Sandbox/Alejandro: Difference between revisions
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==Neutropenia and Cellular Immune Deficient Patients== | |||
= | <SMALL><font color="#FF4C4C">'''▸ Click on the following categories to expand treatment regimens.'''</font></SMALL> | ||
{| | |||
| valign=top | | |||
<div style="border-radius: 5px 5px 0 0; border: solid 1px #20538D; border-bottom: 0px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 250px; background: #A1BCDD; text-align: center;"> | |||
<font color="#FFF"> | |||
'''Neutropenia''' | |||
</font> | |||
</div> | |||
<div class="mw-customtoggle-table25" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 250px; background: #4479BA;"> | |||
<font color="#FFF"> | |||
▸ '''Gram-Negative Bacteria''' | |||
</font> | |||
</div> | |||
<div class="mw-customtoggle-table26" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 250px; background: #4479BA;"> | |||
<font color="#FFF"> | |||
▸ '''Gram-Positive Bacteria''' | |||
</font> | |||
</div> | |||
<div class="mw-customtoggle-table27" style="cursor: pointer; border-radius: 0 0 5px 5px; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 250px; background: #4479BA;"> | |||
<font color="#FFF"> | |||
▸ '''Fungi''' | |||
</font> | |||
</div> | |||
<div style="border-radius: 5px 5px 0 0; border: solid 1px #20538D; border-bottom: 0px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 250px; background: #A1BCDD; text-align: center;"> | |||
<font color="#FFF"> | |||
'''Cellular Immune Deficiency''' | |||
</font> | |||
</div> | |||
<div style="border-radius: 0 0 0 0; border: solid 1px #20538D; border-bottom: 0px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 250px; background: #A1BCDD; text-align: center;"> | |||
<font color="#FFF"> | |||
'''Bacteria''' | |||
</font> | |||
</div> | |||
<div class="mw-customtoggle-table28" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 250px; background: #4479BA;"> | |||
<font color="#FFF"> | |||
▸ '''Nocardia spp''' | |||
</font> | |||
</div> | |||
< | <div class="mw-customtoggle-table29" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 250px; background: #4479BA;"> | ||
<font color="#FFF"> | |||
▸ '''Atypical mycobacteria''' | |||
</font> | |||
</div> | |||
<div style="border-radius: 0 0 0 0; border: solid 1px #20538D; border-bottom: 0px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 250px; background: #A1BCDD; text-align: center;"> | |||
<font color="#FFF"> | |||
'''Fungi''' | |||
</font> | |||
</div> | |||
<div class="mw-customtoggle-table30" style="cursor: pointer; border-radius: 0 0 5px 5px; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 250px; background: #4479BA;"> | |||
<div style="border-radius: 5px 5px | |||
<font color="#FFF"> | <font color="#FFF"> | ||
''' | ▸ '''Cryptococcus spp''' | ||
</font> | </font> | ||
</div> | </div> | ||
<div class="mw-customtoggle- | <div class="mw-customtoggle-table31" style="cursor: pointer; border-radius: 0 0 5px 5px; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 250px; background: #4479BA;"> | ||
<font color="#FFF"> | <font color="#FFF"> | ||
▸ ''' | ▸ '''Histoplasma spp''' | ||
</font> | </font> | ||
</div> | </div> | ||
<div | <div style="border-radius: 0 0 0 0; border: solid 1px #20538D; border-bottom: 0px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 250px; background: #A1BCDD; text-align: center;"> | ||
<font color="#FFF"> | <font color="#FFF"> | ||
'''Viruses''' | |||
</font> | </font> | ||
</div> | </div> | ||
<div style="border-radius: 0 0 | <div class="mw-customtoggle-table32" style="cursor: pointer; border-radius: 0 0 5px 5px; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 250px; background: #4479BA;"> | ||
<font color="#FFF"> | <font color="#FFF"> | ||
''' | ▸ '''Varicella-zoster virus''' | ||
</font> | </font> | ||
</div> | </div> | ||
<div class="mw-customtoggle- | <div class="mw-customtoggle-table33" style="cursor: pointer; border-radius: 0 0 5px 5px; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 250px; background: #4479BA;"> | ||
<font color="#FFF"> | <font color="#FFF"> | ||
▸ ''' | ▸ '''Herpes simplex virus''' | ||
</font> | </font> | ||
</div> | </div> | ||
<div class="mw-customtoggle- | <div class="mw-customtoggle-table34" style="cursor: pointer; border-radius: 0 0 5px 5px; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 250px; background: #4479BA;"> | ||
<font color="#FFF"> | <font color="#FFF"> | ||
▸ ''' | ▸ '''Cytomegalovirus''' | ||
</font> | </font> | ||
</div> | </div> | ||
| valign=top | | | valign=top | | ||
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible- | {| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table25" style="background: #FFFFFF;" | ||
| valign=top | | | valign=top | | ||
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;" | {| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;" | ||
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF| | ! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Buccal Cellulitis <br> ''(H. influenzae)''}} | ||
|- | |- | ||
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5 | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen''''' | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[ | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Ceftriaxone]] 1-2 g IV q24h''''' | ||
|- | |- | ||
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5 | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen''''' | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left |▸ '''''[[ | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Meropenem]] 0.5-1 g IV q8h (infuse over 15-30 min or in bolus over 3-5 min) ''''' <br> OR <br> ▸ '''''[[Imipenem/cilastatin]] 250-1000 mg IV (max: 50mg/kg/day)''''' | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #F5F5F5;" align=left | <small>Adapted from N Engl J Med 2004;350:904-12.<ref>{{Cite journal | |||
| author = [[Morton N. Swartz]] | |||
| title = Clinical practice. Cellulitis | |||
| journal = [[The New England journal of medicine]] | |||
| volume = 350 | |||
| issue = 9 | |||
| pages = 904–912 | |||
| year = 2004 | |||
| month = February | |||
| doi = 10.1056/NEJMcp031807 | |||
| pmid = 14985488 | |||
}}</ref></small> | |||
|} | |} | ||
|} | |} | ||
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible- | {| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table26" style="background: #FFFFFF;" | ||
| valign=top | | | valign=top | | ||
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;" | {| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;" | ||
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF| | ! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Orbital Cellulitis}} | ||
|- | |||
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen 1''''' | |||
|- | |||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Vancomycin]] 15-20 mg/kg IV q8-12h'''''<small> (trough 15—20 μg/mL)</small> | |||
|- | |||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | PLUS | |||
|- | |||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Ceftriaxone]] 2g IV q24h''''' | |||
|- | |||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | PLUS | |||
|- | |||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Metronidazole]] 1g IV q12h''''' | |||
|- | |||
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen 2''''' | |||
|- | |- | ||
| style=" | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Vancomycin]] 15-20 mg/kg IV q8-12h'''''<small> (trough 15—20 μg/mL)</small> | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | PLUS | ||
|- | |- | ||
| style=" | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Piperacillin-tazobactam]] 4.5g IV q8h''''' | ||
|- | |- | ||
| style="font-size: 90% | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen'''''<br>(if penicillin or cephalosporin allergic) | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: # | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Vancomycin]] 15-20 mg/kg IV q8-12h'''''<small> (trough 15—20 μg/mL)</small> | ||
|- | |||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | PLUS | |||
|- | |||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Levofloxacin]] 750 mg IV q24h''''' | |||
|- | |- | ||
|} | |} | ||
|} | |} | ||
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible- | {| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table27" style="background: #FFFFFF;" | ||
| valign=top | | | valign=top | | ||
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;" | {| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;" | ||
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF| | ! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Facial Cellulitis}} | ||
|- | |- | ||
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5 | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen''''' | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[ | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left |▸ '''''[[Vancomycin]] 15-20 mg/kg IV q8-12h'''''<small> (trough 15—20 μg/mL)</small> | ||
|- | |- | ||
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5 | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen''''' | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[ | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Daptomycin]] 4 mg/kg IV q24h''''' <br> OR <br> ▸ '''''[[Linezolid]] 600mg IV q12h''''' | ||
|} | |||
|} | |||
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table28" style="background: #FFFFFF;" | |||
| valign=top | | |||
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;" | |||
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Salt Water Wound Exposure <br> ''(Vibrio vulnificus)''}} | |||
|- | |- | ||
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5 | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen''''' | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left |▸ '''''[[ | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Doxycycline]] 200 mg IV initial dose, then 50-100 mg IV q12h''''' | ||
|- | |- | ||
| style="font-size: 90% | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen''''' | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Cefotaxime]] 1-2 g IV/IM q8-12 (up to 2 g q4-6h)''''' <br> OR <br> ▸ '''''[[Ciprofloxacin]] 400 mg IV q8-12h x 7-14 days'''''<br> OR <br> ▸ '''''[[Ciprofloxacin]] 500-750 mg PO q8-12h x 7-14 days''''' | |||
|} | |} | ||
|} | |} | ||
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible- | {| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table29" style="background: #FFFFFF;" | ||
| valign=top | | | valign=top | | ||
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;" | {| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;" | ||
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF| | ! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Fresh Water Wound Exposure <br> ''(Aeromonas spp)''}} | ||
|- | |- | ||
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5 | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen''''' | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[ | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Ciprofloxacin]] 400mg IV q12h''''' <br> OR <br> ▸ '''''[[Ceftazidime]] 0.5 -2 g IV q8h''''' <BR> PLUS <BR> | ||
▸ '''''[[Gentamicin]] 3-5 mg/kg/day IV/IM divided q6-8h or 4-7 mg/kg IV q24h''''' | |||
|- | |- | ||
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5 | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen''''' | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[ | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Meropenem]] 0.5-1 g IV q8h (infuse over 15-30 min or in bolus over 3-5 min)''''' <br> OR <br> ▸ '''''[[Imipenem/cilastatin]] 250-1000 mg IV (max: 50mg/kg/day)''''' | ||
|} | |||
|} | |||
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table30" style="background: #FFFFFF;" | |||
| valign=top | | |||
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;" | |||
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Butcher, Fisherman, Veterinarian <br> ''(Erysipelothrix rhusiopathiae)''}} | |||
|- | |- | ||
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5 | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen''''' | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left |▸ '''''[[ | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Amoxicillin]] 500 mg PO q8hr''''' | ||
|- | |- | ||
| style="font-size: 90% | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen''''' | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left |▸ '''''[[Cefotaxime]] 1-2 g IV/IM q8-12 (up to 2 g q4-6h)''''' <br> OR <br> ▸ '''''[[Ciprofloxacin]] 400 mg IV q8-12h x 7-14 days'''''<br> OR <br> ▸ '''''[[Ciprofloxacin]] 500-750 mg PO q8-12h x 7-14 days''''' <br> OR <br> ▸ '''''[[Imipenem]]-cilastatin 250-1000 mg IV (max: 50mg/kg/day)''''' | |||
|} | |} | ||
|} | |} | ||
|} | |} |
Revision as of 14:17, 4 June 2014
Neutropenia and Cellular Immune Deficient Patients
▸ Click on the following categories to expand treatment regimens.
Neutropenia ▸ Gram-Negative Bacteria ▸ Gram-Positive Bacteria ▸ Fungi
Cellular Immune Deficiency Bacteria ▸ Nocardia spp ▸ Atypical mycobacteria Fungi ▸ Cryptococcus spp ▸ Histoplasma spp Viruses ▸ Varicella-zoster virus ▸ Herpes simplex virus ▸ Cytomegalovirus
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- ↑ Morton N. Swartz (2004). "Clinical practice. Cellulitis". The New England journal of medicine. 350 (9): 904–912. doi:10.1056/NEJMcp031807. PMID 14985488. Unknown parameter
|month=
ignored (help)