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::* '''Prevotella melaninogenica''' | ::* '''Prevotella melaninogenica''' | ||
:::* Preferred regimen: [[Metronidazole]] 30 mg/kg/day q6h | :::* Preferred regimen: [[Metronidazole]] 30 mg/kg/day q6h | ||
:::* Alternative regimen: [[Clindamycin]] 2400–4800 mg/day IV q6h {{or}} [[Meropenem]] 2 g IV q8h | |||
::* '''Pseudomonas aeruginosa''' | ::* '''Pseudomonas aeruginosa''' | ||
:::* Preferred regimen: [[Ceftazidime]] 6 g/day q8h {{or}} [[Cefepime]] 6 g/day q8h | :::* Preferred regimen: [[Ceftazidime]] 6 g/day q8h {{or}} [[Cefepime]] 6 g/day q8h | ||
:::* Alternative regimen: [[Aztreonam]] 6–8 g/day IV q6–8h {{or}} [[Ciprofloxacin]] 800–1200 mg/day IV q8–12h {{or}} [[Meropenem]] 2 g IV q8h | |||
::* '''Staphylococcus aureus, methicillin-susceptible''' | ::* '''Staphylococcus aureus, methicillin-susceptible''' | ||
:::* Preferred regimen: [[Nafcillin]] 2 g IV q4h {{or}} [[Oxacillin]] 2 g IV q4h | :::* Preferred regimen: [[Nafcillin]] 2 g IV q4h {{or}} [[Oxacillin]] 2 g IV q4h | ||
:::* Alternative regimen: [[Vancomycin]] 30–45 mg/kg/day IV q8–12h | |||
::* '''Staphylococcus aureus, methicillin-resistant''' | ::* '''Staphylococcus aureus, methicillin-resistant''' | ||
:::* Preferred regimen: [[Vancomycin]] 30–45 mg/kg/day IV q8–12h | :::* Preferred regimen: [[Vancomycin]] 30–45 mg/kg/day IV q8–12h | ||
:::* Alternative regimen: [[TMP-SMZ]] 10–20 mg/kg/day q6–12h | |||
::* '''Streptococcus | ::* '''Streptococcus''' | ||
:::* Preferred regimen: [[Penicillin G]] 4 MU IV q4h {{or}} [[Ampicillin]] 2 g IV q4h | :::* Preferred regimen: [[Penicillin G]] 4 MU IV q4h {{or}} [[Ampicillin]] 2 g IV q4h | ||
:::* Alternative regimen: [[Cefotaxime]] 2 g IV q4-6h {{or}} [[Ceftriaxone]] 2 g IV q12h {{or}} [[Vancomycin]] 30–45 mg/kg/day IV q8–12h | |||
:::* | |||
:* Fungi | :* Fungi | ||
::* '''Aspergillus''' | ::* '''Aspergillus''' | ||
:::* Preferred regimen: [[Voriconazole]] 8 mg/kg/day q12h | :::* Preferred regimen: [[Voriconazole]] 8 mg/kg/day q12h | ||
:::* Alternative regimen: [[Amphotericin B]] deoxycholate 0.6–1.0 mg/kg/day IV q24h {{or}} [[Amphotericin B]] lipid complex 5 mg/kg/day IV q24h {{or}} [[Itraconazole]] 400–600 mg/day IV q12h {{or}} [[Posaconazole]] 800 mg/kg/day IV q6–12h | |||
::* '''Candida''' | ::* '''Candida''' | ||
:::* Preferred regimen: [[Amphotericin B]] lipid complex 5 mg/kd/day q24h {{or}} [[Amphotericin B]] deoxycholate 15 mg/kg/day q8h | :::* Preferred regimen: [[Amphotericin B]] lipid complex 5 mg/kd/day q24h {{or}} [[Amphotericin B]] deoxycholate 15 mg/kg/day q8h | ||
:::* Alternative regimen: [[Fluconazole]] 400–800 mg/day IV q24h | |||
::* '''Cryptococcus neoformans''' | ::* '''Cryptococcus neoformans''' | ||
:::* Preferred regimen: [[Amphotericin B]] lipid complex 5 mg/kd/day q24h {{or}} [[Amphotericin B]] deoxycholate 15 mg/kg/day q8h | :::* Preferred regimen: [[Amphotericin B]] lipid complex 5 mg/kd/day q24h {{or}} [[Amphotericin B]] deoxycholate 15 mg/kg/day q8h | ||
:::* Alternative regimen: [[Fluconazole]] 400–800 mg/day IV q24h | |||
::* '''Mucorales''' | ::* '''Mucorales''' | ||
:::* Preferred regimen: [[Amphotericin B]] lipid complex 5 mg/kd/day q24h {{or}} [[Amphotericin B]] deoxycholate 15 mg/kg/day q8h | :::* Preferred regimen: [[Amphotericin B]] lipid complex 5 mg/kd/day q24h {{or}} [[Amphotericin B]] deoxycholate 15 mg/kg/day q8h | ||
:::* Alternative regimen: [[Posaconazole]] 800 mg/kg/day IV q6–12h | |||
::* '''Pseudallescheria boydii (Scedosporium apiospermum)''' | ::* '''Pseudallescheria boydii (Scedosporium apiospermum)''' | ||
:::* Preferred regimen: [[Voriconazole]] 8 mg/kg/day q12h | :::* Preferred regimen: [[Voriconazole]] 8 mg/kg/day q12h | ||
:::* Alternative regimen: [[Itraconazole]] 400–600 mg/day IV q12h {{or}} [[Posaconazole]] 800 mg/kg/day IV q6–12h | |||
:* Protozoa | :* Protozoa | ||
::* '''Toxoplasma gondii''' | ::* '''Toxoplasma gondii''' | ||
:::* Preferred regimen: [[Sulfadiazine]] 4–6 g/day q6h {{and}} [[Pyrimethamine]] 25–100 mg/day qd | :::* Preferred regimen: [[Sulfadiazine]] 4–6 g/day q6h {{and}} [[Pyrimethamine]] 25–100 mg/day qd | ||
:::* Alternative regimen (1): [[Pyrimethamine]] 25–100 mg/day qd {{and}} [[Clindamycin]] 2400–4800 mg/day IV q6h | |||
:::* Alternative regimen (2): [[Pyrimethamine]] 25–100 mg/day qd {{and}} ([[Azithromycin]] 1200–1500 mg/day IV q24h {{or}} [[Atovaquone]] 750 mg IV q6h {{or}} [[Dapsone]] 100 mg PO q24h) | |||
:::* Alternative regimen (3): [[TMP-SMZ]] 10–20 mg/kg/day q6–12h | |||
==References== | ==References== | ||
{{reflist}} | {{reflist}} | ||
Latest revision as of 07:08, 5 June 2015
Brain abscess
- Empiric antimicrobial therapy[1]
- Brain abscess in otherwise healthy patients
- Preferred regimen: (Cefotaxime 8–12 g/day IV q4–6h OR Ceftriaxone 4 g/day IV q12h) AND Metronidazole 30 mg/kg/day IV q6h
- Alternative regimen: Meropenem 6 g/day IV q8h
- Brain abscess with comorbidities
- Otitis media, mastoiditis, or sinusitis
- Preferred regimen: (Cefotaxime 8–12 g/day q4–6h OR Ceftriaxone 4 g/day q12h) AND Metronidazole 30 mg/kg/day q6h
- Dental infection
- Preferred regimen: Penicillin G 4 MU IV q4h AND Metronidazole 30 mg/kg/day q6h
- Penetrating trauma or post-neurosurgy
- Preferred regimen: (Cefotaxime 8–12 g/day q4–6h OR Ceftriaxone 4 g/day q12h OR Cefepime 2 g IV q12h) AND Vancomycin 30–45 mg/kg/day q8–12h
- Lung abscess, empyema, or bronchiectasis
- Preferred regimen: Penicillin G 4 MU IV q4h AND Metronidazole 30 mg/kg/day q6h AND TMP-SMZ 10–20 mg/kg/day q6–12h
- Bacterial endocarditis
- Preferred regimen: Vancomycin 30–45 mg/kg/day q8–12h AND Gentamicin 5 mg/kg/day IV q8h
- Congenital heart disease
- Preferred regimen: Cefotaxime 8–12 g/day q4–6h OR Ceftriaxone 4 g/day q12h
- Transplant recipients
- Preferred regimen: (Cefotaxime 8–12 g/day q4–6h OR Ceftriaxone 4 g/day q12h) AND Metronidazole 30 mg/kg/day q6h AND Voriconazole 8 mg/kg/day q12h AND (TMP-SMZ 10–20 mg/kg/day q6–12h OR Sulfadiazine 4–6 g/day q6h)
- Patients with HIV/AIDS
- Preferred regimen: (Cefotaxime 8–12 g/day q4–6h OR Ceftriaxone 4 g/day q12h) AND Sulfadiazine 4–6 g/day q6h AND Pyrimethamine 25–100 mg/day qd
- Staphylococcus aureus coverage
- Preferred regimen: Vancomycin 30–45 mg/kg/day q8–12h
- Mycobacterium tuberculosis coverage
- Preferred regimen: Isoniazid 300 mg qd AND Rifampin 600 mg qd AND Pyrazinamide 15–30 mg qd AND Ethambutol 15 mg/kg/day qd
- Pathogen-directed antimicrobial therapy[2]
- Bacteria
- Actinomyces
- Preferred regimen: Penicillin G 4 MU IV q4h
- Alternative regimen: Clindamycin 2400–4800 mg/day IV q6h
- Bacteroides fragilis
- Preferred regimen: Metronidazole 30 mg/kg/day IV q6h
- Alternative regimen: Clindamycin 2400–4800 mg/day IV q6h
- Enterobacteriaceae
- Preferred regimen: Cefotaxime 2 g IV q4-6h OR Ceftriaxone 2 g IV q12h OR Cefepime 2 g IV q12h
- Alternative regimen: Aztreonam 6–8 g/day IV q6–8h OR TMP-SMZ 10–20 mg/kg/day q6–12h OR Ciprofloxacin 800–1200 mg/day IV q8–12h OR Meropenem 2 g IV q8h
- Fusobacterium
- Preferred regimen: Metronidazole 30 mg/kg/day q6h
- Alternative regimen: Clindamycin 2400–4800 mg/day IV q6h OR Meropenem 2 g IV q8h
- Haemophilus
- Preferred regimen: Cefotaxime 2 g IV q4-6h OR Ceftriaxone 2 g IV q12h OR Cefepime 2 g IV q12h
- Alternative regimen: Aztreonam 6–8 g/day IV q6–8h OR TMP-SMZ 10–20 mg/kg/day q6–12h
- Listeria monocytogenes
- Preferred regimen: Ampicillin 12 g/day q4h OR Penicillin G 4 MU IV q4h
- Alternative regimen: TMP-SMZ 10–20 mg/kg/day q6–12h
- Nocardia
- Preferred regimen: TMP-SMZ 10–20 mg/kg/day q6–12h OR Sulfadiazine 4–6 g/day q6h
- Alternative regimen: Meropenem 2 g IV q8h OR Cefotaxime 2 g IV q4-6h OR Ceftriaxone 2 g IV q12h OR Amikacin 15 mg/kg/day IV q8h
- Prevotella melaninogenica
- Preferred regimen: Metronidazole 30 mg/kg/day q6h
- Alternative regimen: Clindamycin 2400–4800 mg/day IV q6h OR Meropenem 2 g IV q8h
- Pseudomonas aeruginosa
- Preferred regimen: Ceftazidime 6 g/day q8h OR Cefepime 6 g/day q8h
- Alternative regimen: Aztreonam 6–8 g/day IV q6–8h OR Ciprofloxacin 800–1200 mg/day IV q8–12h OR Meropenem 2 g IV q8h
- Staphylococcus aureus, methicillin-susceptible
- Preferred regimen: Nafcillin 2 g IV q4h OR Oxacillin 2 g IV q4h
- Alternative regimen: Vancomycin 30–45 mg/kg/day IV q8–12h
- Staphylococcus aureus, methicillin-resistant
- Preferred regimen: Vancomycin 30–45 mg/kg/day IV q8–12h
- Alternative regimen: TMP-SMZ 10–20 mg/kg/day q6–12h
- Streptococcus
- Preferred regimen: Penicillin G 4 MU IV q4h OR Ampicillin 2 g IV q4h
- Alternative regimen: Cefotaxime 2 g IV q4-6h OR Ceftriaxone 2 g IV q12h OR Vancomycin 30–45 mg/kg/day IV q8–12h
- Fungi
- Aspergillus
- Preferred regimen: Voriconazole 8 mg/kg/day q12h
- Alternative regimen: Amphotericin B deoxycholate 0.6–1.0 mg/kg/day IV q24h OR Amphotericin B lipid complex 5 mg/kg/day IV q24h OR Itraconazole 400–600 mg/day IV q12h OR Posaconazole 800 mg/kg/day IV q6–12h
- Candida
- Preferred regimen: Amphotericin B lipid complex 5 mg/kd/day q24h OR Amphotericin B deoxycholate 15 mg/kg/day q8h
- Alternative regimen: Fluconazole 400–800 mg/day IV q24h
- Cryptococcus neoformans
- Preferred regimen: Amphotericin B lipid complex 5 mg/kd/day q24h OR Amphotericin B deoxycholate 15 mg/kg/day q8h
- Alternative regimen: Fluconazole 400–800 mg/day IV q24h
- Mucorales
- Preferred regimen: Amphotericin B lipid complex 5 mg/kd/day q24h OR Amphotericin B deoxycholate 15 mg/kg/day q8h
- Alternative regimen: Posaconazole 800 mg/kg/day IV q6–12h
- Pseudallescheria boydii (Scedosporium apiospermum)
- Preferred regimen: Voriconazole 8 mg/kg/day q12h
- Alternative regimen: Itraconazole 400–600 mg/day IV q12h OR Posaconazole 800 mg/kg/day IV q6–12h
- Protozoa
- Toxoplasma gondii
- Preferred regimen: Sulfadiazine 4–6 g/day q6h AND Pyrimethamine 25–100 mg/day qd
- Alternative regimen (1): Pyrimethamine 25–100 mg/day qd AND Clindamycin 2400–4800 mg/day IV q6h
- Alternative regimen (2): Pyrimethamine 25–100 mg/day qd AND (Azithromycin 1200–1500 mg/day IV q24h OR Atovaquone 750 mg IV q6h OR Dapsone 100 mg PO q24h)
- Alternative regimen (3): TMP-SMZ 10–20 mg/kg/day q6–12h
References
- ↑ Bennett, John (2015). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Elsevier/Saunders. ISBN 978-1455748013.
- ↑ Bennett, John (2015). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Elsevier/Saunders. ISBN 978-1455748013.