Sandbox/Alejandro: Difference between revisions

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==Neutropenic Patients<small><small><small><small> Adapted from Guidelines for Skin and Soft-Tissue Infections CID 2005<ref name=IDSA2005>{{Cite journal | author = Dennis L. Stevens, Alan L. Bisno, Henry F. Chambers, E. Dale Everett, Patchen Dellinger, Ellie J. C. Goldstein, Sherwood L. Gorbach, Jan V. Hirschmann, Edward L. Kaplan, Jose G. Montoya & James C. Wade
| title = Practice guidelines for the diagnosis and management of skin and soft-tissue infections
| journal = Clinical infectious diseases: an official publication of the Infectious Diseases Society of America
| volume = 41
| issue = 10
| pages = 1373–1406
| year = 2005
| month = November
| doi = 10.1086/497143
| pmid = 16231249
}}</ref></small></small></small></small>==
* Patients with neutropenia require an antimicrobial therapy with a broader coverage.
* The duration of antimicrobial therapy should be individualized in accordance with patient's clinical response.
{| style="border: 2px solid #696969;"
|+ <SMALL>''Recommended Duration of Antimicrobial Therapy Based on the Microorganism.''</SMALL>
| style="background: #A5B2D6; border: 0px solid #696969; padding: 0 5px; width: 200px"| '''Microorganism''' || style="background: #A5B2D6; border: 0px solid #696969; padding: 0 5px; width: 200px" | '''Duration of Therapy'''
|-
| style="font-size: 90%; padding: 0 5px; background: #F5F5F5" align=left |&nbsp;▸&nbsp;'''''[[Gram-negative bacteria|Gram-negative Bacteria]]''''' || style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ''''' 7-14 days'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #F5F5F5" align=left |&nbsp;▸&nbsp;'''''[[Gram-positive bacteria|Gram-positive Bacteria]]''''' || style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ''''' 7-10 days'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #F5F5F5" align=left |&nbsp;▸&nbsp;'''''[[Fungi]]''''' || style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ''''' Until clinical resolution'''''
|-
|}
<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">
&nbsp;&nbsp;▸&nbsp;&nbsp;'''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">
&nbsp;&nbsp;▸&nbsp;&nbsp;'''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">
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Fungi'''
</font>
</div>
| valign=top |
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table25" 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|Gram-Negative Bacteria}}
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
|-
| 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]] 0.5–1 g IV q6–8h(max: 50mg/kg/day)'''''<br> OR <br> ▸ '''''[[Ertapenem]] 1 g IV/IM q24h'''''<br> OR <br> ▸ '''''[[Cefepime]] 2g IV q8h'''''<br> OR <br> ▸ '''''[[Ceftazidime]] 2g IV q8h'''''<br> OR <br> ▸ '''''[[Piperacillin/tazobactam]] 3.375 g IV q6–8h'''''
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen 1 '''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Amikacin]] 15 mg/kg/day IV/IM divided q8-12h (max: 15 mg/kg/day)'''''<br> OR <br> ▸ '''''[[Gentamicin]] 3-5 mg/kg/day IV/IM divided q6-8h'''''<br> OR <br> ▸ '''''[[Gentamicin]] 4-7 mg/kg/day IV q24h <small>(adjust dosage based on serum concentrations)</small>'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left |PLUS
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left |▸ '''''[[Cefepime]] 2g IV q8h'''''<br> OR <br> ▸ ''''' [[Piperacillin/tazobactam]] 3.375 g IV q6–8h (max 24 g/day)'''''
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen 2 '''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left |▸ ''''' [[Piperacillin/tazobactam]] 3.375 g IV q6–8h (max 24 g/day)'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left |PLUS
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left |▸ ''''' [[Ciprofloxacin]] 400mg IV q8h'''''
|-
|}
|}
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table26" 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|Gram-Positive Bacteria}}
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen '''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Vancomycin]]† 15-20 mg/kg IV q8-12h'''''
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Linezolid]] 600 mg IV/PO q12h'''''<BR> OR <BR>  ▸ '''''[[Daptomycin]] 4mg/kg IV q24h'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #F5F5F5;" align=left | <small>† Vancomycin should be discontinued if culture results remain negative after 72-96 hrs </small>
|-
|}
|}
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table27" 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|Fungi}}
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Liposomal Amphotericin B]] 3 mg/kg/day IV × 1-2 weeks'''''  <br> OR <br> ▸ '''''[[Amphotericin B]] deoxycholate 0.7-1 mg/kg/day IV × 1-2 weeks'''''<br> OR <br> ▸ '''''[[Amphotericin B lipid complex]] 5 mg/kg/day IV × 1-2 weeks'''''
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Voriconazole]] 6 mg/kg IV q12h x 1 day, then 3 mg/kg IV q12h'''''<br> OR <br> ▸ '''''[[Voriconazole]] 200 mg PO q12h''''' <br> OR <br> ▸ '''''[[Caspofungin]] 70 mg IV once, then 50 mg IV q24h x ≥ 14 days'''''
|}
|}
|}
==Cellular Immune Deficient Patients<small><small><small><small> Adapted from Guidelines for Skin and Soft-Tissue Infections CID 2005<ref name=IDSA2005>{{Cite journal| author = Dennis L. Stevens, Alan L. Bisno, Henry F. Chambers, E. Dale Everett, Patchen Dellinger, Ellie J. C. Goldstein, Sherwood L. Gorbach, Jan V. Hirschmann, Edward L. Kaplan, Jose G. Montoya & James C. Wade
| title = Practice guidelines for the diagnosis and management of skin and soft-tissue infections
| journal = Clinical infectious diseases: an official publication of the Infectious Diseases Society of America
| volume = 41
| issue = 10
| pages = 1373–1406
| year = 2005
| month = November
| doi = 10.1086/497143
| pmid = 16231249
}}</ref></small></small></small></small>==
* Patients with cellular immunodeficiency require a pathogen-specific antimicrobial therapy.
* The duration of antimicrobial therapy should be individualized in accordance with patient's clinical response.
{| style="border: 2px solid #696969;"
|+ <SMALL>''Recommended Duration of Antimicrobial Therapy Based on the Microorganism.''</SMALL>
| style="background: #A5B2D6; border: 0px solid #696969; padding: 0 5px; width: 200px"| '''Microorganism''' || style="background: #A5B2D6; border: 0px solid #696969; padding: 0 5px; width: 200px" | '''Duration of Therapy'''
|-
| style="font-size: 90%; padding: 0 5px; background: #F5F5F5" align=left |&nbsp;▸&nbsp;'''''[[Nocardia|Nocardia spp]]''''' || style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ''''' 3-12 months'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #F5F5F5" align=left |&nbsp;▸&nbsp;'''''[[Atypical mycobacteria]]''''' || style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ''''' 6-12 months'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #F5F5F5" align=left |&nbsp;▸&nbsp;'''''[[Cryptococcus|Cryptococcus spp]]''''' || style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ''''' 8-12 weeks'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #F5F5F5" align=left |&nbsp;▸&nbsp;'''''[[Histoplasma|Histoplasma spp]]''''' || style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | '''''≥ 12 months'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #F5F5F5" align=left |&nbsp;▸&nbsp;'''''[[Varicella-zoster virus]]''''' || style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ''''' 7-10 days'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #F5F5F5" align=left |&nbsp;▸&nbsp;'''''[[Herpes simplex virus]]''''' || style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ''''' 7 days'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #F5F5F5" align=left |&nbsp;▸&nbsp;'''''[[Cytomegalovirus]]''''' || style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ''''' 21 days'''''
|-
|}




{|
{|
| valign=top |
| 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">
'''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;">
<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: 225px; background: #A1BCDD; text-align: center;">
<font color="#FFF">
<font color="#FFF">
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Nocardia spp'''
'''Adults'''
</font>
</font>
</div>
</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;">
<div class="mw-customtoggle-table01" 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: 225px; background: #4479BA;">
<font color="#FFF">
<font color="#FFF">
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Atypical mycobacteria'''
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Human Bite'''
</font>
</font>
</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;">
<div class="mw-customtoggle-table02" 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: 225px; background: #4479BA;">
<font color="#FFF">
<font color="#FFF">
'''Fungi'''
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Dog Bite'''
</font>
</font>
</div>
</div>


<div class="mw-customtoggle-table30" 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;">
<div class="mw-customtoggle-table03" 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: 225px; background: #4479BA;">
<font color="#FFF">
<font color="#FFF">
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Cryptococcus spp'''
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Cat Bite'''
</font>
</font>
</div>
</div>


<div class="mw-customtoggle-table31" 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;">
<div class="mw-customtoggle-table04" 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: 225px; background: #4479BA;">
<font color="#FFF">
<font color="#FFF">
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Histoplasma spp'''
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Pig Bite'''
</font>
</font>
</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;">
<div class="mw-customtoggle-table05" 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: 225px; background: #4479BA;">
<font color="#FFF">
<font color="#FFF">
'''Viruses'''
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Monkey Bite'''
</font>
</font>
</div>
</div>


<div class="mw-customtoggle-table32" 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;">
<div class="mw-customtoggle-table06" 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: 225px; background: #4479BA;">
<font color="#FFF">
<font color="#FFF">
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Varicella-zoster virus'''
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Tick Bite'''
</font>
</font>
</div>
</div>


<div class="mw-customtoggle-table33" 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;">
<div class="mw-customtoggle-table07" 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: 225px; background: #4479BA;">
<font color="#FFF">
<font color="#FFF">
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Herpes simplex virus'''
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Rat Bite'''
</font>
</font>
</div>
</div>


<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;">
| valign=top |
<font color="#FFF">
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Cytomegalovirus'''
</font>
</div>


| valign=top |
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table01" style="background: #FFFFFF;"
{|class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table28" 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|Nocardia spp}}
! 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|Human Bite Adults }}
}}
|-
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left |▸ '''''[[TMP-SMX]] x 3-12 months'''''
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Ampicillin sulbactam]] 1.5 gm IV q6h'''''<BR> OR <BR> ▸ '''''[[Cefoxitin]] 2 gm IV q8h'''''<BR> OR <BR> ▸ '''''[[Ticarcillin clavulanate]] 3.1 gm IV q6h'''''<BR> OR <BR> ▸ '''''[[Piperacillin-tazobactam]] 3.375 gm IV q6h or 4.5 gm q8h or 4-hr infusion of 3.375 gm q8h'''''
|-
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen 1'''''
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen (beta-lactam allergy)'''''
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Sulfadiazine]] 2-4 g PO 1 dose'''''
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Clindamycin]] 1.5 gm IV q6h'''''
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | FOLLOWED BY
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | PLUS
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Sulfadiazine]] 2-4 g/day PO q4-8h x 3-12 months'''''
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Moxifloxacin]] 400 mg IV q6h'''''
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen 1'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Imipenem]] 250-500 mg IV q6-8h x 3-12 months '''''
|-
|-
|}
|}
|}
|}
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table29" style="background: #FFFFFF;"
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table02" 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|Atypical mycobacteria†}}
! 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|Dog Bite Adults}}
|-
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left |▸ '''''[[Clarithromycin]] 500 mg PO q12h'''''
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Ampicillin sulbactam]] 1.5 to 3 g IV q6-8h'''''<BR> OR <BR> ▸ '''''[[Piperacillin-tazobactam]] 3.375 gm IV q6-8h'''''<BR> OR <BR> ▸ '''''[[Ertapenem]] 1 gm IV q24h'''''<BR> OR <BR> ▸ '''''[[Imipenem-cilastatin]] 1 gm IV q6-8h'''''<BR> OR <BR> ▸ '''''[[Imipenem]]-[[Cilastin]] 1 gm IV q6-8h'''''<BR> OR <BR> ▸ '''''[[Meropenem]] 1 gm IV q8h'''''
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left |PLUS
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen (beta-lactam allergy)'''''
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left |▸ '''''[[Ethambutol]] 15 mg/kg PO q24h'''''
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Cefazolin]] 1 gm IV q8h'''''<BR> OR <BR> ▸ '''''[[Cefuroxime]] 1 gm IV q24h'''''<BR> OR <BR> ▸ '''''[[Cefoxitin]] 1 gm IV q6-8h'''''<BR> OR <BR>▸ '''''[[Ceftriaxone sodium]] 1 gm IV q12h'''''<BR> OR <BR>▸ '''''[[Cefotaxime]] 2 gm IV q6h'''''<BR> OR <BR>▸ '''''[[Ciprofloxacin]] 400 mg IV q12h'''''<BR> OR <BR>▸ '''''[[Moxifloxacin]] 400 mg IV q24h'''''
|}
|}
 
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table03" 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|Cat Bite Adults}}
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | WITH OR WITHOUT
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left |▸ '''''[[Rifabutin]] 300 mg PO q24h'''''
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen'''''
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left |▸ '''''[[Azithromycin]] 500 mg PO q24h'''''
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Ampicillin sulbactam]] 1.5 to 3 g IV q6-8h'''''<BR> OR <BR> ▸ '''''[[Piperacillin-tazobactam]] 3.375 gm IV q6-8h'''''<BR> OR <BR> ▸ '''''[[Ertapenem]] 1 gm IV q24h'''''<BR> OR <BR> ▸ '''''[[Imipenem-cilastatin]] 1 gm IV q6-8h'''''<BR> OR <BR> ▸ '''''[[Imipenem-cilastatin]] 1 gm IV q6-8h'''''<BR> OR <BR> ▸ '''''[[Meropenem]] 1 gm IV q8h'''''
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left |PLUS
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen (beta-lactam allergy)'''''
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left |▸ '''''[[Ethambutol]] 15 mg/kg PO q24h'''''
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Cefazolin]] 1 gm IV q8h'''''<BR> OR <BR> ▸ '''''[[Cefuroxime]] 1 gm IV q24h'''''<BR> OR <BR> ▸ '''''[[Cefoxitin]] 1 gm IV q6-8h'''''<BR> OR <BR>▸ '''''[[Ceftriaxone sodium]] 1 gm IV q12h'''''<BR> OR <BR>▸ '''''[[Cefotaxime]] 2 gm IV q6h'''''<BR> OR <BR>▸ '''''[[Ciprofloxacin]] 400 mg IV q12h'''''<BR> OR <BR>▸ '''''[[Moxifloxacin]] 400 mg IV q24h'''''
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | WITH OR WITHOUT
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left |▸ '''''[[Rifabutin]] 300-450 mg PO q24h'''''
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center |<small>† Adapted from Am J Respir Crit Care Med Vol 175. pp 367–416, 2007<ref name="GriffithAksamit2007">{{cite journal|last1=Griffith|first1=David E.|last2=Aksamit|first2=Timothy|last3=Brown-Elliott|first3=Barbara A.|last4=Catanzaro|first4=Antonino|last5=Daley|first5=Charles|last6=Gordin|first6=Fred|last7=Holland|first7=Steven M.|last8=Horsburgh|first8=Robert|last9=Huitt|first9=Gwen|last10=Iademarco|first10=Michael F.|last11=Iseman|first11=Michael|last12=Olivier|first12=Kenneth|last13=Ruoss|first13=Stephen|last14=von Reyn|first14=C. Fordham|last15=Wallace|first15=Richard J.|last16=Winthrop|first16=Kevin|title=An Official ATS/IDSA Statement: Diagnosis, Treatment, and Prevention of Nontuberculous Mycobacterial Diseases|journal=American Journal of Respiratory and Critical Care Medicine|volume=175|issue=4|year=2007|pages=367–416|issn=1073-449X|doi=10.1164/rccm.200604-571ST}}</ref></small>
|}
|}
|}
|}
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table30" style="background: #FFFFFF;"
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table04" 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|Cryptococcus spp}}
! 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|Pig (Swine) Bite Adults}}
|-
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | Preferred Regimen
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
|-
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | Moderate Severe to Severe Disease
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Amoxicillin-clavulanate]] 875/125 mg orally q12h X 5 days'''''
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Liposomal Amphotericin B]] 3 mg/kg/day IV × 1-2 weeks'''''  <br> OR <br> ▸ '''''[[Amphotericin B]] deoxycholate 0.7-1 mg/kg/day IV × 1-2 weeks'''''<br> OR <br> ▸ '''''[[Amphotericin B lipid complex]] 5 mg/kg/day IV × 1-2 weeks'''''
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen'''''
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | FOLLOWED BY
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Ampicillin sulbactam]] 1.5 to 3 g IV q6-8h'''''<BR> OR <BR> ▸ '''''[[Imipenem]] 1 gm IV q6-8h'''''<BR> OR <BR> ▸ '''''[[Cephalosporin]]'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Itraconazole]] 200 mg PO q12h x ≥12 months'''''  
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | Mild to Moderate Disease
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Itraconazole]] 200 mg PO q12h x ≥12 months'''''  
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5" align=left | <SMALL>Adapted from ''Clin Infect Dis. 2007;45(7):807-25.''<ref name="Wheat-2007">{{Cite journal  | last1 = Wheat | first1 = LJ. | last2 = Freifeld | first2 = AG. | last3 = Kleiman | first3 = MB. | last4 = Baddley | first4 = JW. | last5 = McKinsey | first5 = DS. | last6 = Loyd | first6 = JE. | last7 = Kauffman | first7 = CA. | title = Clinical practice guidelines for the management of patients with histoplasmosis: 2007 update by the Infectious Diseases Society of America. | journal = Clin Infect Dis | volume = 45 | issue = 7 | pages = 807-25 | month = Oct | year = 2007 | doi = 10.1086/521259 | PMID = 17806045 }}</ref></SMALL>
|-
|-
|}
|}
|}
|}
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table31" style="background: #FFFFFF;"
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table05" 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|Histoplasma spp}}
! 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|High risk bites (deep bites, symptomatic animals)<ref name="pmid2821376">{{cite journal| author=Centers for Disease Control (CDC)| title=Guidelines for prevention of Herpesvirus simiae (B virus) infection in monkey handlers. | journal=MMWR Morb Mortal Wkly Rep | year= 1987 | volume= 36 | issue= 41 | pages= 680-2, 687-9 | pmid=2821376 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2821376  }} </ref><ref name="pmid2160783">{{cite journal| author=Holmes GP, Hilliard JK, Klontz KC, Rupert AH, Schindler CM, Parrish E et al.| title=B virus (Herpesvirus simiae) infection in humans: epidemiologic investigation of a cluster. | journal=Ann Intern Med | year= 1990 | volume= 112 | issue= 11 | pages= 833-9 | pmid=2160783 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2160783  }} </ref>
|-
}}
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Liposomal Amphotericin B]] 3 mg/kg/day x  1- 2 weeks''''' <br> OR <br>
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen (without CNS symptoms)'''''
▸ '''''[[Amphotericin B lipid complex]] 5 mg/kg/day x  1- 2 weeks'''''
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | FOLLOWED BY
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Acyclovir]]  12.5–15 mg per kg IV q8h'''''<BR> OR <BR> ▸ '''''[[Ganciclovir]] 5 mg per kg IV q12h'''''
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left |▸ '''''[[Itraconazole]] 200mg q8h x 3 days '''''
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen (with CNS symptoms)'''''
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | FOLLOWED BY
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Ganciclovir]] 5 mg per kg IV q12h'''''
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left |▸ '''''[[Itraconazole]] 200mg q12h x 6-12 months'''''
|}
|}
|}
|}
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table32" style="background: #FFFFFF;"
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table06" 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|Varicella-zoster virus}}
! 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|Suspected Leptospirosis<ref name="pmid7578715">{{cite journal| author=Farr RW| title=Leptospirosis. | journal=Clin Infect Dis | year= 1995 | volume= 21 | issue= 1 | pages= 1-6; quiz 7-8 | pmid=7578715 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7578715  }} </ref>}}
|-
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Acyclovir]] 10-12 mg/kg IV (infusion over 1 hour) q8h x 7-10 days'''''
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Doxycycline]] 200 mg orally once within 72 hours of tick removal '''''
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left |▸ '''''[[Famciclovir]] 500 mg PO x 7-10 days''''' <br> OR <br> ▸ '''''[[Valacyclovir]] 500 mg PO  x 7-10 days'''''
|}
|}
|}
|}
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table33" style="background: #FFFFFF;"
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table42" 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|Herpes simplex virus}}
! 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|Uncomplicated}}
|-
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Acyclovir]] 10 mg/kg IV (infusion over 1 hour) q8h x 7-10 days'''''  
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Amoxicillin-clavulanate]] 875/125 mg orally q12h'''''
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen (beta-lactam allergy)'''''
|-
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen'''''
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Doxycycline]] 100 mg orally q12h'''''
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left |▸ '''''[[Famciclovir]] 500 mg PO x 7 days''''' <br> OR <br> ▸ '''''[[Valacyclovir]] 500 mg PO x 7 days'''''
! 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|Rat bite fever<ref name="pmid1562665">{{cite journal| author=Rupp ME| title=Streptobacillus moniliformis endocarditis: case report and review. | journal=Clin Infect Dis | year= 1992 | volume= 14 | issue= 3 | pages= 769-72 | pmid=1562665 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1562665  }} </ref>}}
|}
|}
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table34" 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|Cytomegalovirus}}
|-
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Ganciclovir]] 5 mg/kg IV q12h x 21 days'''''
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Penicillin G benzathine]] 600,000 to 1,000,000 units/day IM X 10-14 days'''''<BR> OR <BR> ▸ '''''[[Tetracycline]]  250 to 500 mg orally q6h'''''
|-
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen'''''
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen'''''
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Valganciclovir]] 900 mg PO q12h x 21 days'''''
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Streptomycin]] 15 mg/kg/day IM in a single dose or in 2 divided doses X 10-14 days'''''
|-
|}
|}
|}
|}
|}
|}

Revision as of 14:11, 11 June 2014


Adults

  ▸  Human Bite

  ▸  Dog Bite

  ▸  Cat Bite

  ▸  Pig Bite

  ▸  Monkey Bite

  ▸  Tick Bite

  ▸  Rat Bite

Human Bite Adults

}}

Preferred Regimen
▸ Ampicillin sulbactam 1.5 gm IV q6h
OR
▸ Cefoxitin 2 gm IV q8h
OR
▸ Ticarcillin clavulanate 3.1 gm IV q6h
OR
▸ Piperacillin-tazobactam 3.375 gm IV q6h or 4.5 gm q8h or 4-hr infusion of 3.375 gm q8h
Alternative Regimen (beta-lactam allergy)
▸ Clindamycin 1.5 gm IV q6h
PLUS
▸ Moxifloxacin 400 mg IV q6h
Dog Bite Adults
Preferred Regimen
▸ Ampicillin sulbactam 1.5 to 3 g IV q6-8h
OR
▸ Piperacillin-tazobactam 3.375 gm IV q6-8h
OR
▸ Ertapenem 1 gm IV q24h
OR
▸ Imipenem-cilastatin 1 gm IV q6-8h
OR
▸ Imipenem-Cilastin 1 gm IV q6-8h
OR
▸ Meropenem 1 gm IV q8h
Alternative Regimen (beta-lactam allergy)
▸ Cefazolin 1 gm IV q8h
OR
▸ Cefuroxime 1 gm IV q24h
OR
▸ Cefoxitin 1 gm IV q6-8h
OR
▸ Ceftriaxone sodium 1 gm IV q12h
OR
▸ Cefotaxime 2 gm IV q6h
OR
▸ Ciprofloxacin 400 mg IV q12h
OR
▸ Moxifloxacin 400 mg IV q24h
Cat Bite Adults
Preferred Regimen
▸ Ampicillin sulbactam 1.5 to 3 g IV q6-8h
OR
▸ Piperacillin-tazobactam 3.375 gm IV q6-8h
OR
▸ Ertapenem 1 gm IV q24h
OR
▸ Imipenem-cilastatin 1 gm IV q6-8h
OR
▸ Imipenem-cilastatin 1 gm IV q6-8h
OR
▸ Meropenem 1 gm IV q8h
Alternative Regimen (beta-lactam allergy)
▸ Cefazolin 1 gm IV q8h
OR
▸ Cefuroxime 1 gm IV q24h
OR
▸ Cefoxitin 1 gm IV q6-8h
OR
▸ Ceftriaxone sodium 1 gm IV q12h
OR
▸ Cefotaxime 2 gm IV q6h
OR
▸ Ciprofloxacin 400 mg IV q12h
OR
▸ Moxifloxacin 400 mg IV q24h
Pig (Swine) Bite Adults
Preferred Regimen
▸ Amoxicillin-clavulanate 875/125 mg orally q12h X 5 days
Alternative Regimen
▸ Ampicillin sulbactam 1.5 to 3 g IV q6-8h
OR
▸ Imipenem 1 gm IV q6-8h
OR
▸ Cephalosporin
High risk bites (deep bites, symptomatic animals)[1][2]

Preferred Regimen (without CNS symptoms)
▸ Acyclovir 12.5–15 mg per kg IV q8h
OR
▸ Ganciclovir 5 mg per kg IV q12h
Preferred Regimen (with CNS symptoms)
▸ Ganciclovir 5 mg per kg IV q12h
Suspected Leptospirosis[3]
Preferred Regimen
▸ Doxycycline 200 mg orally once within 72 hours of tick removal
Uncomplicated
Preferred Regimen
▸ Amoxicillin-clavulanate 875/125 mg orally q12h
Alternative Regimen (beta-lactam allergy)
▸ Doxycycline 100 mg orally q12h
Rat bite fever[4]
Preferred Regimen
▸ Penicillin G benzathine 600,000 to 1,000,000 units/day IM X 10-14 days
OR
▸ Tetracycline 250 to 500 mg orally q6h
Alternative Regimen
▸ Streptomycin 15 mg/kg/day IM in a single dose or in 2 divided doses X 10-14 days
  1. ↑ Centers for Disease Control (CDC) (1987). "Guidelines for prevention of Herpesvirus simiae (B virus) infection in monkey handlers". MMWR Morb Mortal Wkly Rep. 36 (41): 680–2, 687–9. PMID 2821376.
  2. ↑ Holmes GP, Hilliard JK, Klontz KC, Rupert AH, Schindler CM, Parrish E; et al. (1990). "B virus (Herpesvirus simiae) infection in humans: epidemiologic investigation of a cluster". Ann Intern Med. 112 (11): 833–9. PMID 2160783.
  3. ↑ Farr RW (1995). "Leptospirosis". Clin Infect Dis. 21 (1): 1–6, quiz 7-8. PMID 7578715.
  4. ↑ Rupp ME (1992). "Streptobacillus moniliformis endocarditis: case report and review". Clin Infect Dis. 14 (3): 769–72. PMID 1562665.
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