Sandbox aparna: Difference between revisions
Jump to navigation
Jump to search
No edit summary |
No edit summary |
||
(73 intermediate revisions by the same user not shown) | |||
Line 1: | Line 1: | ||
:* | ====Bacteria – Gram-Negative Bacilli==== | ||
{{PBI|Achromobacter xylosoxidans}} | |||
{{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 doses {{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]] | |||
::* 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 | |||
::* | |||
:* | {{PBI|Aeromonas hydrophila}} | ||
::* Preferred regimen ( | :* 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> | ||
::* Preferred regimen ( | ::*1. '''Diarrhea''' | ||
::* Preferred regimen ( | :::* Preferred regimen (if not self-limiting, or if severe): [[Ciprofloxacin]] 500 mg PO bid. | ||
:* | :::* Alternate regimen: [[TMP-SMX]] 1DS PO bid | ||
::* Preferred regimen(1): [[ | :::* Note: High resistance to sulfa agents described in Taiwan and Spain | ||
::* Preferred regimen(2): [[ | ::*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. | |||
{{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> | ||
::::* Preferred regimen: | ::* 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 | ||
:::*2.2.2 ''' | ::::* Preferred regimen (2): [[Erythromycin]] 2 g/day PO qid for 14 days | ||
::::* Preferred regimen: | ::::* 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: [[ | :::::* 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(1): | :::::* 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. | |||
::::*Preferred regimen(2): [[ | {{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 | |||
:* | {{PBI|Burkholderia pseudomallei}} | ||
::* | :* Burkholderia pseudomallei | ||
:::* Preferred regimen: [[ | ::* 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: [[ | ::::* Preferred regimen (1): [[Ceftazidime]] 50 mg/kg upto 2 g q6h | ||
::* | ::::* Preferred regimen (2): [[Meropenem]] 25 mg/kg upto 1 g q8h | ||
:::* Preferred regimen: [[ | ::::* 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 | |||
:* | {{PBI|Campylobacter fetus}} | ||
<ref>{{cite book | last = | :* Campylobacter fetus<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 (2): [[ | ::* 1. '''Serious infections''' | ||
::* Preferred regimen (3): [[ | :::* Preferred regimen (1): [[Gentamicin]] 5 mg/kg IV q24h | ||
:::* Preferred regimen (2): [[Imipenem]] 1 mg IV q6h | |||
:::* Preferred regimen (3): [[Ceftriaxone]] 2 g IV q12h | |||
::* 2. '''Endovascular infections''' | |||
:::* Preferred regimen: [[Aminoglycoside]] 4-6 weeks {{and}} [[Carbapenem]] | |||
::* 3. '''CNS''' | |||
:::* preferred regimen (1): [[Ceftriaxone]] | |||
:::* preferred regimen (2): [[Chloramphenicol]] for 2-3 weeks | |||
{{PBI|Campylobacter jejuni}} | |||
:*5. ''' | {{PBI|Capnocytophaga canimorsus}} | ||
::* Preferred regimen(2): [[Ampicillin]] | :* 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> | ||
::* Alternative regimen( | ::* 1. '''Severe cellulitis/sepsis or endocarditis''' | ||
::* Alternative regimen( | :::* 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. | |||
{{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/day | |||
::* 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 | |||
{{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}} | |||
{{PBI|Enterobacter aerogenes}} | |||
:* Enterobacter 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> | |||
::* 1. '''Severe infections''' | |||
:::* Preferred regimen (1): [[Piperacillin-tazobactam]] 3.375-4.5 g IV q6h {{and}} ([[Aminoglycoside]] (gentamicin,tobramycin or amikacin) {{or}} [[Fluoroquinolone]],e.g.,ciprofloxacin 400 mg IV q8-12hrs | |||
:::* Preferred regimen (2) (for coverage of ESBLs): [[Imipenem]] 500 mg IV q6h | |||
:::* Preferred regimen (3) (for coverage of ESBLs): [[Meropenem]] 500-1000 mg IV q8h | |||
:::* Preferred regimen (4) (for coverage of ESBLs): [[Doripenem]] 500 mg IV q8h | |||
:::* Preferred regimen (5) : [[Cefepime]] 2 g IV q8h | |||
::* 2. '''UTI without systemic symptoms''' | |||
:::* Preferred regimen: [[Ciprofloxacin]] 250 mg PO bid {{or}} agent based upon susceptibility profile | |||
{{PBI|Enterobacter cloacae}} | |||
:* Enterobacter cloacae<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> | |||
{{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'''<ref name="pmid15494903">Tunkel AR, Hartman BJ, Kaplan SL, Kaufman BA, Roos KL, Scheld WM et al. (2004) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=15494903 Practice guidelines for the management of bacterial meningitis.] ''Clin Infect Dis'' 39 (9):1267-84. [http://dx.doi.org/10.1086/425368 DOI:10.1086/425368] PMID: [http://pubmed.gov/1549490315494903]</ref> | |||
:::* 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''' | |||
:::* 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''' | |||
::::* 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)''' | |||
::::* 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''' | |||
:::* Preferred regimen (1): [[Ciprofloxacin]] 750 mg PO qd for 1-3 days or other Fluoroquinolones | |||
:::* Preferred regimen (2) (pediatrics & pregnancy): [[Azithromycin]] 10 mg/kg/day single dose | |||
:::* Preferred regimen (3) (pediatrics & pregnancy): [[Ceftriaxone]] 50 mg/kg/day IV qd for 3 days | |||
:::* Note: Avoid fluoroquinolones in pediatrics and pregnancy. | |||
::*5. '''Malacoplakia''' | |||
:::* Preferred regimen (1): [[Bethanechol chloride]] {{and}} [[Ciprofloxacin]] 400 mg IV q12h | |||
:::* Preferred regimen (2): [[TMP-SMX]] 2 mg/kg (TMP component IV q6h) | |||
::*6. '''Bacteremia/pneumonia''' | |||
:::* 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. | |||
---- | |||
{{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) | |||
{{PBI|Helicobacter pylori}} | |||
:* Helicobacter pylori<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> | |||
::* 1. '''Peptic ulcer disease''' | |||
:::* 1.1 '''Regimens for Initial Treatment''' | |||
::::* 1.1.1 '''Triple therapy''' | |||
:::::* Preferred regimen: [[PPI]] (standard dose twice daily) {{and}} [[Amoxicillin]] 1 g bid {{and}} [[Clarithromycin]] 500 mg bid for 7-14 days | |||
::::* 1.1.2 '''Quadruple therapy''' | |||
:::::* Preferred regimen: [[PPI]] (standard dose twice daily) {{and}} [[Metronidazole]] 250 mg q6h {{and}} [[Tetracycline]] 500 mg q6h {{and}} [[Bismuth]] (dose depends on preparation) for 10-14 days | |||
::::* 1.1.3 '''Sequential therapy''' | |||
:::::* Preferred regimen: [[PPI]] (standard dose twice daily) {{and}} [[Amoxicillin]] 1 g bid for 1-5 days {{and}} [[Clarithromycin]] 500 mg bid {{and}} [[Tinidazole]] 500 mg bid for 6-10 days | |||
:::* 1.2 '''Second-Line Therapies''' | |||
::::* 1.2.1 '''Triple therapy''' | |||
:::::* Preferred regimen: [[PPI]] (standard dose twice daily) {{and}} [[Amoxicillin]] 1 g bid {{and}} [[Metronidazole]] 500 mg bid | |||
:::::* Alternative regimen (1) (allergy to amoxicillin): ([[PPI]] {{and}} [[Clarithromycin]] {{and}} [[Metronidazole]]) | |||
:::::* Alternative regimen (2) (allergy to amoxicillin): ([[PPI]] {{and}} [[Tetracycline]] {{and}} [[Metronidazole]]). | |||
::::* 1.2.2 '''Quadruple therapy''' | |||
:::::* Preferred regimen: [[PPI]] (standard dose twice daily) {{and}} [[Metronidazole]] 250 mg q6h {{and}} [[Tetracycline]] 500 mg q6h {{and}} [[Bismuth]] (dose depends on preparation) for 10-14 days | |||
::::* 1.2.3 '''Levofloxacin triple therapy''' | |||
:::::* Preferred regimen: [[PPI]] (standard dose twice daily) {{and}} [[Amoxicillin]] 1 g bid {{and}} [[Levofloxacin]] 500 mg bid for 10 days | |||
::::* 1.2.4 '''Rifabutin triple therapy''' | |||
:::::* Preferred regimen: [[PPI]] (standard dose twice daily) {{and}} [[Amoxicillin]] 1 g bid {{and}} [[Rifabutin]] 150-300 mg/day for 10 days | |||
---- | |||
{{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 | |||
---- | |||
{{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. | |||
---- | |||
{{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> | |||
---- | |||
{{PBI|Legionella pneumophila}} | |||
:* Legionella pneumophila<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. '''Pneumonia''' | |||
:::* Preferred regimen (1): [[Levofloxacin]] 750 mg PO/IV qd for 7-10 days | |||
:::* Preferred regimen (2): [[Moxifloxacin]] 400 mg PO/IV qd for 7-10 days | |||
:::* Preferred regimen (3): [[Azithromycin]] 500 mg PO/IV qd for 7-10 days | |||
:::* Preferred regimen (4): [[Rifampin]] 300 mg PO/IV bid {{and}} any other agents listed | |||
:::* Alternative regimen (1): [[Erythromycin]] 1 g IV q6h and {{then}} 500 mg PO q6h for 7-10 days (total) | |||
:::* Alternative regimen (2): [[Ciprofloxacin]] 400 mg IV q12h {{then}} 750 mg PO bid 7-10 days (total) | |||
::* 2. '''Pontiac fever''' | |||
:::* Preferred regimen: no antibiotic treatment, usually self limited, and usually only diagnosed by delayed serologic testing | |||
::* 3. '''Endocarditis''' | |||
:::* Preferred regimen: (Fluoroquinolones, [[Levofloxacin]] 750 mg PO/IV qd for 7-10 days {{or}} [[Moxifloxacin]] 400 mg PO/IV qd for 7-10 days) {{and}} [[Rifampin]] 300 mg PO bid for 4-6 weeks | |||
{{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 | |||
{{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 | |||
{{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 | |||
{{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 | |||
{{PBI|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 | |||
{{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. | |||
{{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)''' | |||
:::* Preferred regimen (1): [[Cephalosporin|3rd generation cephalosporin]] (Ceftriaxone/Cefotaxime) | |||
:::* Preferred regimen (2): [[Fluoroquinolone]] ([[Ciprofloxacin]], [[Levofloxacin]]) | |||
::* 1.4 '''Bacteremia''' | |||
:::* 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''' | |||
:::* Preferred regimen (1): [[Ceftriaxone]] | |||
:::* Preferred regimen (2): [[Cefotaxime]] | |||
:::* Preferred regimen (3): [[Ciprofloxacin]] 400 mg IV q12h for 6 weeks | |||
::* 1.6 '''Osteomyelitis''' | |||
:::* 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''' | |||
:::* Preferred regimen (1): [[Ceftriaxone]] 2 g IV q24h | |||
:::* Preferred regimen (2): [[Cefotaxime]] 2 g IV q6-8h for 6 weeks | |||
::* 1.8 '''Endocarditis''' | |||
:::* Preferred regimen (1): [[Ceftriaxone]] 2 g IV q24h | |||
:::* Preferred regimen (2): [[Cefotaxime]] 2 g IV q6-8h for 6 weeks | |||
::* 1.9 '''UTI''' | |||
:::*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''' | |||
:::* 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 | |||
{{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 PO 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 500 mg 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. | |||
{{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 '''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 | |||
::* 1.2 '''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 | |||
{{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-resistance): [[Colistin]] 2.5 mg/kg IV q12h | |||
::* Note: Treatment duration uncertain, but usually ≥ 14 days | |||
{{PBI|Vibrio cholerae}} | |||
{{PBI|Vibrio parahaemolyticus}} | |||
{{PBI|Vibrio vulnificus}} | |||
---- | |||
==References== | |||
{{reflist}} |
Latest revision as of 15:53, 23 July 2015
Bacteria – Gram-Negative Bacilli
- Achromobacter xylosoxidans
Return to Top
- Acinetobacter baumannii
Return to Top
- Acinetobacter baumannii[1]
- 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 doses 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 ± Imipenem)
- Preferred regimen (8) (pan-resistant isolates): Ampicillin/sulbactam
- 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
Return to Top
- Aeromonas hydrophila [2]
- 1. Diarrhea
- Preferred regimen (if not self-limiting, or if severe): Ciprofloxacin 500 mg PO bid.
- Alternate regimen: TMP-SMX 1DS 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.
- Bordetella pertussis
Return to Top
- Bordetella pertussis[3]
- 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 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 SMX 40 mg/kg/day bid for 14 days
- 2. Post exposure prophylaxis[4]
- 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
Return to Top
- Burkholderia cepacia complex[5]
- 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
Return to Top
- Burkholderia pseudomallei
- 1. Melioidosis[6]
- 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
Return to Top
- Campylobacter fetus[7]
- 1. Serious infections
- Preferred regimen (1): Gentamicin 5 mg/kg IV q24h
- Preferred regimen (2): Imipenem 1 mg IV q6h
- Preferred regimen (3): Ceftriaxone 2 g IV q12h
- 2. Endovascular infections
- Preferred regimen: Aminoglycoside 4-6 weeks AND Carbapenem
- 3. CNS
- preferred regimen (1): Ceftriaxone
- preferred regimen (2): Chloramphenicol for 2-3 weeks
- Campylobacter jejuni
Return to Top
- Capnocytophaga canimorsus
Return to Top
- Capnocytophaga canimorsus[8]
- 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
Return to Top
- Citrobacter freundii[9]
- 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/day
- 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
Return to Top
- Citrobacter koseri[10]
- 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
- Elizabethkingia meningoseptica
Return to Top
- Enterobacter aerogenes
Return to Top
- Enterobacter species[11]
- 1. Severe infections
- Preferred regimen (1): Piperacillin-tazobactam 3.375-4.5 g IV q6h AND (Aminoglycoside (gentamicin,tobramycin or amikacin) OR Fluoroquinolone,e.g.,ciprofloxacin 400 mg IV q8-12hrs
- Preferred regimen (2) (for coverage of ESBLs): Imipenem 500 mg IV q6h
- Preferred regimen (3) (for coverage of ESBLs): Meropenem 500-1000 mg IV q8h
- Preferred regimen (4) (for coverage of ESBLs): Doripenem 500 mg IV q8h
- Preferred regimen (5) : Cefepime 2 g IV q8h
- 2. UTI without systemic symptoms
- Preferred regimen: Ciprofloxacin 250 mg PO bid OR agent based upon susceptibility profile
- Enterobacter cloacae
Return to Top
- Enterobacter cloacae[12]
- Escherichia coli
Return to Top
- Escherichia coli[13]
- 1. Meningitits[14]
- 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
- 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
- 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): Oral Cephalosporins
- Alternative regimen (3): TMP-SMX 2 mg/kg IV q6h PO for 14 days
- 3.2 Acute pyelonephritis (Hospitalized)
- 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
- Preferred regimen (1): Ciprofloxacin 750 mg PO qd for 1-3 days or other Fluoroquinolones
- Preferred regimen (2) (pediatrics & pregnancy): Azithromycin 10 mg/kg/day single dose
- Preferred regimen (3) (pediatrics & pregnancy): Ceftriaxone 50 mg/kg/day IV qd for 3 days
- Note: Avoid fluoroquinolones in pediatrics and pregnancy.
- 5. Malacoplakia
- Preferred regimen (1): Bethanechol chloride AND Ciprofloxacin 400 mg IV q12h
- Preferred regimen (2): TMP-SMX 2 mg/kg (TMP component IV q6h)
- 6. Bacteremia/pneumonia
- 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
Return to Top
- Francisella tularensis[15]
- 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
Return to Top
- Helicobacter pylori[16]
- 1. Peptic ulcer disease
- 1.1 Regimens for Initial Treatment
- 1.1.1 Triple therapy
- Preferred regimen: PPI (standard dose twice daily) AND Amoxicillin 1 g bid AND Clarithromycin 500 mg bid for 7-14 days
- 1.1.2 Quadruple therapy
- Preferred regimen: PPI (standard dose twice daily) AND Metronidazole 250 mg q6h AND Tetracycline 500 mg q6h AND Bismuth (dose depends on preparation) for 10-14 days
- 1.1.3 Sequential therapy
- Preferred regimen: PPI (standard dose twice daily) AND Amoxicillin 1 g bid for 1-5 days AND Clarithromycin 500 mg bid AND Tinidazole 500 mg bid for 6-10 days
- 1.2 Second-Line Therapies
- 1.2.1 Triple therapy
- Preferred regimen: PPI (standard dose twice daily) AND Amoxicillin 1 g bid AND Metronidazole 500 mg bid
- Alternative regimen (1) (allergy to amoxicillin): (PPI AND Clarithromycin AND Metronidazole)
- Alternative regimen (2) (allergy to amoxicillin): (PPI AND Tetracycline AND Metronidazole).
- 1.2.2 Quadruple therapy
- Preferred regimen: PPI (standard dose twice daily) AND Metronidazole 250 mg q6h AND Tetracycline 500 mg q6h AND Bismuth (dose depends on preparation) for 10-14 days
- 1.2.3 Levofloxacin triple therapy
- Preferred regimen: PPI (standard dose twice daily) AND Amoxicillin 1 g bid AND Levofloxacin 500 mg bid for 10 days
- 1.2.4 Rifabutin triple therapy
- Preferred regimen: PPI (standard dose twice daily) AND Amoxicillin 1 g bid AND Rifabutin 150-300 mg/day for 10 days
- Klebsiella granulomatis
Return to Top
- Klebsiella granulomatis (formly known as Calymmatobacterium granulomatis)
- 1. Granuloma inguinale (donovanosis)[17]
- 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
Return to Top
- Klebsiella pneumoniae[18]
- 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
Return to Top
-
- 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.[22]
- Legionella pneumophila
Return to Top
- Legionella pneumophila[23]
- 1. Pneumonia
- Preferred regimen (1): Levofloxacin 750 mg PO/IV qd for 7-10 days
- Preferred regimen (2): Moxifloxacin 400 mg PO/IV qd for 7-10 days
- Preferred regimen (3): Azithromycin 500 mg PO/IV qd for 7-10 days
- Preferred regimen (4): Rifampin 300 mg PO/IV bid AND any other agents listed
- Alternative regimen (1): Erythromycin 1 g IV q6h and THEN 500 mg PO q6h for 7-10 days (total)
- Alternative regimen (2): Ciprofloxacin 400 mg IV q12h THEN 750 mg PO bid 7-10 days (total)
- 2. Pontiac fever
- Preferred regimen: no antibiotic treatment, usually self limited, and usually only diagnosed by delayed serologic testing
- 3. Endocarditis
- Preferred regimen: (Fluoroquinolones, Levofloxacin 750 mg PO/IV qd for 7-10 days OR Moxifloxacin 400 mg PO/IV qd for 7-10 days) AND Rifampin 300 mg PO bid for 4-6 weeks
- Moraxella catarrhalis
Return to Top
- Moraxella catarrhalis[24]
- 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
Return to Top
- Morganella morganii[25]
- 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
Return to Top
- Plesiomonas shigelloides[26]
- 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
Return to Top
- Proteus mirabilis[27]
- 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
Return to Top
- Indole positive Proteus species[28]
- 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
Return to Top
- Providencia[29]
- 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
Return to Top
- Pseudomonas aeruginosa[30]
- 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
- Salmonella
Return to Top
- 1. Salmonellosis in immunocompetent hosts[31]
- 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[32]
- 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)
- Preferred regimen (1): 3rd generation cephalosporin (Ceftriaxone/Cefotaxime)
- Preferred regimen (2): Fluoroquinolone (Ciprofloxacin, Levofloxacin)
- 1.4 Bacteremia
- 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
- Preferred regimen (1): Ceftriaxone
- Preferred regimen (2): Cefotaxime
- Preferred regimen (3): Ciprofloxacin 400 mg IV q12h for 6 weeks
- 1.6 Osteomyelitis
- 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
- Preferred regimen (1): Ceftriaxone 2 g IV q24h
- Preferred regimen (2): Cefotaxime 2 g IV q6-8h for 6 weeks
- 1.8 Endocarditis
- Preferred regimen (1): Ceftriaxone 2 g IV q24h
- Preferred regimen (2): Cefotaxime 2 g IV q6-8h for 6 weeks
- 1.9 UTI
- Preferred regimen (1): Ceftriaxone
- Preferred regimen (2): Cefotaxime
- Preferred regimen (3): Ciprofloxacin IV for 1-2 weeks THEN (oral Ciprofloxacin OR TMP-SMX for 6 weeks)
- 1.10 Carrier state
- 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[33]
- 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 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
Return to Top
- Serratia marcescens[34]
- 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 PO 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 500 mg 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
Return to Top
- 1. Shigellosis [35]
- 1.1 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
- 1.2 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
- Stenotrophomonas maltophilia
Return to Top
- Stenotrophomonas maltophilia[36]
- 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-resistance): Colistin 2.5 mg/kg IV q12h
- Note: Treatment duration uncertain, but usually ≥ 14 days
- Vibrio cholerae
Return to Top
- Vibrio parahaemolyticus
Return to Top
- Vibrio vulnificus
Return to Top
References
- ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
- ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
- ↑ "Recommended Antimicrobial Agents for the Treatment and Postexposure Prophylaxis of Pertussis 2005 CDC Guidelines".
- ↑ "Recommended Antimicrobial Agents for the Treatment and Post exposure Prophylaxis of Pertussis 2005 CDC Guidelines".
- ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
- ↑ Wiersinga WJ, Currie BJ, Peacock SJ (2012). "Melioidosis". N. Engl. J. Med. 367 (11): 1035–44. doi:10.1056/NEJMra1204699. PMID 22970946.
- ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
- ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
- ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
- ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
- ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
- ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
- ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
- ↑ Tunkel AR, Hartman BJ, Kaplan SL, Kaufman BA, Roos KL, Scheld WM et al. (2004) Practice guidelines for the management of bacterial meningitis. Clin Infect Dis 39 (9):1267-84. DOI:10.1086/425368 PMID: [1]
- ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
- ↑ Lua error: expandTemplate: template "citation error" does not exist.
- ↑ Workowski, Kimberly A.; Bolan, Gail A. (2015-06-05). "Sexually transmitted diseases treatment guidelines, 2015". MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control. 64 (RR-03): 1–137. ISSN 1545-8601. PMID 26042815.
- ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
- ↑ Mukara, B. K.; Munyarugamba, P.; Dazert, S.; Löhler, J. (2014-07). "Rhinoscleroma: a case series report and review of the literature". 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. 271 (7): 1851–1856. doi:10.1007/s00405-013-2649-z. ISSN 1434-4726. PMID 23904142. Check date values in:
|date=
(help) - ↑ de Pontual, Loïc; Ovetchkine, Philippe; Rodriguez, Diana; Grant, Audrey; Puel, Anne; Bustamante, Jacinta; Plancoulaine, Sabine; Yona, Laurent; Lienhart, Pierre-Yves; Dehesdin, Danièle; Huerre, Michel; Tournebize, Régis; Sansonetti, Philippe; Abel, Laurent; Casanova, Jean Laurent (2008-12-01). "Rhinoscleroma: a French national retrospective study of epidemiological and clinical features". Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. 47 (11): 1396–1402. doi:10.1086/592966. ISSN 1537-6591. PMID 18947330.
- ↑ Gaafar, Hazem A.; Gaafar, Alaa H.; Nour, Yasser A. (2011-04). "Rhinoscleroma: an updated experience through the last 10 years". Acta Oto-Laryngologica. 131 (4): 440–446. doi:10.3109/00016489.2010.539264. ISSN 1651-2251. PMID 21198342. Check date values in:
|date=
(help) - ↑ Mukara, B. K.; Munyarugamba, P.; Dazert, S.; Löhler, J. (2014-07). "Rhinoscleroma: a case series report and review of the literature". 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. 271 (7): 1851–1856. doi:10.1007/s00405-013-2649-z. ISSN 1434-4726. PMID 23904142. Check date values in:
|date=
(help) - ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
- ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
- ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
- ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
- ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
- ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
- ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
- ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
- ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
- ↑ "TYPHOID FEVER".
- ↑ "Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents" (PDF).
- ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
- ↑ "Guidelines for the control of shigellosis, including epidemics due to Shigella dysenteriae type 1" (PDF).
- ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.