Sandbox Organ-Based Infections: Difference between revisions
Jump to navigation
Jump to search
Gerald Chi- (talk | contribs) |
Gerald Chi- (talk | contribs) m →Bone |
||
Line 4: | Line 4: | ||
===Bone=== | ===Bone=== | ||
====Osteomyelitis | ====Osteomyelitis==== | ||
====Candidal osteomyelitis==== | |||
{{Rx|Preferred Regimen}} | {{Rx|Preferred Regimen}} | ||
* '''[[Fluconazole]]''' 400 mg (6 mg/kg) IV/po daily {{or}} '''[[Lipid-based Amphotericin B]]''' 3-5 mg/kg daily for two weeks, followed by '''[[Fluconazole]]''' | * '''[[Fluconazole]]''' 400 mg (6 mg/kg) IV/po daily {{or}} '''[[Lipid-based Amphotericin B]]''' 3-5 mg/kg daily for two weeks, followed by '''[[Fluconazole]]''' | ||
Line 12: | Line 14: | ||
</li> | </li> | ||
==== | ====Chronic osteomyelitis==== | ||
{{Rx|Preferred Regimen}} | {{Rx|Preferred Regimen}} | ||
* '''[[Systemic antibiotics]]''' per culture and susceptibility results {{and}} | * '''[[Systemic antibiotics]]''' per culture and susceptibility results {{and}} | ||
Line 18: | Line 20: | ||
</li> | </li> | ||
==== | ====Contiguous with vascular insufficiency==== | ||
{{Rx|Preferred Regimen}} | {{Rx|Preferred Regimen}} | ||
* '''[[Systemic antibiotics]]''' per culture and susceptibility results {{and}} | * '''[[Systemic antibiotics]]''' per culture and susceptibility results {{and}} | ||
Line 25: | Line 27: | ||
</li> | </li> | ||
==== | ====Contiguous without vascular insufficiency==== | ||
{{Rx|Preferred Regimen}} | {{Rx|Preferred Regimen}} | ||
* '''[[Vancomycin]]''' 1 gm IV q12h {{and}} | * '''[[Vancomycin]]''' 1 gm IV q12h {{and}} | ||
Line 48: | Line 50: | ||
</li> | </li> | ||
==== | ====Diabetic foot==== | ||
{{Rx|Chronic Infection or Recent Antibiotic Use}} | {{Rx|Chronic Infection or Recent Antibiotic Use}} | ||
* '''[[Levofloxacin]]''' 750 mg IV/PO q24h {{or}} '''[[Cefoxitin]]''' 1 g IV q4h (or 2 g IV q6–8h) {{or}} '''[[Ceftriaxone]]''' 1–2 g/day IV/IM q12–24h {{or}} '''[[Ampicillin-Sulbactam]]''' 1.5–3 g IV/IM q6h {{or}} '''[[Moxifloxacin]]''' 400 mg IV/PO q24h {{or}} '''[[Ertapenem]]''' 1 g IV/IM q24h {{or}} '''[[Tigecycline]]''' 100 mg IV, then 50 mg IV q12h {{or}} '''[[Imipenem-Cilastatin]]''' 0.5–1 g IV q6–8h | * '''[[Levofloxacin]]''' 750 mg IV/PO q24h {{or}} '''[[Cefoxitin]]''' 1 g IV q4h (or 2 g IV q6–8h) {{or}} '''[[Ceftriaxone]]''' 1–2 g/day IV/IM q12–24h {{or}} '''[[Ampicillin-Sulbactam]]''' 1.5–3 g IV/IM q6h {{or}} '''[[Moxifloxacin]]''' 400 mg IV/PO q24h {{or}} '''[[Ertapenem]]''' 1 g IV/IM q24h {{or}} '''[[Tigecycline]]''' 100 mg IV, then 50 mg IV q12h {{or}} '''[[Imipenem-Cilastatin]]''' 0.5–1 g IV q6–8h | ||
Line 63: | Line 65: | ||
</li> | </li> | ||
==== | ====Foot bone==== | ||
{{Rx|Preferred Regimen}} | {{Rx|Preferred Regimen}} | ||
* '''[[Ciprofloxacin]]''' 750 mg po bid {{or}} '''[[Levofloxacin]]''' 750 mg po q24h | * '''[[Ciprofloxacin]]''' 750 mg po bid {{or}} '''[[Levofloxacin]]''' 750 mg po q24h | ||
Line 71: | Line 73: | ||
</li> | </li> | ||
==== | ====Foot puncture wound==== | ||
{{Rx|Preferred Regimen}} | {{Rx|Preferred Regimen}} | ||
* '''[[Drug]]''' DosageRouteFrequencyDuration {{or}} '''[[Drug]]''' DosageRouteFrequencyDuration {{and}} | * '''[[Drug]]''' DosageRouteFrequencyDuration {{or}} '''[[Drug]]''' DosageRouteFrequencyDuration {{and}} | ||
Line 81: | Line 83: | ||
</li> | </li> | ||
==== | ====Hematogenous==== | ||
{{Rx|Preferred Regimen}} | {{Rx|Preferred Regimen}} | ||
* '''[[Drug]]''' DosageRouteFrequencyDuration {{or}} '''[[Drug]]''' DosageRouteFrequencyDuration {{and}} | * '''[[Drug]]''' DosageRouteFrequencyDuration {{or}} '''[[Drug]]''' DosageRouteFrequencyDuration {{and}} | ||
Line 91: | Line 93: | ||
</li> | </li> | ||
==== | ====Hemoglobinopathy==== | ||
{{Rx|Preferred Regimen}} | {{Rx|Preferred Regimen}} | ||
* '''[[Drug]]''' DosageRouteFrequencyDuration {{or}} '''[[Drug]]''' DosageRouteFrequencyDuration {{and}} | * '''[[Drug]]''' DosageRouteFrequencyDuration {{or}} '''[[Drug]]''' DosageRouteFrequencyDuration {{and}} | ||
Line 101: | Line 103: | ||
</li> | </li> | ||
==== | ====Prosthetic joint infection==== | ||
{{Rx|Preferred Regimen}} | {{Rx|Preferred Regimen}} | ||
* '''[[Drug]]''' DosageRouteFrequencyDuration {{or}} '''[[Drug]]''' DosageRouteFrequencyDuration {{and}} | * '''[[Drug]]''' DosageRouteFrequencyDuration {{or}} '''[[Drug]]''' DosageRouteFrequencyDuration {{and}} | ||
Line 111: | Line 113: | ||
</li> | </li> | ||
==== | ====Spinal implant==== | ||
{{Rx|Preferred Regimen}} | {{Rx|Preferred Regimen}} | ||
* '''[[Drug]]''' DosageRouteFrequencyDuration {{or}} '''[[Drug]]''' DosageRouteFrequencyDuration {{and}} | * '''[[Drug]]''' DosageRouteFrequencyDuration {{or}} '''[[Drug]]''' DosageRouteFrequencyDuration {{and}} | ||
Line 121: | Line 123: | ||
</li> | </li> | ||
==== | ====Staphylococcus aureus==== | ||
{{Rx|Preferred Regimen}} | {{Rx|Preferred Regimen}} | ||
* '''[[Drug]]''' DosageRouteFrequencyDuration {{or}} '''[[Drug]]''' DosageRouteFrequencyDuration {{and}} | * '''[[Drug]]''' DosageRouteFrequencyDuration {{or}} '''[[Drug]]''' DosageRouteFrequencyDuration {{and}} | ||
Line 131: | Line 133: | ||
</li> | </li> | ||
==== | ====Sternal==== | ||
{{Rx|Preferred Regimen}} | {{Rx|Preferred Regimen}} | ||
* '''[[Drug]]''' DosageRouteFrequencyDuration {{or}} '''[[Drug]]''' DosageRouteFrequencyDuration {{and}} | * '''[[Drug]]''' DosageRouteFrequencyDuration {{or}} '''[[Drug]]''' DosageRouteFrequencyDuration {{and}} | ||
Line 140: | Line 142: | ||
* '''[[Drug]]''' DosageRouteFrequencyDuration {{or}} '''[[Drug]]''' DosageRouteFrequencyDuration | * '''[[Drug]]''' DosageRouteFrequencyDuration {{or}} '''[[Drug]]''' DosageRouteFrequencyDuration | ||
</li> | </li> | ||
===Joint=== | ===Joint=== | ||
Revision as of 04:32, 10 May 2015
Musculoskeletal
Bone
Osteomyelitis
Candidal osteomyelitis
- Fluconazole 400 mg (6 mg/kg) IV/po daily OR Lipid-based Amphotericin B 3-5 mg/kg daily for two weeks, followed by Fluconazole
- Caspofungin 70 mg loading dose, then 50 mg/day IV OR Micafungin 100 mg/day IV or Anidulafungin 200 mg IV loading dose, then 100 mg/day IV
Chronic osteomyelitis
- Systemic antibiotics per culture and susceptibility results AND
- Surgical debridement
Contiguous with vascular insufficiency
- Systemic antibiotics per culture and susceptibility results AND
- Surgical debridement AND
- Revascularization if possible
Contiguous without vascular insufficiency
- Vancomycin 1 gm IV q12h AND
- Ceftazidime 2 gm IV q8h OR Cefepime 2 gm IV q12h
- Linezolid 600 mg po/IV bid AND
- Ceftazidime 2 gm IV q8h OR Cefepime 2 gm IV q12h
- Ciprofloxacin 750 mg po bid OR Linezolid 600 mg po/IV bid
- Vancomycin 15-20 mg/kg IV q8-12h targeting trough concentrations of 15-20 mg/L
- Ciprofloxacin 750 mg po bid OR Levofloxacin 750 mg po once daily if susceptible AND
- Rifampin 300-450 mg po bid OR Rifampin 600 mg po once daily if susceptible
Diabetic foot
- Levofloxacin 750 mg IV/PO q24h OR Cefoxitin 1 g IV q4h (or 2 g IV q6–8h) OR Ceftriaxone 1–2 g/day IV/IM q12–24h OR Ampicillin-Sulbactam 1.5–3 g IV/IM q6h OR Moxifloxacin 400 mg IV/PO q24h OR Ertapenem 1 g IV/IM q24h OR Tigecycline 100 mg IV, then 50 mg IV q12h OR Imipenem-Cilastatin 0.5–1 g IV q6–8h
- Linezolid 600 mg IV/PO q12h OR Daptomycin 4 mg/kg IV q24h OR Vancomycin 15–20 mg/kg IV q8–12h (trough: 10–20 mg/L)
- Piperacillin–Tazobactam 3.375 g IV q6–8h
- (Vancomycin 15–20 mg/kg IV q8–12h OR Linezolid 600 mg IV/PO q12h OR Daptomycin 4 mg/kg IV q24h) AND
- (Piperacillin–Tazobactam 3.375 g IV q6–8h OR Imipenem-Cilastatin 0.5–1 g IV q6–8h OR Ertapenem 1 g IV/IM q24h OR Meropenem 1 g IV/IM q24h) OR (Metronidazole 15 mg/kg IV, then 7.5 mg/kg IV q6h PLUS Ceftazidime 2 g IV q8h OR Cefepime 2 g IV q8h OR Aztreonam 2 g IV q6–8h)
Foot bone
- Ciprofloxacin 750 mg po bid OR Levofloxacin 750 mg po q24h
- Ceftazidime 2 gm IV q8h OR Cefepime 2 gm IV q8h OR Meropenem 1 gm IV q8h