Sandbox aparna: Difference between revisions
Jump to navigation
Jump to search
No edit summary |
No edit summary |
||
| Line 151: | Line 151: | ||
:::*2.1 '''Mild infection''' | :::*2.1 '''Mild infection''' | ||
::::* Preferred regimen(1): [[Ciprofloxacin]] 500 mg PO bid | ::::* Preferred regimen(1): [[Ciprofloxacin]] 500 mg PO bid | ||
::::* Preferred regimen(2): [[Levofloxacin]] 500 mg | ::::* Preferred regimen(2): [[Levofloxacin]] 500 mg qd. | ||
:::*2.2 '''Severe infection or sepsis''' | :::*2.2 '''Severe infection or sepsis''' | ||
::::* Preferred regimen(1): [[Ciprofloxacin]] 400 mg IV q8h | ::::* Preferred regimen(1): [[Ciprofloxacin]] 400 mg IV q8h | ||
::::* Preferred regimen(2): [[Levofloxacin]] 750 mg IV q24h | ::::* Preferred regimen(2): [[Levofloxacin]] 750 mg IV q24h | ||
::::*Note(1): For suspicion of water-based injury,empiric coverage for Vibrio [[Doxycycline]] 100mg bid,although Flouroquinolones may also cover {{and}}[[Vancomycin]] 15mg/kg IV q12h {{with | ::::*Note(1): For suspicion of water-based injury,empiric coverage for Vibrio [[Doxycycline]] 100mg bid, although Flouroquinolones may also cover {{and}} [[Vancomycin]] 15mg/kg IV q12h {{with or without}} [[Clindamycin]] {{or}} [[Linezolid]] for inhibition of Gram-positive toxin production | ||
::::* Note(2): Alternatives to [[ | ::::* Note(2): Alternatives to [[Fluoroquinolones]] for Aeromonas coverage include [[carbapenems]] ([[ertapenem]], [[doripenem]], [[imipenem]] or [[meropenem]]),[[ceftriaxone]], [[cefepime]] and [[Aztreonam]]. | ||
::*3. '''Prevention''' | ::*3. '''Prevention''' | ||
:::*Preferred regimen: Frequent recommendations include using a [[Cephalosporin]] (e.g.,cefuroxime, | :::*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: | :::*Note (1): Duration of antibiotic use is 3-5days, some recommend continuing until wound or eschar resolves | ||
:::*Note (2): Aeromonas isolates from leeches have been described as uniformly susceptible to fluoroquinolones. | |||
Revision as of 19:07, 16 July 2015
- 1. Bacteremia[1]
- 1.1 Ampicillin or Penicillin susceptible
- Preferred regimen (1): Ampicillin 2 g IV q4-6h
- Preferred regimen (2): Ampicillin 2 g IV q4-6h AND Gentamicin 1 mg/kg IV/IM q8h
- 1.2 Ampicillin resistant and vancomycin susceptible or Penicillin allergy
- Preferred regimen (1): Vancomycin 15 mg/kg IV q12h AND Gentamicin 1 mg/kg IV/IM q8h
- Preferred regimen (2): Linezolid 600 mg IV q12h
- Preferred regimen (3): Daptomycin 6 mg/kg IV q24h
- 1.3 Ampicillin and Vancomycin resistant
- Preferred regimen (1): Linezolid 600 mg IV q12h
- Preferred regimen (2): Daptomycin 6 mg/kg IV q24h
- 2.1 Endocarditis in Adults
- 2.1.1 Strains Susceptible to Penicillin, Gentamicin, and Vancomycin
- Preferred regimen: (Ampicillin 12 g IV q24h for 4–6 weeks OR Aqueous crystalline penicillin G sodium 18–30 MU IV q24h for 4–6 weeks) AND Gentamicin sulfate 3 mg/kg IV/IM q24h for 4–6 weeks
- Alternative regimen: Vancomycin hydrochloride 30 mg/kg IV q24h for 6 weeks AND Gentamicin sulfate 3 mg/kg IV/IM q24h for 6 weeks
- Note (1): In case of native valve endocarditis with symptoms ≤ 3 months, a 4-week course of therapy is recommended.
- Note (2): In case of native valve endocarditis with symptoms > 3 months, a 6-week course of therapy is recommended.
- Note (3): In case of prosthetic valve or other prosthetic cardiac material, a minimum of 6-week course of therapy is recommended.
- 2.1.2 Strains Susceptible to Penicillin, Streptomycin, and Vancomycin and Resistant to Gentamicin
- Preferred regimen: (Ampicillin 12 g IV q24h for 4–6 weeks OR Aqueous crystalline penicillin G sodium 24 MU IV q24h for 4–6 weeks) ANDStreptomycin sulfate 15 mg/kg IV/IM q24h for 4–6 weeks
- Alternate regimen: Vancomycin hydrochloride 30 mg/kg IV q24h for 6 weeks AND Streptomycin sulfate 15 mg/kg IV/IM q24h for 6 weeks
- 2.1.3 Strains Resistant to Penicillin and Susceptible to Aminoglycoside and Vancomycin
- 2.1.3.1 β Lactamase–producing strain
- Preferred regimen: Ampicillin-sulbactam 12 g IV q24h for 6 weeks AND Gentamicin sulfate 3 mg/kg IV/IM q24h 6 weeks
- Alternate regimen: Vancomycin hydrochloride 30 mg/kg IV q24h for 6 weeks AND Gentamicin sulfate 3 mg/kg IV/IM q24h for 6 weeks
- 2.1.3.2 Intrinsic penicillin resistance
- Preferred regimen: Vancomycin hydrochloride 30 mg/kg IV q24h for 6 weeks AND Gentamicin sulfate 3 mg/kg IV/IM q24h for 6 weeks
- 2.1.4 Strains Resistant to Penicillin, Aminoglycoside, and Vancomycin
- Preferred regimen (1): (Imipenem OR Cilastatin 2 g/day IV for ≥ 8weeks AND Ampicillin 12 g/day IV for ≥ 8weeks)
- Preferred regimen (2): (Ceftriaxone sodium 4 g IV/IM q24h for ≥ 8weeks AND Ampicillin 12 g IV q24h for ≥ 8weeks)
- 2.2 Endocarditis in Pediatrics
- 2.2.1 Strains Susceptible to Penicillin, Gentamicin, and Vancomycin
- Preferred regimen: (Ampicillin 300 mg/kg IV q24h for 4–6 weeks OR Penicillin 0.3 MU/kg IV q24h for 4–6 weeks) AND Gentamicin 3 mg/kg IV/IM q24h 4–6 weeks
- Note (1): In case of native valve endocarditis with symptoms ≤ 3 months, a 4-week course of therapy is recommended.
- Note (2): In case of native valve endocarditis with symptoms > 3 months, a 6-week course of therapy is recommended.
- Note (3): In case of prosthetic valve or other prosthetic cardiac material, a minimum of 6-week course of therapy is recommended.
- Alternate regimen : Vancomycin 40 mg/kg IV q24h for 6 weeks AND Gentamicin 3 mg/kg IV/IM q24h for 6 weeks
- 2.2.2 Strains Susceptible to Penicillin, Streptomycin, and Vancomycin and Resistant to Gentamicin
- Preferred regimen: (Ampicillin 300 mg/kg IV q24h for 4–6 weeks OR Penicillin 0.3 MU/kg IV q24h for 4–6 weeks) AND Streptomycin 20–30 mg/kg IV/IM q24h for 4–6 weeks
- Alternate regimen: Vancomycin hydrochloride 40 mg/kg IV q24h for 6 weeks AND Streptomycin sulfate 15 mg/kg IV/IM q24h for 6 weeks
- 2.2.3 Strains Resistant to Penicillin and Susceptible to Aminoglycoside and Vancomycin
- 2.2.3.1 β Lactamase–producing strain
- Preferred regimen: Ampicillin-sulbactam 300 mg/kg IV q24h for 6 weeks AND Gentamicin 3 mg/kg IV/IM q24h for 6 weeks
- Alternate regimen: Vancomycin 40 mg/kg IV q24h for 6 weeks AND Gentamicin 3 mg/kg IV/IM q24h for 6 weeks
- 2.2.3.2 Intrinsic penicillin resistance
- Preferred regimen: Vancomycin 40 mg/kg IV q24h AND Gentamicin 3 mg/kg IV/IM q24h for 6 weeks
- 2.2.4 Strains Resistant to Penicillin, Aminoglycoside, and Vancomycin
- Preferred regimen: Imipenem/Cilastatin 60–100 mg/kg IV q24h for ≥ 8weeks AND Ampicillin 300 mg/kg IV q24h for ≥ 8 weeks
- Alternate regimen: Ceftriaxone 100 mg/kg IV/IM q24h AND Ampicillin 300 mg/kg IV q24h for ≥ 8 weeks
- 3. Meningitis[4]
- 3.1 Ampicillin susceptible
- Preferred regimen: Ampicillin 12 g/day IV q4h AND Gentamicin 5 mg/kg/day IV q8h
- 3.2 Ampicillin resistant
- Preferred regimen: Vancomycin 30–45 mg/kg/day IV q8–12h AND Gentamicin 5 mg/kg/day IV q8h
- 3.3 Ampicillin and vancomycin resistant
- Preferred regimen: Linezolid 600 mg IV q12h
- 4. Urinary tract infections [5]
- Preferred regimen (1): Nitrofurantoin 100 mg PO q6h for 5 days
- Preferred regimen (2): Fosfomycin 3 g PO single dose
- Preferred regimen (3): Amoxicillin 875 mg to 1 g PO q12h for 5 days
- 5. Intra abdominal or Wound infections [6]
- Preferred regimen(1): Penicillin
- Preferred regimen(2): Ampicillin
- Alternative regimen(Penicillin allergy or high-level Penicillin resistance): Vancomycin
- Alternative regimen(For complicated skin-skin structure and intra-abdominal infection): Tigecycline 100 mg IV single dose and 50 mg IV q12h
- 1. Bacteremia[7]
- 1.1 Ampicillin or Penicillin susceptible
- Preferred regimen (1): Ampicillin 2 g IV q4-6h
- Preferred regimen (2): Ampicillin 2 g IV q4-6h AND Gentamicin 1 mg/kg IV/IM q8h
- 1.2 Ampicillin resistant and vancomycin susceptible or Penicillin allergy
- Preferred regimen (1): Vancomycin 15 mg/kg IV q12h AND Gentamicin 1 mg/kg IV/IM q8h
- Preferred regimen (2): Linezolid 600 mg IV q12h
- Preferred regimen (3): Daptomycin 6 mg/kg IV q24h.
- 1.3 Ampicillin and Vancomycin resistant
- Preferred regimen (1): Linezolid 600 mg IV q12h
- Preferred regimen (2): Daptomycin 6 mg/kg IV q24h
- 2. Endocarditis
- 2.1 Endocarditis in Adults
- 2.1.1 Strains Susceptible to Penicillin, Gentamicin, and Vancomycin
- Preferred regimen: (Ampicillin 12 g/day IV for 4–6 weeks OR Aqueous crystalline penicillin G sodium 18–30 MU/day IV for 4–6 weeks) AND Gentamicin sulfate 3 mg/kg IV/IM q24h for 4–6 weeks
- Alternative regimen: Vancomycin hydrochloride 30 mg/kg IV q24h for 6 weeks AND Gentamicin sulfate 3 mg/kg IV/IM q24h for 6 weeks
- Alternate regimen: Vancomycin hydrochloride 30 mg/kg IV q24h for 6 weeks AND Gentamicin sulfate 3 mg/kg IV/IM q24h for 6 weeks
- Note (1): In case of native valve endocarditis with symptoms ≤ 3 months, a 4-week course of therapy is recommended.
- Note (2): In case of native valve endocarditis with symptoms > 3 months, a 6-week course of therapy is recommended.
- Note (3): In case of prosthetic valve or other prosthetic cardiac material, a minimum of 6-week course of therapy is recommended.
- 2.1.2 Strains Susceptible to Penicillin, Streptomycin, and Vancomycin and Resistant to Gentamicin
- Preferred regimen: (Ampicillin 12 g/day IV for 4–6 weeks OR Aqueous crystalline penicillin G sodium 24 MU/day IV q24h for 4–6 weeks) ANDStreptomycin sulfate 15 mg/kg IV/IM q24h for 4–6 weeks
- Alternate regimen: Vancomycin hydrochloride 30 mg/kg IV q24h for 6 weeks AND Streptomycin sulfate 15 mg/kg IV/IM q24h for 6 weeks
- 2.1.3 Strains Resistant to Penicillin and Susceptible to Aminoglycoside and Vancomycin
- 2.1.3.1 β Lactamase–producing strain
- Preferred regimen: Ampicillin-sulbactam 12 g IV q24h for 6 weeks AND Gentamicin sulfate 3 mg/kg IV/IM q24h for 6 weeks
- Alternate regimen: Vancomycin hydrochloride 30 mg/kg IV q24h for 6 weeks AND Gentamicin sulfate 3 mg/kg IV/IM q24h for 6 weeks
- 2.1.3.2 Intrinsic penicillin resistance
- Preferred regimen: Vancomycin hydrochloride 30 mg/kg IV q24h for 6 weeks AND Gentamicin sulfate 3 mg/kg IV/IM q24h for 6 weeks
- 2.1.4 Strains Resistant to Penicillin, Aminoglycoside, and Vancomycin
- Preferred regimen(1): Linezolid 1200 mg IV/PO q24h ≥8 weeks
- Preferred regimen(2): Quinupristin-Dalfopristin 22.5 mg/kg IV q24h ≥ 8 weeks
- 2.2 Endocarditis in Pediatrics
- 2.2.1 Strains Susceptible to Penicillin, Gentamicin, and Vancomycin
- Preferred regimen: (Ampicillin 300 mg/kg IV q24h for 4–6 weeks OR Penicillin 0.3MU/kg IV q24h for 4–6 weeks) AND Gentamicin 3 mg/kg IV/IM q24h 4–6 weeks
- Alternate regimen : Vancomycin 40 mg/kg IV q24h for 6 weeks AND Gentamicin 3 mg/kg IV/IM q24h for 6 weeks
- Note (1): In case of native valve endocarditis with symptoms ≤ 3 months, a 4-week course of therapy is recommended.
- Note (2): In case of native valve endocarditis with symptoms > 3 months, a 6-week course of therapy is recommended.
- Note (3): In case of prosthetic valve or other prosthetic cardiac material, a minimum of 6-week course of therapy is recommended.
- 2.2.2 Strains Susceptible to Penicillin, Streptomycin, and Vancomycin and Resistant to Gentamicin
- Preferred regimen: (Ampicillin 300 mg/kg IV q24h for 4–6 weeks OR Penicillin 0.3MU/kg IV q24h for 4–6 weeks) AND Streptomycin 20–30 mg/kg IV/IM q24h for 4–6 weeks
- Alternate regimen: Vancomycin hydrochloride 40 mg/kg IV q24h for 6 weeks ANDStreptomycin sulfate 15 mg/kg IV/IM q24h for 6 weeks
- 2.2.3 Strains Resistant to Penicillin and Susceptible to Aminoglycoside and Vancomycin
- 2.2.3.1 β Lactamase–producing strain
- Preferred regimen: Ampicillin-sulbactam 300 mg/kg IV q24h for 6 weeks AND Gentamicin 3 mg/kg IV/IM q24h for 6 weeks
- Alternate regimen: Vancomycin 40 mg/kg IV q24h for 6 weeks AND Gentamicin 3 mg/kg IV/IM q24h for 6 weeks
- 2.2.3.2 Intrinsic penicillin resistance
- Preferred regimen: Vancomycin 40 mg/kg IV q24h AND Gentamicin 3 mg/kg IV/IM q24h for 6 weeks
- 2.2.4 Strains Resistant to Penicillin, Aminoglycoside, and Vancomycin
- Preferred regimen(1): Linezolid 30 mg/kg IV/PO q24h ≥ 8 weeks
- Preferred regimen(2): Quinupristin-Dalfopristin 22.5 mg/kg IV q24h ≥ 8 weeks
- 3. Meningitis[4]
- 3.1 Ampicillin susceptible
- Preferred regimen: Ampicillin 12 g/day IV q4h AND Gentamicin 5 mg/kg/day IV q8h
- 3.2 Ampicillin resistant
- Preferred regimen: Vancomycin 30–45 mg/kg/day IV q8–12h AND Gentamicin 5 mg/kg/day IV q8h
- 3.3 Ampicillin and vancomycin resistant
- Preferred regimen: Linezolid 600 mg IV q12h
- 4. Urinary tract infections[8]
- Preferred regimen (1): Nitrofurantoin 100 mg PO q6h for 5 days
- Preferred regimen (2): Fosfomycin 3 g PO single dose
- Preferred regimen (3): Amoxicillin 875 mg to 1 g PO q12h for 5 days
- 5. Intra abdominal or Wound infections [9]
- Preferred regimen(1): Penicillin
- Preferred regimen(2): Ampicillin
- Alternative regimen(Penicillin allergy or high-level Penicillin resistance): Vancomycin
- Alternative regimen(For complicated skin-skin structure and intra-abdominal infection): Tigecycline 100 mg IV single dose and 50 mg IV q12h
- Aeromonas hydrophila [10]
- 1. Diarrhea
- Preferred regimen(if not self-limiting, or if severe): Ciprofloxacin 500 mg PO bid.
- Alternate regimen: TMP-SMX single dose 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 100mg bid, although Flouroquinolones may also cover AND Vancomycin 15mg/kg IV q12h Template: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 3-5days, some recommend continuing until wound or eschar resolves
- Note (2): Aeromonas isolates from leeches have been described as uniformly susceptible to fluoroquinolones.
- ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
- ↑ Baddour, LM.; Wilson, WR.; Bayer, AS.; Fowler, VG.; Bolger, AF.; Levison, ME.; Ferrieri, P.; Gerber, MA.; Tani, LY. (2005). "Infective endocarditis: diagnosis, antimicrobial therapy, and management of complications: a statement for healthcare professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association: endorsed by the Infectious Diseases Society of America". Circulation. 111 (23): e394–434. doi:10.1161/CIRCULATIONAHA.105.165564. PMID 15956145. Unknown parameter
|month=ignored (help) - ↑ "Infective Endocarditis Diagnosis, Antimicrobial Therapy, and Management of Complications A Statement for Healthcare Professionals From the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association".
- ↑ 4.0 4.1 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 15494903.
- ↑ Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
- ↑ 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.
- ↑ Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
- ↑ 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.