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* '''Empiric antimicrobial therapy'''<ref>{{Cite journal| doi = 10.1086/425368| issn = 1537-6591| volume = 39| issue = 9| pages = 1267–1284| last1 = Tunkel| first1 = Allan R.| last2 = Hartman| first2 = Barry J.| last3 = Kaplan| first3 = Sheldon L.| last4 = Kaufman| first4 = Bruce A.| last5 = Roos| first5 = Karen L.| last6 = Scheld| first6 = W. Michael| last7 = Whitley| first7 = Richard J.| title = Practice guidelines for the management of bacterial meningitis| journal = Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America| date = 2004-11-01| pmid = 15494903}}</ref><ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref> | *1. '''Empiric antimicrobial therapy'''<ref>{{Cite journal| doi = 10.1086/425368| issn = 1537-6591| volume = 39| issue = 9| pages = 1267–1284| last1 = Tunkel| first1 = Allan R.| last2 = Hartman| first2 = Barry J.| last3 = Kaplan| first3 = Sheldon L.| last4 = Kaufman| first4 = Bruce A.| last5 = Roos| first5 = Karen L.| last6 = Scheld| first6 = W. Michael| last7 = Whitley| first7 = Richard J.| title = Practice guidelines for the management of bacterial meningitis| journal = Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America| date = 2004-11-01| pmid = 15494903}}</ref><ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref> | ||
:* Preferred regimen: [[Vancomycin]] 30–45 mg/kg/day IV q8–12h {{and}} ([[Cefepime]] 2 g IV q8h {{or}} [[Ceftazidime]] 2 g IV q8h {{or}} [[Meropenem]] 2 g IV q8h) | :* Preferred regimen: [[Vancomycin]] 30–45 mg/kg/day IV q8–12h {{and}} ([[Cefepime]] 2 g IV q8h {{or}} [[Ceftazidime]] 2 g IV q8h {{or}} [[Meropenem]] 2 g IV q8h) | ||
* Pathogen-directed antimicrobial therapy<ref>{{Cite journal| doi = 10.1086/425368| issn = 1537-6591| volume = 39| issue = 9| pages = 1267–1284| last1 = Tunkel| first1 = Allan R.| last2 = Hartman| first2 = Barry J.| last3 = Kaplan| first3 = Sheldon L.| last4 = Kaufman| first4 = Bruce A.| last5 = Roos| first5 = Karen L.| last6 = Scheld| first6 = W. Michael| last7 = Whitley| first7 = Richard J.| title = Practice guidelines for the management of bacterial meningitis| journal = Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America| date = 2004-11-01| pmid = 15494903}}</ref><ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref> | *2. Pathogen-directed antimicrobial therapy<ref>{{Cite journal| doi = 10.1086/425368| issn = 1537-6591| volume = 39| issue = 9| pages = 1267–1284| last1 = Tunkel| first1 = Allan R.| last2 = Hartman| first2 = Barry J.| last3 = Kaplan| first3 = Sheldon L.| last4 = Kaufman| first4 = Bruce A.| last5 = Roos| first5 = Karen L.| last6 = Scheld| first6 = W. Michael| last7 = Whitley| first7 = Richard J.| title = Practice guidelines for the management of bacterial meningitis| journal = Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America| date = 2004-11-01| pmid = 15494903}}</ref><ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref> | ||
:* '''Enterococcus''' | :*2.1 '''Enterococcus''' | ||
::* Preferred regimen: ([[Penicillin G]] 4 MU IV q4h {{or}} [[Ampicillin]] 2 g IV q4h) {{and}} [[Gentamicin]] 1–1.7 mg/kg IV q8h | ::* Preferred regimen: ([[Penicillin G]] 4 MU IV q4h {{or}} [[Ampicillin]] 2 g IV q4h) {{and}} [[Gentamicin]] 1–1.7 mg/kg IV q8h | ||
:* '''Gram-negative bacilli''' | :*2.2 '''Gram-negative bacilli''' | ||
::* Preferred regimen: [[Ceftriaxone]] 2 g IV q12h {{or}} [[Cefepime]] 2 g IV q12h {{or}} [[Meropenem]] 2 g IV q8h {{or}} [[Aztreonam]] 2 g IV q6h | ::* Preferred regimen: [[Ceftriaxone]] 2 g IV q12h {{or}} [[Cefepime]] 2 g IV q12h {{or}} [[Meropenem]] 2 g IV q8h {{or}} [[Aztreonam]] 2 g IV q6h | ||
:* '''Propionibacterium acnes''' | :*2.3 '''Propionibacterium acnes''' | ||
::* Preferred regimen: ([[Penicillin G]] 4 MU IV q4h {{or}} [[Ampicillin]] 2 g IV q4h) {{withorwithout}} [[Gentamicin]] 1–1.7 mg/kg IV q8h | ::* Preferred regimen: ([[Penicillin G]] 4 MU IV q4h {{or}} [[Ampicillin]] 2 g IV q4h) {{withorwithout}} [[Gentamicin]] 1–1.7 mg/kg IV q8h | ||
:* '''Staphylococcus, coagulase-negative''' | :*2.4 '''Staphylococcus, coagulase-negative''' | ||
::* Preferred regimen: [[Vancomycin]] 30–45 mg/kg/day IV q8–12h {{withorwithout}} [[Rifampin]] 600 mg IV/PO q24h | ::* Preferred regimen: [[Vancomycin]] 30–45 mg/kg/day IV q8–12h {{withorwithout}} [[Rifampin]] 600 mg IV/PO q24h | ||
:* '''Staphylococcus aureus, methicillin-resistant (MRSA)''' | :*2.5 '''Staphylococcus aureus, methicillin-resistant (MRSA)''' | ||
::* Preferred regimen: [[Vancomycin]] 30–45 mg/kg/day IV q8–12h {{withorwithout}} [[Rifampin]] 600 mg IV/PO q24h | ::* Preferred regimen: [[Vancomycin]] 30–45 mg/kg/day IV q8–12h {{withorwithout}} [[Rifampin]] 600 mg IV/PO q24h | ||
::: Note: Shunt removal is recommended, and it should not be replaced until cerebrospinal fluid cultures are repeatedly negative. | ::: Note: Shunt removal is recommended, and it should not be replaced until cerebrospinal fluid cultures are repeatedly negative. | ||
:* '''Staphylococcus aureus, methicillin-susceptible (MSSA)''' | :*2.6 '''Staphylococcus aureus, methicillin-susceptible (MSSA)''' | ||
::* Preferred regimen: ([[Nafcillin]] 2 g IV q4h {{or}} [[Oxacillin]] 2 g IV q4h) {{withorwithout}} [[Rifampin]] 600 mg IV/PO q24h | ::* Preferred regimen: ([[Nafcillin]] 2 g IV q4h {{or}} [[Oxacillin]] 2 g IV q4h) {{withorwithout}} [[Rifampin]] 600 mg IV/PO q24h | ||
:* '''Streptococcus agalactiae''' | :*2.7 '''Streptococcus agalactiae''' | ||
::* Preferred regimen: ([[Penicillin G]] 4 MU IV q4h {{or}} [[Ampicillin]] 2 g IV q4h) {{and}} [[Gentamicin]] 1–1.7 mg/kg IV q8h | ::* Preferred regimen: ([[Penicillin G]] 4 MU IV q4h {{or}} [[Ampicillin]] 2 g IV q4h) {{and}} [[Gentamicin]] 1–1.7 mg/kg IV q8h | ||
:* '''Fungi''' | :*2.8 '''Fungi''' | ||
::* Preferred regimen: [[Amphotericin B]] 0.6–1.0 mg/kg IV q24h {{or}} [[Amphotericin B]] liposomal 5 mg/kg/day IV q24h | ::* Preferred regimen: [[Amphotericin B]] 0.6–1.0 mg/kg IV q24h {{or}} [[Amphotericin B]] liposomal 5 mg/kg/day IV q24h | ||
Latest revision as of 12:50, 29 July 2015
- Preferred regimen: Vancomycin 30–45 mg/kg/day IV q8–12h AND (Cefepime 2 g IV q8h OR Ceftazidime 2 g IV q8h OR Meropenem 2 g IV q8h)
- 2.1 Enterococcus
- Preferred regimen: (Penicillin G 4 MU IV q4h OR Ampicillin 2 g IV q4h) AND Gentamicin 1–1.7 mg/kg IV q8h
- 2.2 Gram-negative bacilli
- Preferred regimen: Ceftriaxone 2 g IV q12h OR Cefepime 2 g IV q12h OR Meropenem 2 g IV q8h OR Aztreonam 2 g IV q6h
- 2.3 Propionibacterium acnes
- Preferred regimen: (Penicillin G 4 MU IV q4h OR Ampicillin 2 g IV q4h) ± Gentamicin 1–1.7 mg/kg IV q8h
- 2.4 Staphylococcus, coagulase-negative
- Preferred regimen: Vancomycin 30–45 mg/kg/day IV q8–12h ± Rifampin 600 mg IV/PO q24h
- 2.5 Staphylococcus aureus, methicillin-resistant (MRSA)
- Preferred regimen: Vancomycin 30–45 mg/kg/day IV q8–12h ± Rifampin 600 mg IV/PO q24h
- Note: Shunt removal is recommended, and it should not be replaced until cerebrospinal fluid cultures are repeatedly negative.
- 2.6 Staphylococcus aureus, methicillin-susceptible (MSSA)
- 2.7 Streptococcus agalactiae
- Preferred regimen: (Penicillin G 4 MU IV q4h OR Ampicillin 2 g IV q4h) AND Gentamicin 1–1.7 mg/kg IV q8h
- 2.8 Fungi
- Preferred regimen: Amphotericin B 0.6–1.0 mg/kg IV q24h OR Amphotericin B liposomal 5 mg/kg/day IV q24h
- ↑ Tunkel, Allan R.; Hartman, Barry J.; Kaplan, Sheldon L.; Kaufman, Bruce A.; Roos, Karen L.; Scheld, W. Michael; Whitley, Richard J. (2004-11-01). "Practice guidelines for the management of bacterial meningitis". Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. 39 (9): 1267–1284. doi:10.1086/425368. ISSN 1537-6591. PMID 15494903.
- ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
- ↑ Tunkel, Allan R.; Hartman, Barry J.; Kaplan, Sheldon L.; Kaufman, Bruce A.; Roos, Karen L.; Scheld, W. Michael; Whitley, Richard J. (2004-11-01). "Practice guidelines for the management of bacterial meningitis". Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. 39 (9): 1267–1284. doi:10.1086/425368. ISSN 1537-6591. PMID 15494903.
- ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.