Sandbox g28: Difference between revisions
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:::* Anaerobic Gram-positive cocci (Veillonella, Peptostreptococcus, others) | :::* Anaerobic Gram-positive cocci (Veillonella, Peptostreptococcus, others) | ||
:::* Anaerobic Gram-negative bacilli (Bacteroides, Fusobacterium, Prevotella) | :::* Anaerobic Gram-negative bacilli (Bacteroides, Fusobacterium, Prevotella) | ||
:* Empiric antimicrobial therapy | |||
:::: Note (1): The choice of antimicrobial agent should be based on Gram stain results and the likely causative microorganisms. | |||
:::: Note (2): Metronidazole is recommended if anaerobes are suspected. Metronidazole is not necessary for antianaerobic activity if meropenem is used. | |||
:::: Note (3): For coverage of aerobic Gram-negative bacilli, empiric therapy with Cefepime, Ceftazidime, or Meropenem is appropriate. | |||
:::: Note (4): Depending on the clinical response, parenteral antimicrobial therapy should be administered for 3 to 4 weeks after drainage. Parenteral or oral therapy is frequently continued for up to a total of 6 weeks of therapy. | |||
:::: Note (5): A longer course of treatment (minimum of 6–8 weeks) may be required if the patient has accompanying osteomyelitis. | |||
:::: Note (6): Consider adjunctive medications including prophylactic anticonvulsants, corticosteroids, and mannitol if clinically indicated. | |||
<!--HPIM Bacterial Meningitis--><!-- | |||
:* Empiric antimicrobial therapy | :* Empiric antimicrobial therapy | ||
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::* '''Impaired cell-mediated immunity or hospital-acquired, post-neurosurgery, or post-traumatic meningitis (adult)''' | ::* '''Impaired cell-mediated immunity or hospital-acquired, post-neurosurgery, or post-traumatic meningitis (adult)''' | ||
:::* Preferred regimen: [[Ampicillin]] 12 g/day IV q4h {{and}} [[Vancomycin]] 2 g/day IV q12h {{and}} ([[Ceftazidime]] 6 g/day IV q8h {{or}} [[Meropenem]] 3 g/day IV q8h) | :::* Preferred regimen: [[Ampicillin]] 12 g/day IV q4h {{and}} [[Vancomycin]] 2 g/day IV q12h {{and}} ([[Ceftazidime]] 6 g/day IV q8h {{or}} [[Meropenem]] 3 g/day IV q8h) | ||
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Revision as of 03:53, 8 June 2015
Subdural empyema ⇧ Return to Top ⇧
- Subdural empyema[1]
- Causative pathogens
- More common
- Streptococcus milleri
- Other streptococci and enterococci
- Aerobic Gram-negative bacilli (Haemophilus influenzae, Proteus, Escherichia coli, Pseudomonas, Klebsiella, Acinetobacter, Salmonella, Morganella, Eikenella)
- No growth
- Less common
- Streptococcus pneumoniae
- Staphylococcus aureus, coagulase-negative staphylococci
- Anaerobic Gram-positive cocci (Veillonella, Peptostreptococcus, others)
- Anaerobic Gram-negative bacilli (Bacteroides, Fusobacterium, Prevotella)
- Empiric antimicrobial therapy
- Note (1): The choice of antimicrobial agent should be based on Gram stain results and the likely causative microorganisms.
- Note (2): Metronidazole is recommended if anaerobes are suspected. Metronidazole is not necessary for antianaerobic activity if meropenem is used.
- Note (3): For coverage of aerobic Gram-negative bacilli, empiric therapy with Cefepime, Ceftazidime, or Meropenem is appropriate.
- Note (4): Depending on the clinical response, parenteral antimicrobial therapy should be administered for 3 to 4 weeks after drainage. Parenteral or oral therapy is frequently continued for up to a total of 6 weeks of therapy.
- Note (5): A longer course of treatment (minimum of 6–8 weeks) may be required if the patient has accompanying osteomyelitis.
- Note (6): Consider adjunctive medications including prophylactic anticonvulsants, corticosteroids, and mannitol if clinically indicated.