bid {{and}} [[Pyrimethamine]] 25 mg-[[Leucovorin]] 10 mg PO qd
:::::* Alternative regimen (4): [[Atovaquone]] 750–1500 mg PO bid {{and}} [[Sulfadiazine]] 2000–4000 mg PO qd in 2–4 divided doses
:::::* Alternative regimen (5): [[Atovaquone]] 750–1500 mg PO bid with food

::* 6.3. '''Mycobacterium tuberculosis infection'''
:::* 6.3.1. '''Prevention'''
::::* 6.3.1.1. '''Indication'''
:::::* Positive screening test for latent tuberculosis infection, with no evidence of active tuberculosis, and no prior treatment for active tuberculosis or latent tuberculosis infection.
:::::* Close contact with a person with infectious tuberculosis, with no evidence of active tuberculosis, regardless of screening test results.
:::::* Preferred regimen: ([[Isoniazid]] 300 mg PO qd {{and}} [[Pyridoxine]] 25 mg PO qd for 9 months) {{or}} ([[Isoniazid]] 900 mg PO two times a week (by DOT) {{and}} [[Pyridoxine]] 25 mg PO qd for 9 months)
:::::* Alternative regimen (1): [[Rifampin]] 600 mg PO qd for 4 months
:::::* Alternative regimen (2): [[Rifabutin]] (dose adjusted based on concomitant ART) PO qd for 4 months
:::* 6.3.2. '''Treatment'''
:::::* Preferred regimen
::::::* Initiation phase: [[Isoniazid]] 300 mg PO qd {{and}} ([[Rifampin]] 600 mg PO qd {{or}} [[Rifabutin]] 300 mg PO qd) {{and}} [[Pyrazinamide ]] (upto 2000 mg) PO qd {{and}} [[Ethambutol]] (upto 1600 mg) PO qd for initial phase for 2 months.
:::::* Continuation phase: [[Isoniazid]] 300 mg PO qd {{and}} ([[Rifampin]] 600 mg PO qd {{or}} [[Rifabutin]] 300 mg PO qd) (5–7 times/week) or three times a week.
:::::* Duration of therapy:
::::::* Pulmonary tuberculosis: 6 months 
::::::* Pulmonary tuberculosis and culture positive after 2 months of tuberculosis treatment: 9 months
::::::* Extra-pulmonary tuberculosis w/CNS infection: 9–12 months
::::::* Extra-pulmonary tuberculosis with bone or joint involvement: 6 to 9 months
::::::* Extra-pulmonary tuberculosis in other sites: 6 months
::::::* Total duration of therapy should be based on number of doses received, not on calendar time
::::* 6.3.1.3. '''Treatment for drug-resistant tuberculosis'''
:::::* Resistant to [[Isoniazid]]:
::::::* Preferred regimen (1): ([[Rifampin]] 600 mg PO qd {{or}} [[Rifabutin]] 300mg PO qd) {{and}} [[Ethambutol]] (upto 1600 mg) PO qd {{and}} [[Pyrazinamide]] (upto 2000 mg) PO qd {{and}} ([[Moxifloxacin]] 400 mg PO or IV qd {{or}} [[Levofloxacin]] 500-1000 mg PO or IV qd) for 2 months; followed by [[Rifampin]] 600 mg PO qd for 7 months.
::::::* Preferred regimen (2): [[Rifabutin]] 300mg PO qd {{and}} [[Ethambutol]] (upto 1600 mg) PO qd {{and}} ([[Moxifloxacin]] 400 mg PO or IV qd{{or}} [[Levofloxacin]] 500-1000 mg PO or IV qd) for 7 months

::* 6.4. '''Disseminated mycobacterium avium complex (MAC) disease'''
:::* 6.4.1. '''Prevention'''
::::* 6.4.1.1. '''Indication-CD4 count <50 cells/µL—after ruling out active disseminated MAC disease based on clinical assessment'''
:::::* Preferred regimen (1): [[Azithromycin]] 1200 mg PO once weekly 
:::::* Preferred regimen (2): [[Clarithromycin]] 500 mg PO bid
:::::* Preferred regimen (3): [[Azithromycin]] 600 mg PO twice weekly.
:::* 6.4.2. '''Treatment'''
::::* Preferred regimen:  [[Clarithromycin]] 500 mg PO bid {{and}} [[Ethambutol]] 15 mg/kg PO qd {{or}} [[Azithromycin]] 500–600 mg PO qd for at least 12 months of therapy
::::* Note (1): Treatment can be discontinued if no signs and symptoms of MAC disease and sustained (>6 months) CD4 count >100 cells/µL in response to anti retroviral therapy.
::::* Note (2): Addition of a third or fourth drug should be considered for patients with advanced immunosuppression (CD4 counts <50 cells/µL), high mycobacterial loads (>2 log CFU/mL of blood), or in the absence of effective anti retroviral therapy which include [[Amikacin]] 10–15 mg/kg IV qd, [[Streptomycin]] 1 g IV or IM qd, [[Moxifloxacin]] 400 mg PO qd, [[Levofloxacin]] 500 mg PO qd.

::* 6.5. '''Streptococcus pneumoniae infection'''
:::* 6.5.1. '''Prevention'''
::::* 6.5.1.1. '''Indication'''
:::::* 6.5.1.1.1. '''For individuals who have not received any pneumococcal vaccine, regardless of CD4 count'''
::::::* Preferred regimen: PCV13 0.5ml IM single dose
::::::* Alternative regimen: PPV23 0.5 mL IM or SQ single dose
::::::* Note (1): If CD4 count ≥200 cells/µL, administer PPV23 0.5 mL IM or SQ at least 8 weeks after the PCV13 vaccine.
::::::* Note (2): If CD4 count <200 cells/µL, PPV23 can be offered at least 8 weeks after receiving PCV13 or can wait until CD4 count increased to ≥200 cells/µL.
::::* 6.5.1.1.2. '''For individuals who have previously received PPV23'''
:::::* Note: One dose of PCV13 should be given atleast 1 year after the last receipt of PPV23
::::* 6.5.1.1.3. '''Re-vaccination'''
:::::* If age 19–64 years and ≥5 years since the first PPV23 dose  PPV23 0.5 mL IM or SQ
:::::*  If age ≥65 years, and if ≥5 years since the previous PPV23 dose PPV23 0.5 mL IM or SQ
:::::* If age ≥65 years, and if ≥5 years since the previous PPV23 dose PPV23 0.5 mL IM or SQ

::* 6.6. '''Influenza A and B virus infection'''

:::* 6.6.1. '''Prevention'''
::::* 6.6.1.1. '''Indication'''
:::::* All HIV-infected patients
:::::* Note (1): Inactivated influenza vaccine annually (per recommendation for the season).
:::::* Note (2): Live-attenuated influenza vaccine is contraindicated in HIV-infected patients.

::* 6.7. '''Syphilis'''
:::* 6.7.1. '''Prevention'''
::::* 6.7.1.1. '''Indication'''
:::::* For individuals exposed to a sex partner with a diagnosis of primary, secondary, or early latent syphilis within past 90 days.
:::::* For individuals exposed to a sex partner >90 days before syphilis diagnosis in the partner, if serologic test results are not available immediately and the opportunity for follow-up is uncertain.
:::::* Preferred regimen: [[Benzathine penicillin]] G 2.4 million units IM single dose
:::::* Alternative regimen (1): [[Doxycycline]] 100 mg PO bid for 14 days
:::::* Alternative regimen (2): [[Ceftriaxone]] 1 g IM or IV q24h for 8– 10 days
:::::* Alternative regimen (3): [[Azithromycin]] 2 g PO single dose
:::::* Note: [[Azithromycin]] is not recommended for MSM or pregnant women.
:::* 6.7.2. '''Treatment'''
::::* 6.7.2.1. '''Early stage (primary, secondary, and early-latent syphilis)'''
:::::* Preferred regimen:  [[Benzathine penicillin]] G 2.4 million units IM single dose 
:::::* Alternative regimen (1): [[Doxycycline]] 100 mg PO bid for 14 days 
:::::* Alternative regimen (2): [[Ceftriaxone]] 1 g IM or IV q24h for 10–14 days 
:::::* Alternative regimen (3): [[Azithromycin]] 2 g PO single dose
::::* 6.7.2.2. '''Late-stage (tertiary–cardiovascular or gummatous disease)'''
:::::* Preferred regimen: [[Benzathine penicillin]] G 2.4 million units IM weekly for 3 doses
:::::* Alternative regimen: [[Doxycycline]] 100 mg PO bid for 28 days
::::* 6.7.2.3. '''Neurosyphilis (including otic or ocular disease)'''
:::::* Preferred regimen: Aqueous crystalline [[Penicillin]] G 18– 24 million units per day (administered as 3–4 million units IV q4h or by continuous IV infusion) for 10–14 days with or without [[Benzathine penicillin G]] 2.4 million units IM weekly for 3 doses after completion of IV therapy
:::::* Alternative regimen: [[Procaine penicillin]] 2.4 million units IM q24h {{and}} [[Probenecid]] 500 mg PO qid for 10–14 days  with or without [[Benzathine penicillin]] G 2.4 million units IM weekly for 3 doses after completion
:::::* Note (1): The Jarisch-Herxheimer reaction is an acute febrile reaction accompanied by headache and myalgia that can occur within the first 24 hours after therapy for syphilis.
:::::* Note (2): This reaction occurs most frequently in patients with early syphilis, high nontreponemal titers and prior penicillin treatment.

::* 6.8. '''Histoplasma capsulatum infection'''
:::* 6.8.1. '''Prevention'''
::::* 6.8.1.1. '''Indication'''
:::::* CD4 count ≤150 cells/µL and at high risk because of occupational exposure or live in a community with a hyperendemic rate of histoplasmosis (>10 cases/100 patient-years).
:::::* Preferred regimen: [[Itraconazole]] 200 mg PO qd
:::* 6.8.2. '''Treatment'''
::::* 6.8.2.1. '''Moderately severe to severe disseminated disease'''
:::::* Induction therapy (for at least 2 weeks or until clinically improved)
::::::* Preferred regimen: Liposomal [[Amphotericin B]] 3 mg/kg IV q24h
:::::* Maintenance therapy: 
::::::* Preferred regimen: [[Itraconazole]] 200 mg PO tid for 3 days, then 200 mg PO bid
::::* 6.8.2.2. '''Less severe disseminated disease'''
:::::* Induction therapy: 
::::::* Preferred regimen: Liposomal [[Amphotericin B]] 3 mg/kg IV q24h
::::::* Alternative regimen: [[Amphotericin B]] lipid complex 3 mg/kg IV q24h {{or}} [[Amphotericin B]] cholesteryl sulfate complete 3 mg/kg IV q24h
::::::* Note: Induction therapy should be for at least 2 weeks or until clinically improved.
:::::* Maintenance therapy: 
::::::* Preferred regimen: [[Itraconazole]] 200 mg PO tid for 3 days and then [[Itraconazole]] 200 mg PO bid for 12 months
::::::* Alternative regimen (1): [[Voriconazole]] 400 mg PO bid for 1 day, then 200 mg bid 
::::::* Alternative regimen (2): [[Posaconazole]] 400 mg PO bid 
::::::* Alternative regimen (3): [[Fluconazole]] 800 mg PO qd
::::* 6.8.2.3. '''Meningitis'''
:::::* Induction therapy: 
::::::* Preferred regimen: Liposomal [[amphotericin B]] 5 mg/kg/day for 4–6 weeks
:::::* Maintenance therapy: 
::::::* Preferred regimen: [[Itraconazole]] 200 mg PO bid to tid for ≥1 year 
:::::* Note: Treatment continued until resolution of abnormal CSF findings.
:::::* Long-Term Suppression Therapy
::::::* Preferred regimen: [[Itraconazole]] 200 mg PO qd
::::::* Alternative regimen: [[Fluconazole]] 400 mg PO qd
::::::* Note: Therapeutic drug monitoring and dosage adjustment may be necessary to ensure [[Triazole]] antifungal and ARV efficacy and reduce concentration-related toxicities.

::* 6.9. '''Coccidioidomycosis'''
:::* 6.9.1. '''Prevention'''
:::* 6.9.1.1. '''Indication'''
::::* A new positive IgM or IgG serologic test in patients who live in a disease-endemic area and with CD4 count <250 cells/µL.
::::* Preferred regimen: [[Fluconazole]] 400 mg PO qd
:::* 6.9.2. '''Treatment'''
::::* 6.9.2.1. '''Clinically mild infections (e.g., focal pneumonia)'''
:::::* Preferred regimen: [[Fluconazole]] 400 mg PO qd {{or}} [[Itraconazole]] 200 mg PO bid
:::::* Alternative regimen: [[Posaconazole]] 200 mg PO bid {{or}} [[Voriconazole]] 200 mg PO bid
::::* 6.9.2.2. '''Severe, non-meningeal infection (diffuse pulmonary infection or severely ill patients with extrathoracic, disseminated disease)'''
:::::* Preferred regimen: [[Amphotericin B]] deoxycholate 0.7–1.0 mg/kg IV qd {{or}} Lipid formulation [[Amphotericin B]] 4–6 mg/kg IV qd
:::::* Alternative regimen: [[Fluconazole]] or [[Itraconazole]], with [[Itraconazole]] preferred for bone disease 400 mg per day to [[Amphotericin B]] therapy and continue triazole once [[Amphotericin B]] is stopped.
::::* 6.9.2.3. '''Meningeal infections'''
:::::* Preferred regimen: [[Fluconazole]] 400–800 mg IV or PO qd
:::::* Alternative regimen: [[Itraconazole]] 200 mg PO tid for 3 days, then 200 mg PO bid {{or}} [[Posaconazole]] 200 mg PO bid {{or}} [[Voriconazole]] 200–400 mg PO bid
::::* 6.9.2.4. '''Chronic suppressive therapy'''
:::::* Preferred regimen: [[Fluconazole]] 400 mg PO qd {{or}} [[Itraconazole]] 200 mg PO bid
:::::* Alternative regimen:  [[Posaconazole]] 200 mg PO bid {{or}} [[Voriconazole]] 200 mg PO bid
:::::* Note (1): Therapy should be continued indefinitely in patients with diffuse pulmonary or disseminated diseases because relapse can occur in 25%–33% of HIV-negative patients. It can also occur in HIV-infected patients with CD4 counts >250 cells/µL.
:::::* Note (2): Therapy should be lifelong in patients with meningeal infections because relapse occurs in 80% of HIV-infected patients after discontinuation of triazole therapy.

::* 6.10. '''Herpes simplex virus (HSV) Disease'''
:::* 6.10.1. '''Orolabial lesions (For 5–10 Days)'''
::::* Preferred regimen (1): [[Valacyclovir]] 1 g PO bid
::::* Preferred regimen (2): [[Famciclovir]] 500 mg PO bid
::::* Preferred regimen (3): [[Acyclovir]] 400 mg PO tid
:::* 6.10.2. '''Initial or recurrent genital HSV (For 5–14 Days)'''
::::* Preferred regimen (1): [[Valacyclovir]] 1 g PO bid
::::* Preferred regimen (2): [[Famciclovir]] 500 mg PO bid
::::* Preferred regimen (3): [[Acyclovir]] 400 mg PO tid
:::* 6.10.3. '''Severe mucocutaneous HSV'''
::::* Preferred regimen:  Initial therapy [[Acyclovir]] 5 mg/kg IV q8h.
::::* Note:  After lesions begin to regress, change to PO therapy as above. Continue until lesions are completely healed.
:::* 6.10.4. '''Chronic suppressive therapy'''
::::* Preferred regimen (1): [[Valacyclovir]] 500 mg PO bid
::::* Preferred regimen (2): [[Famciclovir]] 500 mg PO bid
::::* Preferred regimen (3): [[Acyclovir]] 400 mg PO bid
:::* 6.10.4. '''For acyclovir-resistant HSV'''
::::* Preferred therapy: [[Foscarnet]] 80–120 mg/kg/day IV q12h-q8h
::::* Alternative regimen: [[Cidofovir]] IV {{or}} Topical [[Trifluridine]] {{or}} Topical [[Imiquimod]] for 21-28 days
::::* Note: Continue indefinitely regardless of CD4 cell count.

::* 6.11. '''Varicella-zoster virus (VZV) infection'''
:::* 6.11.1. '''Varicella-zoster virus (VZV) infection'''
::::* 6.11.1.2 '''Prevention'''
:::::* 6.11.1.1. '''Pre-exposure prevention''' 
::::::* Indication: Patients with CD4 counts ≥200 cells/µL who have not been vaccinated, have no history of varicella or herpes zoster, or who are seronegative for VZV.
::::::* Preferred regimen: Primary varicella vaccination, 2 doses (0.5 mL SQ each) administered 3 months apart
::::::* Alternative regimen: VZV-susceptible household contacts of susceptible HIV-infected persons should be vaccinated to prevent potential transmission of VZV to their HIV-infected contacts
::::::* Note (1):  Routine VZV serologic testing in HIV-infected adults and adolescents is not recommended.
::::::* Note (2): If vaccination results in disease because of vaccine virus, treatment with [[Acyclovir]] is recommended.
:::::* 6.11.1.2. '''Post-exposure prevention''' 
::::::* Indication: Close contact with a person with chickenpox or herpes zoster; and is susceptible (i.e., no history of vaccination or of either condition, or known to be VZV seronegative).
::::::* Preferred regimen: Varicella-zoster immune globulin (VariZIG™) 125 international units per 10 kg (maximum 625 international units) IM, administered as soon as possible and within 10 days after exposure.
::::::* Alternative regimen (1): [[Acyclovir]] 800 mg PO qd for 5– 7 days
::::::* Alternative regimen (2): [[Valacyclovir]] 1 g PO tid for 5–7 days
::::::* Note (1):  Individuals receiving monthly high-dose IVIG (>400 mg/kg) are likely to be protected if the last dose of IVIG was administered <3 weeks before exposure.
::::::* Note (2): If antiviral therapy is used, varicella vaccines should not be given until at least 72 hours after the last dose of the antiviral drug.
::::* 6.11.1.2. '''Treatment'''
:::::* 6.11.1.2.1 '''Primary varicella infection (chickenpox)'''
::::::* 6.11.1.2.1. '''Uncomplicated cases (For 5–7 Days)'''
:::::::* Preferred regimen (1):  [[Valacyclovir]] 1 g PO tid 
:::::::* Preferred regimen (2): [[Famciclovir]] 500 mg PO tid
::::::* 6.11.1.2.1. '''Severe or complicated Cases'''
:::::::* Preferred regimen: [[Acyclovir]] 10–15 mg/kg IV q8h for 7–10 days.
:::::::* Alternative regimen: [[Acyclovir]] 800 mg PO 5 times/day for 5-7 days.
:::::* 6.11.1.2.2. '''Herpes zoster (Shingles)'''
::::::* 6.11.1.2.2.1. '''Acute localized dermatomal'''
:::::::* Preferred regimen (1): [[Valacyclovir]] 1 g PO tid for 7–10 days; consider longer duration if lesions are slow to resolve
:::::::* Preferred regimen (2): [[Famciclovir]] 500 mg tid for 7–10 days; consider longer duration if lesions are slow to resolve
::::::* 6.11.1.2.2.2. '''Extensive cutaneous lesion or visceral involvement'''
:::::::* Preferred regimen: [[Acyclovir]] 10–15 mg/kg IV q8h until clinical improvement is evident. 
:::::::* Note: Treatment may switch to PO therapy ([[Valacyclovir]], [[Famciclovir]], or [[Acyclovir]]) after clinical improvement (i.e., when no new vesicle formation or improvement of signs and symptoms of visceral VZV), to complete a 10–14 day course.
:::::::* Alternative regimen: [[Acyclovir]] 800 mg PO 5 times/day for 7–10 days; consider longer duration if lesions are slow to resolve.
::::::* 6.11.1.2.2.3. '''Progressive outer retinal necrosis (PORN)'''
:::::::* Preferred regimen: ([[Ganciclovir]] 5 mg/kg with or without [[Foscarnet]] 90 mg/kg) IV q12h {{and}} ([[Ganciclovir]] 2 mg/0.05mL with or without [[Foscarnet]] 1.2 mg/0.05 ml) intravitreal injection biweekly.
::::::* 6.11.1.2.2.4. '''Acute retinal necrosis (ARN)'''
:::::::* Preferred regimen: [[Acyclovir]] 10-15 mg/kg IV q8h {{and}} ([[Ganciclovir]] 2 mg/0.05mL intravitreal injection 1-2 doses biweekly for 10-14 days, followed by [[Valacyclovir]] 1g PO tid for 6 weeks

::* 6.12. '''Cytomegalovirus (CMV) Disease'''
:::* 6.12.1. '''Treatment'''
::::* 6.12.1.1. '''CMV retinitis'''
:::::* Induction therapy
::::::* Preferred regimen (1): [[Ganciclovir]] 2mg {{or}} [[Foscarnet]]  2.4mg intravitreal injections for 1-4 doses over a period of 7-10 days to achieve high intraocular concentration faster
::::::* Preferred regimen (2): [[Valganciclovir]] 900 mg PO bid for 14–21 days
::::::* Alternative regimen (1): [[Ganciclovir]] 5 mg/kg IV q12h for 14–21 days 
::::::* Alternative regimen (2): [[Foscarnet]] 90 mg/kg IV q12h or 60 mg/kg q8h for 14–21 days 
::::::* Alternative regimen (3): [[Cidofovir]] 5 mg/kg/week IV for 2 weeks
::::::* Note: Saline hydration before and after therapy should be given and [[Probenecid]], 2 g PO 3 hours before dose, followed by 1 g PO 2 hours and 8 hours after the dose (total of 4 g) is recommended.
:::::* Chronic maintenance (secondary prophylaxis):
::::::*  Preferred regimen: [[Valganciclovir]] 900 mg PO qd
::::::* Alternative regimen (1): [[Ganciclovir]] 5 mg/kg IV 5–7 times weekly  
::::::* Alternative regimen (2): [[Foscarnet]] 90–120 mg/kg IV once daily
::::::* Alternative regimen (3): [[Cidofovir]] 5 mg/kg/week IV for 2 weeks; saline hydration before and after therapy {{and}} [[Probenecid]], 2 g PO 3 hours before dose, followed by 1 g PO 2 hours and 8 hours after the dose (total of 4 g) 
::::* 6.12.1.2. '''CMV esophagitis or colitis'''
:::::* 6.12.1.2.1. '''Severe condition'''
::::::* Preferred regimen: [[Ganciclovir]] 5 mg/kg IV q12h; may switch to [[Valganciclovir]] 900 mg PO bid once the patient can tolerate oral therapy for 21-42 days or till the symptoms are resolved
::::::* Alternative regimen: [[Foscarnet]] 90 mg/kg IV q12h or 60 mg/kg q8h for 21-42 days
::::::* Note: For patients with treatment-limiting toxicities to [[Ganciclovir]] or with [[Ganciclovir]] resistance, above regimen is recommended.
:::::* 6.12.1.2.2. '''Mild disease and able to tolerate oral therapy'''
::::::* Preferred regimen: [[Valganciclovir]] 900 mg PO bid 21-42 days
::::* 6.12.1.3. '''CMV neurological disease'''
:::::* Preferred regimen: [[Ganciclovir]] 5 mg/kg IV q12h {{and}} ([[Foscarnet]] 90 mg/kg IV q12h or 60 mg/kg IV q8h) to stabilize disease

::* 6.13. '''HHV-8 Diseases (kaposi sarcoma [KS], primary effusion lymphoma [PEL], multicentric castleman’s disease [MCD])'''
:::* 6.13.1. '''Treatment'''
::::* Mild to moderate KS (ACTG Stage T0)
:::::* Note:  Initiate or optimize anti retroviral therapy.
::::* Advanced KS [ACTG Stage T1, Including Disseminated Cutaneous (AI) Or Visceral KS]
:::::* Note: Chemotherapy (per oncology consult) {{and}} anti retroviral therapy. 
::::* Primary effusion lymphoma
:::::* Preferred regimen (1): [[Valganciclovir]] 900 mg PO bid for 3 weeks
:::::* Preferred regimen (2): [[Ganciclovir]] 5 mg/kg IV q12h for 3 weeks
:::::* Preferred regimen (3): [[Valganciclovir]] 900 mg PO bid {{and}} [[Zidovudine]] 600 mg PO qid for 7– 21 days
:::::* Alternative regimen: [[Rituximab]] (375 mg/m<sup>2</sup> given weekly for 4–8 weeks) may be an alternative to or used adjunctively with antiviral therapy
:::::* Note: [[Valganciclovir]] PO {{or}} [[Ganciclovir]] IV can be used as adjunctive therapy

::* 6.14. '''Human papillomavirus (HPV) infection'''
:::* 6.14.1. '''Prevention'''
::::* For females aged 13–26 years
:::::* Preferred regimen (1): HPV quadrivalent vaccine 0.5 mL IM at months 0, 1–2, and 6 {{or}} HPV bivalent vaccine 0.5 mL IM at months 0, 1–2, and 6
::::* Males aged 13–26 years
:::::* Preferred regimen (1): HPV quadrivalent vaccine 0.5 mL IM at months 0, 1–2, and 6
:::* 6.14.2. '''Treatment'''
::::* 6.14.2.1. '''Patient-applied therapy for uncomplicated external warts that can be easily identified by patients'''
:::::* Preferred regimen (1):  [[Podophyllotoxin]] (e.g., podofilox 0.5% solution or 0.5% gel)
:::::* Note: Apply to all lesions bid for 3 consecutive days, followed by 4 days of no therapy, repeat weekly for up to 4 cycles, until lesions are no longer visible)
:::::* Preferred regimen (2):  [[Imiquimod]] 5% cream
:::::* Note: Apply to lesion at bedtime and remove in the morning on 3 nonconsecutive nights weekly for up to 16 weeks, until lesions are no longer visible. Each treatment should be washed with soap and water 6–10 hours after application.
:::::* Preferred regimen (3): [[Sinecatechins]] 15% ointment
:::::* Note: Apply to affected areas tid for up to 16 weeks, until warts are completely cleared and not visible
::::* 6.14.2.2. '''Provider-applied therapy for complex or multicentric lesions, or lesions inaccessible to patient'''
:::::* Note (1): Cryotherapy (liquid nitrogen or cryoprobe): Apply until each lesion is thoroughly frozen. Repeat every 1–2 weeks for up to 4 weeks, until lesions are no longer visible. Some providers allow the lesion to thaw, then freeze a second time in each session.
:::::* Note (2): [[Trichloroacetic acid]] or [[bichloroacetic acid]] cauterization: 80%–90% aqueous solution, apply to wart only, allow to dry until a white frost develops. Repeat weekly for up to 6 weeks, until lesions are no longer visible.
:::::* Note (3): Surgical excision or laser surgery to external or anal warts.
:::::* Note (4): [[Podophyllin]] resin 10%–25% in tincture of benzoin: Apply to all lesions (up to 10 cm2 ), then wash off a few hours later, repeat weekly for up to 6 weeks until lesions are no longer visible. 

::* 6.15. '''Hepatitis A virus (HAV) infection'''
:::* 6.15.1. '''Prevention'''
::::* Indication: HAV-susceptible patients with chronic liver disease, or who are injection-drug users or homosexuals
::::* Preferred regimen: Hepatitis A vaccine 1 mL IM  2 doses at 0 and 6–12 months.
::::* Alternative regimen: Combined HAV and HBV vaccine 1 mL IM as a 3-dose (0, 1, and 6 months) or 4-dose series (days 0, 7, 21 to 30, and 12 months).
::::* Note (1): For patients susceptible to both HAV and hepatitis B virus (HBV) infection, alternative regimen is recommended. 
::::* Note (2): IgG antibody response should be assessed 1 month after vaccination; nonresponders should be revaccinated when CD4 count >200 cells/µL.

::* 6.16. '''Hepatitis B virus (HBV) infection'''
:::* 6.16.1. '''Prevention'''
::::* 6.16.1.1. '''Indication''' 
:::::*  Patients without chronic HBV or without immunity to HBV (i.e., anti-HBs <10 international units/mL).
:::::*  Patients with isolated anti-HBc and negative HBV DNA.
:::::* Early vaccination is recommended before CD4 count falls below 350 cells/µL.
:::::*  However, in patients with low CD4 cell counts, vaccination should not be deferred until CD4 count reaches >350 cells/µL, because some patients with CD4 counts <200 cells/µL do respond to vaccination.
:::::* Preferred regimen (1): HBV vaccine IM (Engerix-B 20 µg/mL or Recombivax HB 10 µg/mL), 0, 1, and 6 months
:::::* Preferred regimen (2): HBV vaccine IM (Engerix-B 40 µg/mL or Recombivax HB 20 µg/mL) 0, 1, 2 and 6 months
:::::* Preferred regimen (3): Combined HAV and HBV vaccine, 1 mL IM as a 3-dose (0, 1, and 6 months) or 4-dose series (days 0, 7, 21 to 30, and 12 months)
:::::* Alternative regimen: Some experts recommend vaccinating with 40-µg doses of either HBV vaccine
:::::* Note:  Anti-HBs should be obtained 1 month after completion of the vaccine series. Patients with anti-HBs <10 international units/mL at 1 month are considered nonresponders.
:::::* Vaccine Non-Responders: 
::::::* Preferred regimen (1): HBV vaccine IM (Engerix-B 40 µg/mL or Recombivax HB 20 µg/mL), 0, 1, 2 and 6 months.
::::::* Note (1): Vaccination non-responders have anti-HBs <10 international units/mL 1 month after vaccination series.
::::::* Note (2): For patients with low CD4 counts at time of first vaccine series, some experts might delay revaccination until after a sustained increase in CD4 count with anti retroviral therapy.
:::* 6.16.2. '''Treatment'''
::::* Preferred regimen: [[Tenofovir]] 300 mg PO qd{{and}} [[Emtricitabine]] 200 mg PO qd {{or}} [[Lamivudine]] 300 mg PO qd {{and}} additional drug(s) for HIV
::::* Note: Anti retroviral therapy regimen should include 2 drugs that are active against both HBV and HIV.
::::* Alternative regimen: [[Peginterferon]] alfa-2a 180 μg SQ once weekly for 48 weeks {{or}} [[Peginterferon]] alfa 2b 1.5 μg/kg SQ once weekly for 48 weeks.
::::* Note: For HBV treatment is indicated for patients with elevated ALT and HBV DNA >2,000 IU/mL significant liver fibrosis, advanced liver disease or cirrhosis, above regimen is indicated.

::* 6.17. '''Penicilliosis marneffei'''
:::* 6.17.1. '''Prevention'''
::::* 6.17.1.1. '''Indication''' 
:::::* Patients with CD4 cell counts <100 cells/µL who live or stay for a long period in rural areas in northern Thailand, Vietnam, or Southern China.
:::::* Preferred regimen: [[Itraconazole]] 200 mg PO qd
:::::* Alternative regimen: [[Fluconazole]] 400 mg PO once weekly
:::* 6.17.2. '''Treatment'''
::::* 6.17.2.1. '''For acute infection in severely ill patients'''
:::::* Preferred regimen: [[Liposomal amphotericin]] B 3–5 mg/kg/day IV for 2 weeks, followed by [[Itraconazole]] 200 mg PO bid for 10 weeks, followed by chronic maintenance therapy
:::::* Alternative regimen: [[Voriconazole]] 6 mg/kg IV q12h for 1 day, then 4 mg/kg IV q12h for at least 3 days, followed by 200 mg PO bid for a maximum of 12 weeks, followed by maintenance therapy
::::* 6.17.2.2. '''For mild disease'''
:::::* Preferred regimen: [[Itraconazole]] 200 mg PO bid for 8 weeks; followed by chronic maintenance therapy
:::::* Alternative regimen: [[Voriconazole]] 400 mg PO bid for 1 day, then 200 mg bid for a maximum of 12 weeks, followed by chronic maintenance therapy
::::* 6.17.2.3. '''Chronic Maintenance Therapy (Secondary Prophylaxis)'''
:::::* Preferred regimen: [[Itraconazole]] 200 mg PO qd
:::::* Note (1): Anti retroviral therapy should be initiated simultaneously with treatment for penicilliosis to improve treatment outcome.
:::::* Note (2): [[Itraconazole]] and [[Voriconazole]] may have significant interactions with certain ARV agents. These interactions are complex and can be bi-directional.
:::::* Note (3): Therapeutic drug monitoring and dosage adjustment may be necessary to ensure triazole antifungal and ARV efficacy and reduce concentration-related toxicities.

::* 6.18. '''Isosporiasis'''
:::* 6.18.1. '''Treatment'''
::::* For Acute Infection:
:::::* Preferred regimen (1): [[Trimethoprim/Sulfamethoxazole]] 160 mg/800 mg PO (or IV) qid for 10 days
:::::* Preferred regimen (2): [[Trimethoprim/Sulfamethoxazole]] 160 mg/800 mg PO (or IV) bid for 7–10 days
:::::* Alternative regimen (1): [[Pyrimethamine]] 50–75 mg PO daily {{and}} [[Leucovorin]] 10–25 mg PO qd
:::::* Alternative regimen (2):  [[Ciprofloxacin]] 500 mg PO bid for 7 days as a second line alternative
::::* Chronic Maintenance Therapy (Secondary Prophylaxis):
:::::* Preferred regimen (1): In patients with CD4 count <200/µL, [[Trimethoprim/sulfamethoxazole]] 160 mg/800 mg PO three times a week
:::::* Alternative regimen (1): [[Trimethoprim/sulfamethoxazole]] 160 mg/800 mg PO qd or (320 mg/1600 mg) three times a week
:::::* Alternative regimen (2): [[Pyrimethamine]] 25 mg PO qd {{and}} [[Leucovorin]] 5–10 mg PO qd
:::::* Alternative regimen (3): [[Ciprofloxacin]] 500 mg three times a week as a second-line alternative
:::::* Note (1): Fluid and electrolyte management in patients with dehydration.
:::::* Note (2): Immune reconstitution with anti retroviral therapy may result in fewer relapses.
:::::* Note (3): IV therapy may be used for patients with potential or documented mal-absorption.

::* 6.19. '''Chagas disease (American trypanosomiasis)'''
:::* 6.19.1. '''Treatment'''
::::* For acute, earlychronic, and reactivated Disease:
:::::* Preferred regimen: [[Benznidazole]] 5–8 mg/kg/day PO in 2 divided doses for 30–60 days
:::::* Alternative regimen: [[Nifurtimox]] 8–10 mg/kg/day PO for 90–120 days.

::* 6.20. '''Leishmaniasis, visceral'''
:::* 6.20.1. '''Leishmaniasis, visceral'''
::::* 6.20.1.1. '''Treatment'''
:::::* For initial infection:
::::::* Preferred regimen (1): Liposomal [[amphotericin B]] 2–4 mg/kg IV qd
::::::* Preferred regimen (2): Liposomal [[amphotericin B]] interrupted schedule (e.g., 4 mg/kg on days 1–5, 10, 17, 24, 31, 38)
::::::* Alternative regimen (1): [[Amphotericin B]] deoxycholate 0.5–1.0 mg/kg IV q24h for total dose of 1.5–2.0 g
::::::* Alternative regimen (2): Sodium stibogluconate (pentavalent antimony) 20 mg/kg IV or IM q24h for 28 days
::::::* Alternative regimen (3): [[Miltefosine]] 100 mg PO qd for 4 weeks 
:::::* Chronic maintenance therapy (secondary prophylaxis); Especially in Patients with CD4 Count <200 cells/µL:
::::::* Preferred regimen (1): Liposomal [[amphotericin B]] 4 mg/kg every 2–4 weeks
::::::* Preferred regimen (2): [[Amphotericin B]] lipid complex 3 mg/kg every 21 days
::::::* Alternative regimen: [[Sodium stibogluconate]] 20 mg/kg IV or IM every 4 weeks
:::* 6.20.2. '''Leishmaniasis, cutaneous'''
::::::* Preferred regimen (1): Liposomal [[amphotericin B]] 2–4 mg/kg IV daily for 10 days
::::::* Preferred regimen (2): Liposomal [[amphotericin B]] interrupted schedule (e.g., 4 mg/kg on days 1–5, 10, 17, 24, 31, 38) to achieve total dose of 20–60 mg/kg
::::::* Preferred regimen (3): [[Sodium stibogluconate]] 20 mg/kg IV or IM daily for 3–4 weeks

::* 6.21. '''Aspergillosis, invasive'''
:::* 6.21.1. '''Treatment'''
::::* Preferred regimen: [[Voriconazole]] 6 mg/kg IV q12h for 1 day, then 4 mg/kg IV q12h, followed by [[Voriconazole]] 200 mg PO q12h after clinical improvement until CD4 cell count >200 cells/µL and the infection appears to be resolved.
::::* Alternative regimen (1): Lipid formulation of [[Amphotericin B]] 5 mg/kg IV q24h
::::* Alternative regimen (2): [[Amphotericin B]] deoxycholate 1mg/kg IV q24h
::::* Alternative regimen (3): [[Caspofungin]] 70 mg IV single dose, then 50 mg IV q24h 
::::* Alternative regimen (4): [[Micafungin]] 100–150 mg IV q24h
::::* Alternative regimen (5): [[Anidulafungin]] 200 mg IV single dose, then 100 mg IV q24h
::::* Alternative regimen (6): [[Posaconazole]] 200 mg PO qid, then, after condition improved, 400 mg PO bid

::* 6.22. '''Malaria'''
:::* 6.22.1. '''Prevetion<ref name=CDC Malaria prophylaxis>{{cite web | title = CDC Malaria prophylaxis | url =http://wwwnc.cdc.gov/travel/yellowbook/2016/infectious-diseases-related-to-travel/malaria#4660 }}</ref>'''
::::* 6.22.1.1. '''Prophylaxis in all areas'''
:::::* Preferred regimen (1): [[Atovaquone]] 250 mg  and [[Proguanil hydrochloride]] 100 mg PO qd
:::::* Pediatric doses: Pediatric tablets contain 62.5 mg atovaquone and 25 mg proguanil hydrochloride 
::::::* 5–8 kg: 1/2 pediatric tablet daily
::::::* >8–10 kg: 3/4 pediatric tablet daily
::::::* >10–20 kg: 1 pediatric tablet daily
::::::* >20–30 kg: 2 pediatric tablets daily
::::::* >30–40 kg: 3 pediatric tablets daily
:::::* Note (1): Begin 1–2 days before travel to malarious areas. Take daily at the same time each day while in the malarious area and for 7 days after leaving such areas. Contraindicated in people with severe renal impairment (creatinine clearance <30 mL/min).
:::::* Note (2):  Atovaquone-proguanil should be taken with food or a milky drink. Not recommended for prophylaxis for children weighing <5 kg, pregnant women, and women breastfeeding infants weighing <5 kg. Partial tablet doses may need to be prepared by a pharmacist and dispensed in individual capsules.
:::::* Preferred regimen (2): [[Doxycycline]] 100 mg PO qd 
:::::* Pediatric dose: ≥8 years of age: 2.2 mg/kg up to adult dose of 100 mg/day
:::::* Note: Begin 1–2 days before travel to malarious areas. Take daily at the same time each day while in the malarious area and for 4 weeks after leaving such areas. Contraindicated in children <8 years of age and pregnant women.
::::* 6.22.1.2. '''Prophylaxis only in areas with chloroquine-sensitive malaria'''
:::::* Preferred regimen: [[Chloroquine phosphate]] 300 mg base (500 mg salt) PO once a week 
:::::* Note: Begin 1–2 weeks before travel to malarious areas. Take weekly on the same day of the week while in the malarious area and for 4 weeks after leaving such areas. May exacerbate psoriasis.
:::::* Alternative regimen: [[Hydroxychloroquine sulfate]] 400 mg salt PO once a week 
:::::* Note: Begin 1–2 weeks before travel to malarious areas. Take weekly on the same day of the week while in the malarious area and for 4 weeks after leaving such areas.
:::::* Pediatric doses: [[Chloroquine phosphate]] 5 mg/kg base (8.3 mg/kg salt) orally, once/week, up to maximum adult dose of 300 mg base; [[Hydroxychloroquine sulfate]] 5 mg/kg base (6.5 mg/kg salt) orally, once/week, up to a maximum adult dose of 310 mg base 
::::* 6.22.1.3. '''Prophylaxis in areas with mefloquine-sensitive malaria'''
:::::* Preferred regimen: [[Mefloquine]] 250 mg PO once a week 
:::::* Note (1): Begin ≥2 weeks before travel to malarious areas. Take weekly on the same day of the week while in the malarious area and for 4 weeks after leaving such areas. Contraindicated in people allergic to mefloquine or related compounds (quinine, quinidine) and in people with active depression, a recent history of depression, generalized anxiety disorder, psychosis, schizophrenia, other major psychiatric disorders, or seizures.
:::::* Note (2): Use with caution in persons with psychiatric disturbances or a previous history of depression. Not recommended for persons with cardiac conduction abnormalities.
:::::* Pediatric dose: [[Mefloquine]] ≤9 kg: 4.6 mg/kg base (5 mg/kg salt) orally, once/week
::::::* >9–19 kg: 1/4 tablet once/week
::::::* >19–30 kg: 1/2 tablet once/week
::::::* >30–45 kg: 3/4 tablet once/week
::::::* >30–45 kg: 3/4 tablet once/week
::::* 6.22.1.4. '''Prophylaxis for short-duration travel to areas with principally Plasmodium vivax'''
:::::* Preferred regimen: [[Primaquine]] 52.6 mg PO qd 
:::::* Note: Begin 1–2 days before travel to malarious areas. Take daily at the same time each day while in the malarious area and for 7 days after leaving such areas. Contraindicated in people with G6PD deficiency. Also contraindicated during pregnancy and lactation, unless the infant being breastfed has a documented normal G6PD level.
:::::* Pediatric dose: [[Primaquine]] 0.5 mg/kg base (0.8 mg/kg salt) up to adult dose orally, daily
::::* 6.22.1.5. '''Terminal prophylaxis to decrease the risk for relapses of Plasmodium vivax and Plasmodium ovale'''
:::::* Preferred regimen: [[Primaquine]] 52.6 mg PO qd  for 14 days after departure from the malarious area
:::::* Note: Indicated for people who have had prolonged exposure to P. vivax, P. ovale, or both. Contraindicated in people with G6PD deficiency. Also contraindicated during pregnancy and lactation, unless the infant being breastfed has a documented normal G6PD level.
:::::* Pediatric dose: [[Primaquine]] 0.5 mg/kg base (0.8 mg/kg salt) up to adult dose orally, daily for 14 days after departure from the malarious area
:::* 6.22.2. '''Treatment'''
::::* Note (1): Patients coinfected with HIV  should avoid [[Artesunate]] {{and}} [[Sulfadoxine]]-[[Pyrimethamine]] if they are also receiving [[Co-trimoxazole]], and avoid [[Artesunate]] {{and}} [[Amodiaquine ]] if they are also receiving [[Efavirenz]] {{or}} [[Zidovudine]].
::::* Note (2):   Because Plasmodium falciparum malaria can progress within hours from mild symptoms or low-grade fever to severe disease or death, all HIV-infected patients with confirmed or suspected P.  falciparum infection should be hospitalized for evaluation, initiation of treatment, and observation.
::::* 6.22.2.1. '''Plasmodium falciparum'''<ref>{{cite web | title = Guidelines for the treatment of malaria. Third edition April 2015 | url = http://apps.who.int/iris/bitstream/10665/162441/1/9789241549127_eng.pdf?ua=1&ua=1 }}</ref>
:::::* 6.22.2.1.1. '''Treatment of uncomplicated Plasmodium falciparum malaria'''
::::::* 6.22.2.1.1.1. '''Treat children and adults with uncomplicated Plasmodium falciparum malaria (except pregnant women in their first trimester) with one of the following recommended ACT (artemisinin-based combination therapy)'''
:::::::* Preferred regimen (1): [[Artemether]] 5–24 mg/kg/day PO bid {{and}} [[Lumefantrine]] 29–144 mg/kg/day PO bid for 3 days
:::::::* Note: The first two doses should, ideally, be given 8 hours apart.
:::::::* Dosage regimen based on Body weight (kg)
::::::::* Body weight (kg)-5 to < 15- [[Artemether]] 20 mg PO bid {{and}} [[Lumefantrine]] 120 mg PO bid  for 3 days
::::::::* Body weight (kg)-15 to < 25- [[Artemether]] 40 mg PO bid {{and}} [[Lumefantrine]] 240 mg PO bid  for 3 days
::::::::* Body weight (kg)-25 to < 35- [[Artemether]] 60 mg PO bid {{and}} [[Lumefantrine]] 360 mg PO bid  for 3 days
::::::::* Body weight (kg)   ≥ 35- [[Artemether]] 80 mg PO bid {{and}} [[Lumefantrine]] 480 mg PO bid  for 3 days
:::::::* Preferred regimen (2): [[Artesunate]] 2–10 mg/kg/day PO qd {{and}} [[Amodiaquine]] 7.5–15 mg/kg/day PO qd for 3 days 
:::::::* Note: A total therapeutic dose range of 6–30 mg/kg/day [[Artesunate]] and 22.5–45 mg/kg/day per dose [[Amodiaquine]] is recommended.
:::::::* Dosage regimen based on body weight (kg)
::::::::* Body weight (kg)-4.5 to < 9- [[Artesunate]] 25 mg PO qd {{and}} [[Amodiaquine]] 67.5 mg PO qd  for 3 days
::::::::* Body weight (kg)-9 to < 18 - [[Artesunate]] 50 mg PO qd {{and}} [[Amodiaquine]] 135 mg PO qd for 3 days
::::::::* Body weight (kg)-18 to < 36- [[Artesunate]] 100 mg PO qd {{and}} [[Amodiaquine]] 270 mg PO qd for 3 days
::::::::* Body weight (kg)   ≥ 36 - [[Artesunate]] 200 mg PO qd {{and}} [[Amodiaquine]] 540 mg PO qd for 3 days
:::::::* Preferred regimen (3): [[Artesunate]] 2–10 mg/kg/day PO qd {{and}} [[Mefloquine]] 2–10 mg/kg/day PO qd for 3 days
:::::::* Dosage regimen based on body weight (kg)
::::::::* Body weight (kg)-5 to < 9- [[Artesunate]] 25 mg PO qd {{and}} [[Mefloquine]] 55 mg PO qd  for 3 days
::::::::* Body weight (kg)-9to < 18- [[Artesunate]] 50 mg PO qd {{and}} [[Mefloquine]] 110 mg PO qd for 3 days
::::::::* Body weight (kg)-18 to < 36- [[Artesunate]] 100 mg PO qd {{and}} [[Mefloquine]] 220 mg PO qd for 3 days
::::::::* Body weight (kg)- ≥ 36  - [[Artesunate]] 200 mg PO qd {{and}} [[Mefloquine]] 440 mg PO qd for 3 days
:::::::* Preferred regimen (4): [[Artesunate]] 2–10 mg/kg/day PO qd for 3 days {{and}} [[Sulfadoxine]]-[[Pyrimethamine]]  1.25 (25–70 / 1.25–3.5) mg/kg/day  PO given as a single dose on day 1
:::::::* Dosage regimen based on body weight (kg)
::::::::* Body weight (kg)- 5 to < 10- [[Artesunate]] 25 mg PO qd for 3 days {{and}} [[Sulfadoxine]]-[[Pyrimethamine]] 250/12 mg PO given as a single dose on day 1
::::::::* Body weight (kg)- 10 to < 25- [[Artesunate]] 50 mg PO qd for 3 days {{and}} [[Sulfadoxine]]-[[Pyrimethamine]] 500/25 mg PO given as a single dose on day 1
::::::::* Body weight (kg)- 25 to < 50- [[Artesunate]] 100 mg PO qd for 3 days {{and}} [[Sulfadoxine]]-[[Pyrimethamine]] 1000/50 mg PO given as a single dose on day 1 
::::::::* Body weight (kg)- ≥50- [[Artesunate]] 200 mg PO qd for 3 days {{and}} [[Sulfadoxine]]-[[Pyrimethamine]] 1500/75 mg PO given as a single dose on day 1
:::::::*  Preferred regimen (5): [[Dihydroartemisinin]] 2–10 mg/kg/day PO qd {{and}} [[Piperaquine]]16–27 mg/kg/day PO qd for 3 days
:::::::* Dosage regimen based on Body weight (kg)
::::::::* Body weight (kg)-5 to < 8: [[Dihydroartemisinin]] 20 mg PO qd {{and}} [[Piperaquine]] 160 mg PO qd for 3 days
::::::::* Body weight (kg)-8 to < 11: [[Dihydroartemisinin]] 30 mg PO qd {{and}} [[Piperaquine]] 240 mg PO qd for 3 days
::::::::* Body weight (kg)-11 to < 17: [[Dihydroartemisinin]] 40 mg PO qd {{and}} [[Piperaquine]] 320 mg PO qd for 3 days
::::::::* Body weight (kg)-17 to < 25: [[Dihydroartemisinin]] 60 mg PO qd {{and}}  [[Piperaquine]] 480 mg PO qd for 3 days
::::::::* Body weight (kg)-25 to < 36: [[Dihydroartemisinin]] 80 mg PO qd {{and}}  [[Piperaquine]] 640 mg PO qd for 3 days
::::::::* Body weight (kg)-36 to < 60: [[Dihydroartemisinin]] 120 mg PO qd {{and}}  [[Piperaquine]] 960 mg PO qd for 3 days
::::::::*  Body weight (kg)-60 < 80: [[Dihydroartemisinin]] 160 mg PO qd {{and}}  [[Piperaquine]] 1280 mg PO qd for 3 days
::::::::* Body weight (kg)- >80: Dose of [[Dihydroartemisinin]] 200 mg PO qd {{and}}  [[Piperaquine]] 1600 mg PO qd for 3 days
::::::* 6.22.2.1.1.2 '''Reducing the transmissibility of treated Plasmodium falciparum infections In low-transmission areas in  patients with Plasmodium falciparum malaria (except pregnant women, infants aged < 6 months and women breastfeeding infants aged < 6 months) '''
:::::::* Preferred regimen: [[Primaquine]] 0.25 mg/kg PO single dose with ACT 
:::::* 6.22.2.1.2. '''Recurrent falciparum malaria''' 
::::::* 6.22.2.1.2.1. '''Failure within 28 days '''
:::::::* Note: The recommended second-line treatment is an alternative ACT known to be effective in the region. Adherence to 7-day treatment regimens with [[Artesunate]] or [[Quinine]] both of which should be co-administered with [[Tetracycline]], or [[Doxycycline]] or [[Clindamycin]]) is likely to be poor if treatment is not directly observed; these regimens are no longer generally recommended. 
::::::* 6.22.2.1.2.2. '''Failure after 28 days'''
:::::::* Note: All presumed treatment failures after 4 weeks of initial treatment should, from an operational standpoint, be considered new infections and be treated with the first-line ACT. However, reuse of [[Mefloquine]] within 60 days of first treatment is associated with an increased risk for neuropsychiatric reactions, and an alternative ACT should be used.
:::::* 6.22.2.1.3. '''Reducing the transmissibility of treated Plasmodium falciparum infections in low-transmission areas in  patients with Plasmodium falciparum malaria (except pregnant women, infants aged < 6 months and women breastfeeding infants aged < 6 months) ''' 
::::::* Note: Single dose of 0.25 mg/kg biweekly [[Primaquine]] with ACT 
:::::* 6.22.2.1.4. '''Treating uncomplicated Plasmodium falciparum malaria in special risk groups'''
::::::* 6.22.2.1.4.1. '''Pregnancy '''
:::::::* First trimester of pregnancy : [[Quinine]] {{and}} [[Clindamycin]] 10 mg/kg/day PO bid for 7 days
:::::::* Second and third trimesters : [[Mefloquine]] is considered safe for the treatment of malaria during the second and third trimesters; however, it should be given only in combination with an artemisinin derivative.
:::::::* Note (1): [[Quinine]] is associated with an increased risk for hypoglycaemia in late pregnancy, and it should be used (with clindamycin) only if effective alternatives are not available.
:::::::* Note (2): [[Primaquine]] and [[Tetracyclines]] should not be used in pregnancy.
::::::* 6.22.2.1.4.2. '''Infants less than 5kg body weight'''
:::::::* Note: They should be treated with an ACT at the same mg/kg bw target dose as for children weighing 5 kg.
::::::* 6.22.2.1.4.4. '''Large and obese adults'''
:::::::* Note: For obese patients, less drug is often distributed to fat than to other tissues; therefore, they should be dosed on the basis of an estimate of lean body weight, ideal body weight. Patients who are heavy but not obese require the same mg/kg bw doses as lighter patients.
::::::* 6.22.2.1.4.5. '''Non-immune travellers'''
:::::::* Note: Treat travellers with uncomplicated P. falciparum malaria returning to nonendemic settings with an ACT.
::::::* 6.22.2.1.4.6. '''Uncomplicated hyperparasitaemia'''
:::::::* Note: People with P. falciparum hyperparasitaemia are at increased risk of treatment failure, severe malaria and death so should be closely monitored, in addition to receiving an ACT.
::::* 6.22.2.2. '''Treatment of uncomplicated malaria caused by Plasmodium vivax, Plasmodium ovale, Plasmodium malariae or Plasmodium knowlesi'''
:::::* 6.22.2.2.1.  '''Blood Stage infection'''
::::::* 6.22.2.2.1.1.  '''Uncomplicated malaria caused by Plasmodium vivax'''
:::::::* 6.22.2.2.1.1.1. '''In areas with chloroquine-sensitive Plasmodium vivax'''
::::::::* Preferred regimen: [[Chloroquine]] total dose of 25 mg/kg PO. [[Chloroquine]] is given at an initial dose of 10 mg/kg, followed by 10 mg/kg on the second day and 5 mg/kg on the third day PO
:::::::* 6.22.2.2.1.1.2. '''In areas with chloroquine-resistant Plasmodium vivax'''
::::::::* Note: ACTs containing [[Piperaquine]], [[Mefloquine]] {{or}} [[Lumefantrine]] are the recommended treatment, although [[Artesunate]] {{and}} [[Amodiaquine]] may also be effective in some areas. In the systematic review of ACTs for treating P. vivax malaria, [[Dihydroartemisinin]] {{and}} [[Piperaquine]] provided a longer prophylactic effect than ACTs with shorter half-lives ([[Artemether]] {{and}}[[Lumefantrine]]) {{or}} ([[Artesunate]] {{and}} [[Amodiaquine]]), with significantly fewer recurrent parasitaemias during 9 weeks of follow-up.
::::::* 6.22.2.2.1.2. '''Uncomplicated malaria caused by Plasmodium ovale, Plasmodium malariae or Plasmodium knowlesi malaria'''
:::::::* Note: Resistance of P. ovale, P. malariae and P. knowlesi to antimalarial drugs is not well characterized, and infections caused by these three species are generally considered to be sensitive to [[Chloroquine]]. In only one study, conducted in Indonesia, was resistance to [[Chloroquine]] reported in P. malariae. The blood stages of P. ovale, P. malariae and P. knowlesi should therefore be treated with the standard regimen of ACT or [[Chloroquine]], as for vivax malaria. 
::::::* 6.22.2.2.1.3. '''Mixed malaria infections '''
:::::::* Note: ACTs are effective against all malaria species and so are the treatment of choice for mixed infections.
:::::* 6.22.2.2.2. '''Liver stages (hypnozoites) of Plasmodium vivax and Plasmodium ovale'''
::::::* Note: To prevent relapse, treat P. vivax or P. ovale malaria in children and adults (except pregnant women, infants aged < 6 months, women breastfeeding infants < 6 months, women breastfeeding older infants unless they are known not to be G6PD deficient and people with G6PD deficiency) with a 14-day course of [[Primaquine]] in all transmission settings. Strong recommendation, high-quality evidence In people with G6PD deficiency, consider preventing relapse by giving primaquine base at 0.75 mg base/kg bw once a week for 8 weeks, with close medical supervision for potential primaquine-induced adverse haematological effects.
:::::* 6.22.2.2.2.1. '''Primaquine for preventive relapse'''
::::::* Preferred regimen: [[Primaquine]] 0.25–0.5 mg/kg/day PO qd for 14 days
:::::* 6.22.2.2.2.2. '''Primaquine and glucose-6-phosphate dehydrogenase deficiency'''
::::::* Preferred regimen: [[Primaquine]] 0.75 mg base/kg/day PO once a week for 8 weeks
::::::* Note: The decision to give or withhold [[Primaquine]] should depend on the possibility of giving the treatment under close medical supervision, with ready access to health facilities with blood transfusion services.
:::::* 6.22.2.2.2.3. '''Prevention of relapse in pregnant or lacating women and infants'''
::::::* Note: [[Primaquine]] is contraindicated in pregnant women, infants < 6 months of age and in lactating women (unless the infant is known not to be G6PD deficient)
::::* 6.22.2.3. '''Treatment of severe malaria'''
:::::* 6.22.2.3.1. '''Treatment of severe falciparum infection with Artesunate'''
::::::* 6.22.2.3.1.1. '''Adults and children with severe malaria (including infants, pregnant women in all trimesters and lactating women)'''
:::::::* Preferred regimen: [[Artesunate]] IV/IM for at least 24 h and until they can tolerate oral medication. Once a patient has received at least 24 h of parenteral therapy and can tolerate oral therapy, complete treatment with 3 days of an ACT (add single dose [[Primaquine]] in areas of low transmission).
::::::* 6.22.2.3.1.2. '''Young children weighing < 20 kg'''
:::::::* Preferred regimen:[[Artesunate]] 3 mg/kg per dose IV/IM q24h
:::::::* Alternative regimen: use [[Artemether]] in preference to quinine for treating children and adults with severe malaria
:::::* 6.22.2.3.2.'''Treating cases of suspected severe malaria pending transfer to a higher-level facility (pre-referral treatment)'''
::::::* 6.22.2.3.2.1. '''Adults and children'''
:::::::* Preferred regimen: [[Artesunate]] IM q24h
:::::::* Alternative regimen: [[Artemether]] IM {{or}} [[Quinine]] IM
::::::* 6.22.2.3.2.2.  '''Children < 6 years'''
:::::::* Preferred regimen: Where intramuscular injections of artesunate are not available, treat with a single rectal dose (10 mg/kg) of [[Artesunate]], and refer immediately to an appropriate facility for further care.
:::::::* Note: Do not use rectal artesunate in older children and adults.
:::::* 6.22.2.3.3. '''Pregancy'''
::::::* Note: Parenteral artesunate is the treatment of choice in all trimesters. Treatment must not be delayed.
:::::* 6.22.2.3.4. '''Treatment of severe Plasmodium Vivax infection'''
::::::* Note: Parenteral [[Artesunate]], treatment can be completed with a full treatment course of oral ACT or [[Chloroquine]] (in countries where [[Chloroquine]] is the treatment of choice). A full course of radical treatment with [[Primaquine]] should be given after recovery.
:::::* 6.22.2.3.5. '''Additional aspects of management in severe malaria'''
::::::* Fluid therapy:  It is not possible to give general recommendations on fluid replacement; each patient must be assessed individually and fluid resuscitation based on the estimated deficit.
::::::* Blood Transfusion: In high-transmission settings, blood transfusion is generally recommended for children with a haemoglobin level of < 5 g/100 mL(haematocrit < 15%). In low-transmission settings, a threshold of 20% (haemoglobin,7 g/100 mL) is recommended.
::::::* Exchange blood transfusion: Exchange blood transfusion requires intensive nursing care and a relatively large volume of blood, and it carries significant risks. There is no consensus on the indications, benefits and dangers involved or on practical details such as the volume of blood that should be exchanged. It is, therefore, not possible to make any recommendation regarding the use of exchange blood transfusion. 

::* 6.23. '''Cryptococcosis'''
:::* 6.23.1. '''Treatment'''
::::* 6.23.1.1. '''Cryptococcal meningitis'''
:::::* 6.23.1.1.1. '''Induction therapy'''
::::::* Preferred regimen: Liposomal [[amphotericin B]] 3–4 mg/kg IV q24h {{and}} [[Flucytosine]] 25 mg/kg PO qid for at least 2 weeks, followed by consolidation therapy
::::::* Alternative regimen (1):  [[Amphotericin B]] deoxycholate 0.7 mg/kg IV q24h {{and}} [[Flucytosine]] 25 mg/kg PO qid 
::::::* Alternative regimen (2): [[Amphotericin B]] lipid complex 5 mg/kg IV q24h {{and}} [[Flucytosine]] 25 mg/kg PO qid 
::::::* Alternative regimen (3): Liposomal [[Amphotericin B]] 3-4 mg/kg IV q24h {{and}} [[Fluconazole]] 800 mg PO or IV q24h
::::::* Alternative regimen (4): [[Amphotericin B]] deoxycholate 0.7 mg/kg IV q24h {{and}} [[Fluconazole]] 800 mg PO or IV q24h
::::::* Alternative regimen (5): [[Fluconazole]] 400–800 mg PO or IV qd {{and}} [[Flucytosine]] 25 mg/kg PO qid
::::::* Alternative regimen (6): [[Fluconazole]] 1200 mg PO or IV qd
:::::* 6.23.1.1.2. '''Consolidation therapy''' 
::::::* Preferred regimen: [[Fluconazole]] 400 mg PO (or IV) qd for atleast 8 weeks 
::::::* Note: Preferred therapy followed by maintenance therapy.
::::::*  Maintenance therapy:  Fluconazole 200 mg PO qd for at least 12 months
::::::* Alternative regimen:  [[Itraconazole]] 200 mg PO bid for 8 weeks
::::* 6.23.1.2. '''Non-CNS cryptococcosis with mild-to-moderate symptoms and focal pulmonary infiltrates'''
:::::* Preferred regimen: [[Fluconazole]], 400 mg PO qd for 12 months
:::::* Note: Patients receiving [[Flucytosine]] should have either blood levels monitored (peak level 2 hours after dose should be 30–80 mcg/mL) or close monitoring of blood counts for development of cytopenia. Dosage should be adjusted in patients with renal insufficiency.

::* 6.24. '''Mucocutaneous candidiasis'''
:::* 6.24.1. '''Treatment'''
::::* 6.24.1.1. '''For oropharyngeal candidiasis'''
:::::* Oral Therapy
::::::* Preferred regimen: [[Fluconazole]] 100 mg PO qd for 7-14 days.
::::::* Alternative regimen:  [[Itraconazole]] oral solution 200 mg PO qd for 7-14 days {{or}} [[Posaconazole]] oral suspension 400 mg PO bid for 1 day, then 400 mg qd 7-14 days
:::::* Topical therapy
::::::* Preferred regimen: [[Clotrimazole]] troches, 10 mg PO 5 times daily {{or}} [[Miconazole]] mucoadhesive buccal 50-mg tablet
::::::* Note: Apply to mucosal surface over the canine fossa once daily (do not swallow, chew, or crush).
::::::* Alternative regimen: [[Nystatin]] suspension 4–6 mL qid or 1–2 flavored pastilles 4– 5 times daily
::::* 6.24.1.2. '''For esophageal candidiasis''' 
::::::* Preferred regimen: [[Fluconazole]] 100 mg (up to 400 mg) PO or IV qd for 14-21 days {{or}}  [[Itraconazole]] oral solution 200 mg PO qd for 14-21 days
::::::* Alternative regimen (1): [[Voriconazole]] 200 mg PO or IV bid for 14-21 days
::::::* Alternative regimen (2): [[Anidulafungin]] 100 mg IV single dose, then 50 mg IV qd for 14-21 days
::::::* Alternative regimen (3): [[Caspofungin]] 50 mg IV qd for 14-21 days
::::::* Alternative regimen (4): [[Micafungin]] 150 mg IV qd for 14-21 days 
::::::* Alternative regimen (5): [[Amphotericin B]] deoxycholate 0.6 mg/kg IV qd for 14-21 days
::::::* Alternative regimen (6): Lipid formulation of amphotericin B 3–4 mg/kg IV qd for 14-21 days
::::* 6.24.1.3. '''For uncomplicated vulvo-vaginal candidiasis'''
:::::* Preferred regimen:  Oral [[Fluconazole]] 150 mg for 1 dose {{or}} Topical azoles ([[Clotrimazole]], [[Butoconazole]], [[Miconazole]], [[Tioconazole]], or [[Terconazole]]) for 3– 7 days
:::::* Alternative regimen:  [[Itraconazole]] oral solution 200 mg PO qd for 3–7 days
::::* 6.24.1.4. '''For severe or recurrent vulvovaginal candidiasis'''
:::::* Preferred regimen: [[Fluconazole]] 100–200 mg PO qd for ≥7 days {{or}} Topical antifungal ≥7 days

::* 6.25. '''Bartonellosis'''
:::* 6.25.1. '''Treatment'''
::::* 6.25.1.1. '''For bacillary angiomatosis, peliosis hepatis, bacteremia, and osteomyelitis'''
:::::* Preferred regimen (1): [[Doxycycline]] 100 mg PO or IV q12h for 3 months
:::::* Preferred regimen (2): [[Erythromycin]] 500 mg PO or IV q6h for 3 months
:::::* Alternative regimen (1):  [[Azithromycin]] 500 mg PO qd 
:::::* Alternative regimen (2):} [[Clarithromycin]] 500 mg PO bid
::::* 6.25.1.2. '''Confirmed bartonella endocarditis'''
:::::* Preferred regimen: [[Doxycycline]] 100 mg IV q12h {{and}} [[Gentamicin]] 1 mg/kg IV q8h) for 2 weeks, then continue with [[Doxycycline]] 100 mg IV or PO q12h
:::::* Altered regimen: [[Doxycycline]] 100 mg IV {{and}} [[Rifabutin]] 300 mg PO or IV q12h for 2 weeks, then continue with [[Doxycycline]] 100 mg IV or PI q12h 
::::* 6.25.1.3. '''CNS infections'''
:::::* Preferred regimen: ([[Doxycycline]] 100 mg with or without [[Rifabutin]] 300 mg PO or IV q12h
::::* 6.25.1.4. '''Other severe infections'''
:::::* Preferred regimen (1): [[Doxycycline]] 100 mg PO or IV with or without [[Rifabutin]] 300 mg PO or IV) q12h for 3 months
:::::* Preferred regimen (2): [[Erythromycin]] 500 mg PO or IV q6h) with or without [[Rifabutin]]) 300 mg PO or IV q12h for 3 months.
::::* Note: If relapse occurs after initial (>3 month) course of therapy, longterm suppression with [[Doxycycline]] or a macrolide is recommended as long as CD4 count <200 cells/µL.

::* 6.26. '''Campylobacteriosis'''
:::* 6.26.1. '''Treatment'''
::::* 6.26.1.1. '''For mild-to-moderate disease (If Susceptible)'''
:::::* Preferred regimen: [[Ciprofloxacin]] 500–750 mg PO or 400 mg IV q12h {{or}} [[ Azithromycin]] 500 mg PO qd
:::::* Alternative regimen: [[Levofloxacin]] 750 mg PO or IV q24h {{or}}  [[Moxifloxacin]] 400 mg (PO or IV) q24h
::::* 6.26.1.2. '''For campylobacter bacteremia'''
:::::* Preferred regimen: [[Ciprofloxacin]] 500–750 mg PO or 400 mg IV q12h {{and}} an aminoglycoside.
:::::* Duration of Therapy:
::::::* Gastroenteritis: 7–10 days (5 days with [[Azithromycin]]) 
::::::* Bacteremia: ≥14 days
::::::* Recurrent bacteremia: 2–6 weeks.

::* 6.27. '''Shigellosis'''
:::* 6.27.1. '''Treatment'''
::::* Preferred regimen: [[Ciprofloxacin]] 500–750 mg PO or 400 mg IV q12h
::::* Duration of Therapy:
:::::* Gastroenteritis: 7–10 days
:::::* Bacteremia: ≥14 days 
:::::* Recurrent Infections: 2–6 weeks 
::::* Alternative regimen (1): [[Levofloxacin]] 750 mg PO or IV q24h for 5 days
::::* Alternative regimen (2): [[Moxifloxacin]] 400 mg PO or IV q24h for 5 days
::::* Alternative regimen (3): [[Trimethoprim/Sulfamethoxazole]] 160 mg/800 mg PO or IV q12h for 5 days
::::* Alternative regimen (4): [[Azithromycin]] 500 mg PO qd for 5 days
::::* Note: Antimotility agents should be avoided.

::* 6.28. '''Salmonellosis'''
:::* 6.28.1. '''Treatment'''
::::* Preferred regimen: [[Ciprofloxacin]] 500–750 mg PO or 400 mg IV q12h
::::* Alternative regimen (1): Levofloxacin 750 mg PO or IV q24h 
::::* Alternative regimen (2): [[Moxifloxacin]] 400 mg PO or IV q24h
::::* Alternative regimen (3): [[Trimethoprim/Sulfamethoxazole]] 160 mg/800 mg PO or IV q12h 
::::* Alternative regimen (4): [[Cefotaxime]] 1 g IV q8h
::::* Alternative regimen (5): [[Ceftriaxone]] 1 g IV q24h
::::* Duration of therapy: 
:::::* For gastroenteritis without bacteremia:
::::::* If CD4 count ≥200 cells/µL: 7–14 days.
::::::* If CD4 count <200 cells/µL: 2–6 weeks.
:::::* For gastroenteritis with bacteremia:
::::::*  If CD4 count ≥200/µL: 14 days; longer duration if bacteremia persists or if the infection is complicated (e.g., if metastatic foci of infection are present) 
::::::*  If CD4 count <200 cells/µL: 2–6 weeks
::::* Note (1): The role of long-term secondary prophylaxis in patients with recurrent Salmonella bacteremia is not well established. Must weigh benefit against risks of long-term antibiotic exposure.
::::* Note (2): Secondary Prophylaxis Should Be Considered For:
:::::* Patients with recurrent Salmonella gastroenteritis +/- bacteremia.
:::::* Patients with CD4 <200 cells/µL with severe diarrhea.

::* 6.29. '''Bacterial enteric infections'''
:::* 6.29.1. '''Empiric therapy'''
::::* Preferred regimen: [[Ciprofloxacin]] 500–750 mg PO or 400 mg IV q12h
::::* Alternative regimen:  [[Ceftriaxone]] 1 g IV q24h {{or}}  [[Cefotaxime]] 1 g IV q8h
::::* Note: Antimotility agents should be avoided if there is concern about inflammatory diarrhea, including Clostridium-difficile-associated diarrhea.

::* 6.30.'''Bacterial respiratory diseases''' 
:::* 6.30.1. '''Treatment'''
::::* 6.30.1.1. '''Empiric outpatient therapy'''
:::::* Preferred regimen: [[Amoxicillin]] 500 mg PO  {{and}} ([[Azithromycin]] 500 mg PO {{or}} [[Clarithromycin]] 500 mg PO) qd for 7-10 days
:::::* Alternative regimen: [[Amoxicillin]] 500 mg PO {{and}} [[Doxycycline]] 100mg PO qd
:::::* Note: Therapy should be adjusted based on the results of diagnostic workup.
::::* 6.30.1.2. '''For penicillin-allergic patients'''
:::::* Preferred regimen: [[Ceftriaxone]] 1 g IV q24h {{and}} ([[Azithromycin]] 500 mg PO {{or}} [[Clarithromycin]] 500 mg PO) qd for 7-10 days
:::::* Alternative regimen: [[Aztreonam]] 1 g IV q24h {{and}} [[Levofloxacin]] 750 mg IV q24h {{or}} [[Moxifloxacin]] 400 mg IV q24h
::::* 6.30.1.3. '''Empiric therapy for non-ICU hospitalized patients'''
:::::* Preferred regimen: [[Ceftriaxone]] 1 g IV q24h {{and}} ([[Azithromycin]] 500 mg PO {{or}} [[Clarithromycin]] 500 mg PO) qd
::::* 6.30.1.3. '''Empiric therapy for patients at risk of pseudomonas pneumonia'''
:::::* Preferred regimen: : [[Piperacillin-Tazobactam]] 2 g-0.25 g IV q24h {{and}} ([[Ciprofloxacin]] 400 mg IV q8–12h {{or}} [[Levofloxacin]] 750 mg IV) q24h
::::* 6.30.1.4. '''Empiric therapy for patients at risk for methicillin-resistant staphylococcus aureus pneumonia'''
:::::* Preferred regimen: [[Amoxicillin]] 500 mg PO {{and}} ([[Azithromycin]] 500 mg PO {{or}} [[Clarithromycin]] 500 mg) PO {{and}} [[Linezolid]] 600 mg (IV or PO).
:::::* Note (1): Empiric therapy with a macrolide alone is not routinely recommended, because of increasing pneumococcal resistance.
:::::* Note (2): Chemoprophylaxis can be considered for patients with frequent recurrences of serious bacterial pneumonia.

::* 6.31. '''Cryptosporidiosis'''
:::* 6.31.1. '''Treatment'''
::::* Note (1): Initiate or optimize ART for immune restoration to CD4 count >100 cells/µL. Aggressive oral or IV rehydration and replacement of electrolyte loss and symptomatic treatment of diarrhea with anti-motility agents.
::::* Preferred regimen (1): [[Nitazoxanide]] 500–1000 mg PO bid for 14 days 
::::* Preferred regimen (2): [[Paromomycin]] 500 mg PO qid for 14–21 days
::::* Note (2): With optimized anti retroviral therapy, symptomatic treatment and rehydration and electrolyte replacement is recommended. Tincture of opium may be more effective than [[Loperamide]] in management of diarrhea.

::* 6.32. '''Microsporidiosis'''
:::* 6.32.1. '''Treatment'''
::::* 6.32.1.1. '''For GI infections caused by enterocytozoon bienuesi'''
:::::* Note: Initiate or optimize anti retroviral therapy as immune restoration to CD4 count >100 cells/µL {{and}} manage severe dehydration, malnutrition, and wasting by fluid support.
:::::* Preferred therapy (1): [[Fumagillin]] 60 mg/day  PO bid
:::::* Preferred therapy (2): [[TNP-470]] PO bid
:::::* Preferred therapy (3): [[Nitazoxanide]] 1000 mg PO bid
::::* 6.32.1.2. '''For intestinal and disseminated (not ocular) infections caused by microsporidia other than E. bienuesi and vittaforma corneae'''
:::::* Preferred regimen: [[Albendazole]] 400 mg PO bid, continue until CD4 count >200 cells/µL for >6 months after initiation of anti retroviral therapy
:::::* Alternative regimen: [[Itraconazole]] 400 mg PO qd {{and}} [[Albendazole]] 400 mg PO bid
::::* 6.32.1.3. '''For ocular infection'''
:::::* Preferred regimen: Topical [[fumagillin]] bicylohexylammonium (Fumidil B) eye drops: 3 mg/mL in saline ([[fumagillin]] 70 µg/mL)—2 drops q2h for 4 days, then 2 drops qid {{and}} [[Albendazole]] 400 mg PO bid, for management of systemic infection
:::::* Note: Therapy should be continued until resolution of ocular symptoms and CD4 count increase to >200 cells/µL for >6 months in response to anti retroviral therapy.

::* 6.33. '''Progressive Multifocal Leukoencephalopathy (PML)'''
:::* Note (1): There is no specific antiviral therapy for JC virus infection. The main treatment approach is to reverse the immunosuppression caused by HIV.
:::* Note (2): Initiate anti retroviral therapy immediately in anti retroviral therapy naive patients.
:::* Note (3): Optimize anti retroviral therapy in patients who develop PML in phase of HIV viremia on anti retroviral therapy.
:::* Note (4): [[Corticosteroids]] may be used for PML-IRIS characterized by contrast enhancement, edema or mass effect, and with clinical deterioration.
==References==
{{reflist}}


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