Sandbox ID3

WikiDoc Infectious Disease Project — Pathogen-Based Infections

Pathogens of Public Health Significance

3

Pathogens of Clinical Significance

3

Bacteria – Gram-Positive Cocci

Staphylococcus aureus

1. Infectious endocarditis

1.1 In adults

Preferred regimen: Vancomycin, 15-20 mg/kg IV q8-12h OR Daptomycin 6mg/kg/dose IV qd

2. Intravascular catheter-related infections^[1]

2.1 Methicillin susceptible Staphylococcus aureus (MSSA)

Preferred regimen: Nafcillin 2 g IV q6h OR Oxacillin, 2 g IV q6h.
Alternative regimen: Cefazolin, 2 g IV q8h OR Vancomycin, 15 mg/kg IV q12h.
2.1.1 Pediatric dose

2.1.1.1 Nafcillin

2.1.1.1.1 Neonates

0–4 weeks of age and 1200 g- 50 mg/kg/day q12h.
≤7 days and 1200–2000 g- 50 mg/kg/day q12h.
>7 days of age and <2000g- 75 mg/kg/day q8h.
>7 days of age and >1200 g - 100 mg/kg/day q6h.

2.1.1.1.2 Infants and children: Nafcillin 100–200 mg/kg/day q4–6h.

2.1.1.2 Oxacillin

2.1.1.2.1 Neonates

0–4 weeks of age and 1200 g - 50 mg/kg/day q12h.
Postnatal age <7 days and 1200–2000 g- 50–100 mg/kg/day q12h.
Postnatal age <7 days and >2000 g, 75–150 mg/kg/day q8h.
Postnatal age ≥7 days and 1200–2000 g- 75–150 mg/kg/day q8h.
Postnatal age ≥7 days and >2000 g, 100–200 mg/kg/day q6h.

2.1.1.3 Cefazolin

2.1.1.3.1 Neonates

Postnatal age ≤7 days: 40 mg/kg/day q12h.
Postnatal age >7 days and 2000 g: 40 mg/kg/day q12h.
Postnatal age >7 days and 12000 g: 60 mg/kg/day q8h.

2.1.1.3.2 Infants and children: 50 mg/kg/day q8h.

2.1.1.4 Vancomycin

2.1.1.4.1 Neonates

Postnatal age ≤7 days and <1200 g, 15 mg/kg/day q24h.
Postnatal age ≤7 days and 1200–2000 g, 10–15 mg/kg q12–18h.
Postnatal age ≤7 days and >2000 g, 10–15 mg/kg q8–12h.
Postnatal age >7 days and <1200 g, 15 mg/kg/day q24h.
Postnatal age >7 days and 1200–2000 g, 10–15 mg/kg q8–12h.
Postnatal age >7 days and >2000 g, 15–20 mg/kg q8h.

2.1.1.4.2 Infants and children: 40 mg/kg/day q6–8h.

2.2 Methicillin resistant Staphylococcus aureus (MRSA)

Preferred regimen: Vancomycin, 15 mg/kg IV q12h OR Daptomycin, 6–8 mg/kg per day IV, or Linezolid 10 mg/kg q 12 hr IV or PO ; OR Vancomycin 15 mg/kg IV q12h AND (Rifampicin IV or Gentamycin IV); or Trimethoprim-Sulfamethoxazole 6–12 mg TMP/kg/day in divided doses q12h alone (if susceptible).
2.2.1 Pediatric dose

2.2.1.1 Linezolid 10 mg/kg IV or PO q12h

2.2.1.1.1 Neonates

0–4 weeks of age and birthweight <1200 g: 10 mg/kg q8–12h (note: q12h in patients <34 weeks gestation and <1 week of age).
<7 days of age and birthweight >1200 g, 10 mg/kg q8–12h (note: q12h in patients <34 weeks gestation and <1 week of age).
7 days and birthweight >1200 g, 10 mg/kg q8h.

2.2.1.1.2 Infants and children <12 years of age: 10 mg/kg q8h Children 12 years of age and adolescents: 10 mg/kg q12h.

2.2.1.2 Gentamycin

2.2.1.2.1 Neonates

Premature neonates and <1000 g, 3.5 mg/kg q24h; 0–4 weeks and <1200 g, 2.5 mg/kg q18-24h.
Postnatal age 7 days: 2.5 mg/kg q12h.
Postnatal age 17 days and 1200–2000 g, 2.5 mg/kg q8-12h.
Postnatal age 17 days and 12000 g, 2.5 mg/kg q8h.
Once daily dosing for premature neonates with normal renal function, 3.5–4 mg/kg q24h.
Once daily dosing for term neonates with normal renal function, 3.5–5 mg/kg q24h.

2.2.1.2.2 Infants and children <5 years of age: 2.5 mg/kg q8h; qd dosing in patients with normal renal function, 5–7.5 mg/kg q24h.
2.2.1.2.3 Children >5 years of age: 2–2.5 mg/kg q8h; qd s with normal renal function, 5–7.5 mg/kg every 24 h.

2.2.1.3 Trimethoprim-Sulfamethoxazole

2.2.1.3.1 Infants 12 months of age and children: mild-to-moderate infections, 6–12 mg TMP/kg/day q12h; serious infection, 15–20 mg TMP/kg/day q6-8h.

3. Cellulitis

3.1 Purulent cellulitis (defined as cellulitis associated with purulent drainage or exudate in the absence of a drainable abscess)

3.1.1 In adults

Preferred regimen: Clindamycin 300–450 mg PO TID OR Trimethoprim-Sulfamethoxazole 1–2 DS tab PO BID OR Doxycycline 100 mg PO BID OR Minocycline 200 mg as a single dose, then 100 mg PO BID OR Linezolid 600 mg PO BID

3.1.2 In childern

Preferred regimen: Clindamycin 10–13 mg/kg/dose PO q6–8 h, not to exceed 40 mg/kg/day OR Trimethoprim 4–6 mg/kg, Sulfamethoxazole 20–30 mg/kg PO q12h OR Doxycycline If patient body weight <45kg: 2 mg/kg/dose PO q12 h.

Doxycycline If patient body weight 45kg: adult dose OR Minocycline 4 mg/kg PO 200 mg as a single dose, then 2 mg/kg/dose PO q12h OR Linezolid 10 mg/kg PO q8h, not to exceed 600 mg/dose

3.2 Nonpurulent cellulitis (defined as cellulitis with no purulent drainage or exudate and no associated abscess)

3.2.1 In adults

Preferred regimen: Beta-lactam (eg, Cephalexin and Dicloxacillin) 500 mg PO QID OR Clindamycin 300–450 mg PO TID OR Amoxicillin 500 PO mg TID OR Linezolid 600 mg PO BID

Note: Empirical therapy for b-hemolytic streptococci is recommended. Empirical coverage for CA-MRSA is recommended in patients who do not respond to b-lactam therapy and may be considered in those with systemic toxicity.

Note: Provide coverage for both b-hemolytic streptococci and CA-MRSA b-lactam (eg, amoxicillin) and/or TMP-SMX or a tetracycline

3.2.2 In childern

Preferred regimen: Clindamycin 10–13 mg/kg PO q6–8 h, not to exceed 40 mg/kg/day OR Trimethoprim 4–6 mg/kg, Sulfamethoxazole 20–30 mg/kg PO q12h OR Linezolid 10 mg/kg PO q8h, not to exceed 600 mg

Note (1): Clindamycin causes Clostridium difficile–associated disease may occur more frequently, compared with other oral agents.

Note (2): Trimethoprim-Sulfamethoxazole not recommended for women in the third trimester of pregnancy and for children ,2 months of age.

Note (3): Tetracyclines are not recommended for children under 8 years of age and are pregnancy category D.

4. Brain abscess^[2]^[3]^[4]

4.1 Methicillin-resistant Staphylococcus aureus (MRSA)

4.1.1 In adults

Preferred regimen: Vancomycin 30–45 mg/kg/day IV q8–12h for 4–6 weeks
Alternative regimen: Linezolid 600 mg PO/IV q12h for 4–6 weeks OR Trimethoprim-Sulfamethoxazole 5 mg/kg/dose PO/IV q8–12h for 4–6 weeks

4.1.2 In childern

Preferred regimen: Vancomycin15 mg/kg/dose IV q6h OR Linezolid 10 mg/kg/dose PO/IV q8h

Note: Consider the addition of Rifampin 600 mg qd OR 300–450 mg bid to Vancomycin.

4.2 Methicillin-susceptible Staphylococcus aureus (MSSA)

Preferred regimen: Nafcillin 2 g IV q4h OR Oxacillin 2 g IV q4h
Alternative regimen: Vancomycin 30–45 mg/kg/day IV q8–12h

5. Cerebrospinal fluid shunt infection ^[5]^[6]

5.1 Methicillin-resistant Staphylococcus aureus (MRSA)

Preferred regimen: Vancomycin 30–45 mg/kg/day IV q8–12h AND/OR Rifampin 600 mg IV or PO q24h

Note: Shunt removal is recommended, and it should not be replaced until cerebrospinal fluid cultures are repeatedly negative.

5.2 Methicillin-susceptible Staphylococcus aureus (MSSA)

Preferred regimen: (Nafcillin 2 g IV q4h OR Oxacillin 2 g IV q4h) AND/OR Rifampin 600 mg IV/PO q24h

6. Spinal epidural abscess ^[7]^[8]^[9]^[10]

6.1 Penicillin-susceptible Staphylococcus aureus or Streptococcus

Preferred regimen: Penicillin G 4 MU IV q4h for 2–4 weeks, then PO to complete 6–8 weeks

6.2 Methicillin-susceptible Staphylococcus aureus or Streptococcus

Preferred regimen: Cefazolin 2 g IV q8h for 2–4 weeks, then PO to complete 6–8 weeks OR Nafcillin 2 g IV q4h for 2–4 weeks, then PO to complete 6–8 weeks OR Oxacillin 2 g IV q4h for 2–4 weeks, then PO to complete 6–8 weeks
Alternative regimen: Clindamycin 600 mg IV q6h for 2–4 weeks, then PO to complete 6–8 weeks

6.3 Methicillin-resistant Staphylococcus aureus (MRSA)

6.3.1 In adults

Preferred regimen: Vancomycin loading dose 25–30 mg/kg IV followed by 15–20 mg/kg IV q8–12h for 2–4 weeks, then PO to complete 6–8 weeks
Alternative regimen: Linezolid 600 mg PO or IV q12h for 4–6 weeks OR TMP-SMX 5 mg/kg PO or IV q8–12h for 4–6 weeks

6.3.2 Pediatric dose

Preferred regimen: Vancomycin 15 mg/kg IV q6h OR Linezolid 10 mg/kg PO or IV q8h

Note: Consider the addition of Rifampin 600 mg qd or 300–450 mg bid to Vancomycin in adult patients.

7. Bacterial meningitis

7.1 Methicillin susceptible Staphylococcus aureus (MSSA)

Preferred regimen: Nafcillin 9–12 g/day IV q4h OR Oxacillin 9–12 g/day IV q4h
Alternative regimen: Vancomycin 30–45 mg/kg/day IV q8–12h OR Meropenem 6 g/day IV q8h

7.2 Methicillin resistant Staphylococcus aureus (MRSA)

Preferred regimen: Vancomycin 30–45 mg/kg/day IV q8–12h
Alternative regimen: Trimethoprim-Sulfamethoxazole 10–20 mg/kg/day q6–12h OR Linezolid 600 mg IV q12h

Note: Consider the addition of Rifampin 600 mg qd or 300–450 mg bid to Vancomycin in adult patients.

8. Septic thrombosis of cavernous or dural venous sinus^[11]

8.1 Methicillin-resistant Staphylococcus aureus (MRSA)

8.1.1 In adults

Preferred regimen: Vancomycin 15–20 mg/kg IV q8–12h for 4–6 weeks
Alternative regimen: Linezolid 600 mg PO IV q12h for 4–6 weeks OR TMP-SMX 5 mg/kg/dose PO/IV q8–12h for 4–6 weeks

8.1.2 Pediatric dose

Preferred regimen: Vancomycin 15 mg/kg IV q6h OR Linezolid 10 mg/kg PO or IV q8h

Note (1): Surgical evaluation for incision and drainage of contiguous sites of infection or abscess is recommended whenever possible.

Note (2): Consider the addition of Rifampin 600 mg qd or 300–450 mg bid to Vancomycin.

9. Subdural empyema

9.1 Methicillin-resistant Staphylococcus aureus (MRSA)^[12]

9.1.1 In adults

Preferred regimen: Vancomycin 30–45 mg/kg/day IV q8–12h for 4–6 weeks
Alternative regimen: Linezolid 600 mg PO or IV q12h for 4–6 weeks OR TMP-SMX 5 mg/kg/dose PO/IV q8–12h for 4–6 weeks

9.1.2 In childern

Preferred regimen: Vancomycin 15 mg/kg/dose IV q6h OR Linezolid 10 mg/kg/dose PO/IV q8h

Note: Consider the addition of Rifampin 600 mg qd or 300–450 mg bid to Vancomycin.

10. Acute conjunctivitis ^[13]

10.1 Methicillin-resistant Staphylococcus aureus (MRSA)

Preferred regimen: Vancomycin ointment 1% qid

11. Appendicitis

11.1 Health Care–Associated Complicated Intra-abdominal Infection ^[14]

11.1.1 Methicillin-resistant Staphylococcus aureus (MRSA)

Preferred regimen: Vancomycin 15–20 mg/kg IV q8–12h

12. Diverticulitis

12.1 Health Care–Associated Complicated Intra-abdominal Infection ^[14]

12.1.1Methicillin-resistant Staphylococcus aureus (MRSA)

Preferred regimen: Vancomycin 15–20 mg/kg IV q8–12h.

13. Peritonitis secondary to bowel perforation, peritonitis secondary to ruptured appendix, peritonitis secondary to ruptured appendix, typhlitis

13.1 Health Care–Associated Complicated Intra-abdominal Infection ^[14]

13.1.1 Methicillin-resistant Staphylococcus aureus (MRSA)

Preferred regimen: Vancomycin 15–20 mg/kg IV q8–12h

14. Cystic fibrosis ^[15]

14.1 Preferred Regimen (Adult)

If methicillin sensitive staphylococcus aureus: Nafcillin 2 gm IV q4hs OR Oxacillin 2 gm IV q4hs
If methicillin resistant staphylococcus aureus: Vancomycin 15-20 mg/kg IV q8-12h OR Linezolid 600 mg po/IV q12h

14.2 Preferred regimen (Pediatric)

If methicillin sensitive staphylococcus aureus: Nafcillin 5 mg/kg q6h (Age >28 days) OR Oxacillin 75 mg/kg q6h (Age >28 days)]]
If methicillin resistant staphylococcus aureus: Vancomycin 40 mg/kg q6-8h (Age >28 days) OR Linezolid 10 mg/kg po or IV q8h (up to age 12)

15. Bronchiectasis ^[16]

15.1 Preferred Regimen in adults

15.1.1 Recommended first-line treatment and length of treatment

15.1.1.1 Methicillin-susceptible Staphylococcus aureus (MSSA): Flucloxacillin 500 mg oral qds for 14 days

15.1.1.2 Methicillin-resistant Staphylococcus aureus (MRSA): Patient's body weight is <50 kg: Rifampicin 450 mg oral od AND Trimethoprim 200 mg oral bd for 14 days ; Patient's body weight is >50 kg: Rifampicin 600 mg oral od AND Trimethoprim 200 mg oral bd for 14 days

15.1.1.3 Methicillin-resistant Staphylococcus aureus (MRSA): Vancomycin 1 g IV bd (monitor serum levels and adjust dose accordingly) OR Teicoplanin 400 mg od for 14 days

15.1.2 Recommended second-line treatment and length of treatment

15.1.2.1 Methicillin-susceptible Staphylococcus aureus (MSSA): Clarithromycin 500 mg oral bd 14 days

15.1.2.2 Methicillin-resistant Staphylococcus aureus (MRSA): Patient's body weight is <50 kg: Rifampicin 450 mg oral od AND Doxycycline 200 mg oral od 14 days, Patient's body weight is >50 kg: Rifampicin 600 mg oral AND Doxycycline 200 mg oral od 14 days. Third-line: Linezolid 600 mg bd 14 days

15.1.2.3 Methicillin-resistant Staphylococcus aureus (MRSA): Linezolid 600 mg IV bd 14 days

15.2 Preferred Regimen in children

15.2.1 Recommended first-line treatment and length of treatment

15.2.1.1 Methicillin-susceptible Staphylococcus aureus (MSSA): Flucloxacillin

15.2.1.2 Methicillin-resistant Staphylococcus aureus (MRSA): Children (< 12 yr): Trimethoprim 4-6 mg/kg/24 hr divided q 12 hr PO Children (> 12 yr) : Trimethoprim 100-200 mg q 12 hr PO. Rifampicin 450 mg oral od : Rifampicin 600 mg oral od AND

15.2.1.3 Methicillin-resistant Staphylococcus aureus (MRSA): Vancomycin 45-60 mg/kg/24 hr divided q 8-12 hr IV OR Teicoplanin

15.2.2 Recommended second-line treatment and length of treatment

15.2.2.1 Methicillin-susceptible Staphylococcus aureus (MSSA): Clarithromycin 15 mg/kg/24 hr divided q 12 hr PO

15.2.2.2 Methicillin-resistant Staphylococcus aureus (MRSA): Rifampicin AND Doxycycline 2-5 mg/kg/24 hr divided q 12-24 hr PO or IV (max dose: 200 mg/24 hr) ; Rifampicin AND Doxycycline 2-5 mg/kg/24 hr divided q 12-24 hr PO or IV (max dose: 200 mg/24 hr) . Third-line: Linezolid 10 mg/kg q 12 hr IV or PO

15.2.2.3 Methicillin-resistant Staphylococcus aureus (MRSA): Linezolid 10 mg/kg q 12 hr IV or PO

15.3 Long-term oral antibiotic treatment

15.3.1 Preferred Regimen in adults

15.3.1.1 Recommended first-line treatment and length of treatment

15.3.1.1.1 Methicillin-susceptible Staphylococcus aureus (MSSA): Flucloxacillin 500 mg oral bd

15.3.1.2 Recommended second-line treatment and length of treatment

15.3.1.2.1 Methicillin-susceptible Staphylococcus aureus (MSSA): Clarithromycin 250 mg oral bd

16. Empyema

Preferred regimen: Nafcillin 2 gm IV q4h OR oxacillin 2 gm IV q4h if MSSA
Alternate regimen: Vancomycin 1 gm IV q12h OR Linezolid 600 mg po bid if MRSA

17. Community-acquired pneumonia

17.1 Methicillin-susceptible Staphylococcus aureus (MSSA)

Preferred Regimen : Nafcillin 1000-2000 mg q4h OR Oxacillin 2 g IV q4h OR Flucloxacillin 250 mg IM/IV q6h
Alternative Regimen : Cefazolin 500 mg IV q12h OR Clindamycin 150-450 mg PO q6-8h

17.2 Methicillin-resistant Staphylococcus aureus (MRSA)

Preferred Regimen : Vancomycin 45-60 mg/kg/day divided q8-12h (max: 2000 mg/dose) for 7-21 days OR Linezolid 600 mg PO/IV q12h for 10-14 days
Alternative Regimen: Trimethoprim-Sulfamethoxazole 1-2 double-strength tablets (800/160 mg) q12-24h

18. Olecranon bursitis or prepatellar bursitis

18.1 Methicillin-susceptible Staphylococcus aureus (MSSA)

Preferred regimen: Nafcillin 2 g IV q4h OR Oxacillin 2 g IV q4h OR Dicloxacillin 500 mg PO qid

18.2 Methicillin-resistant Staphylococcus aureus (MRSA)

Preferred regimen: Vancomycin 1 g IV q12h OR Linezolid 600 mg PO qd

Note: Initially aspirate q24h and treat for a minimum of 2–3 weeks.

19. Septic arthritis

19.1 In adults

19.1.1 Methicillin-resistant Staphylococcus aureus (MRSA)

Preferred regimen: Vancomycin 15–20 mg/kg IV q8–12h
Alternative regimen (1): Daptomycin 6 mg/kg IV q24h in adults
Alternative regimen (2): Linezolid 600 mg PO/IV q12h
Alternative regimen (3): Clindamycin 600 mg PO/IV q8h
Alternative regimen (4): TMP-SMX 3.5–4.0 mg/kg PO/IV q8–12h

19.2 In childern

Preferred regimen: Vancomycin 15 mg/kg IV q6h OR Daptomycin 6–10 mg/kg IV q24h OR Linezolid 10 mg/kg PO/IV q8h OR Clindamycin 10–13 mg/kg/dose PO/IV q6–8h

19.2.1 Methicillin-susceptible Staphylococcus aureus (MSSA)

Preferred regimen: Nafcillin 2 g IV q6h OR Clindamycin 900 mg IV q8h
Alternative regimen: Cefazolin 0.25–1 g IV/IM q6–8h OR Vancomycin 500 mg IV q6h or 1 g IV q12h

20. Septic arthritis, prosthetic joint infection (device-related osteoarticular infections)

20.1 Methicillin-susceptible Staphylococcus aureus (MSSA)

Preferred regimen: Nafcillin 2 g IV q4–6h OR Oxacillin 2 g IV q4–6h
Alternative regimen: Cefazolin 1–2 g IV q8h OR Ceftriaxone 2 g IV q24h
Alternative regimen (if allergic to penicillins): Clindamycin 900 mg IV q8h OR Vancomycin 15–20 mg/kg IV q8–12 hours, not to exceed 2 g per dose

20.2 Methicillin-resistant Staphylococcus aureus (MRSA)

Early-onset (< 2 months after surgery) or acute hematogenous prosthetic joint infections involving a stable implant with short duration (< 3 weeks) of symptoms and debridement (but device retention)

Preferred regimen: Vancomycin AND Rifampin 600 mg PO qd or 300–450 mg PO bid for 2 weeks
Alternative regimen: (Daptomycin 6 mg/kg IV q24h OR Linezolid 600 IV q8h) AND Rifampin 600 mg PO qd or 300–450 mg PO bid for 2 weeks

Note: The above regimen should be followed by Rifampin plus a fluoroquinolone, TMP/SMX, a tetracycline or Clindamycin for 3 or 6 months for hips and knees, respectively.

21. Hematogenous osteomyelitis

21.1 Adult (>21 yrs)

21.1.1 Methicillin-resistant Staphylococcus aureus (MRSA) possible

Preferred regimen: Vancomycin 1 gm IV q12h (if over 100 kg, 1.5 gm IV q12h)

21.1.2 Methicillin-resistant Staphylococcus aureus (MRSA) unlikely

Preferred regimen: Nafcillin OR Oxacillin 2 gm IV q4h

21.2 Children (>4 mos.)-Adult

21.2.1 Methicillin-resistant Staphylococcus aureus (MRSA) possible

Preferred regimen: Vancomycin 40 div q6–8h

21.2.2 Methicillin-resistant Staphylococcus aureus (MRSA) unlikely

Preferred regimen: Nafcillin OR Oxacillin 37 q6h (to max. 8–12 gm per day)

Note: Add Ceftazidime 50 q8h or Cefepime 150 div q8h if Gm-neg. bacilli on Gram stain

21.3 Newborn (<4 mos.)

21.3.1 Methicillin-resistant Staphylococcus aureus (MRSA) possible

Preferred regimen: Vancomycin AND (Ceftazidime 2 gm IV q8h or Cefepime 2 gm IV q12h)

21.3.2 Methicillin-resistant Staphylococcus aureus (MRSA) unlikely

Preferred regimen: (Nafcillin OR Oxacillin) AND (Ceftazidime OR Cefepime)

21.4 Specific therapy

21.4.1 Methicillin-susceptible Staphylococcus aureus (MSSA)

Preferred regimen: Nafcillin OR Oxacillin 2 gm IV q4h OR Cefazolin 2 gm IV q8h
Alternative regimen: Vancomycin 1 gm IV q12h (if over 100 kg, 1.5 gm IV q12h)

21.4.2 Methicillin-resistant Staphylococcus aureus (MRSA)

Preferred regimen: Vancomycin 1 gm IV q12h
Alternative regimen: Linezolid 600 mg q12h IV/po ± Rifampin 300 mg po/IV bid

22. Diabetic foot osteomyelitis

High Risk for MRSA

Preferred regimen: 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)

23. Necrotizing fasciitis^[17]

23.1 In adult

Preferred regimen (1): Nafcillin 1–2 g IV q4h (Severe Pencillin allergy: Vancomycin, linezolid, quinupristin/dalfopristin, daptomycin)
Preferred regimen (2): Oxacillin 1–2 g IV q4h
Preferred regimen (3): Cefazolin 1 g IV q8h
Preferred regimen (4): Vancomycin 15 mg/kg IV bid
Preferred regimen (5): Clindamycin 600–900 mg IV q8h

23.2 In childern

Preferred regimen (1): Nafcillin 50 mg/kg/dose IV q6h (Severe Pencillin allergy: Vancomycin, linezolid, quinupristin/dalfopristin, daptomycin)
Preferred regimen (2): Oxacillin 50 mg/kg/dose IV q6h
Preferred regimen (3): Cefazolin 33 mg/kg/dose IV q8h
Preferred regimen (4): Vancomycin 15 mg/kg/dose IV q6h
Preferred regimen (5): Clindamycin 10–13 mg/kg/dose IV q8h (Bacteriostatic; potential cross-resistance and emergence of resistance in erythromycin-resistant strains; inducible resistance in methicillin resistent staphylococcus aureus)

24. Staphylococcal toxic shock syndrome ^[18]

24.1 Methicillin sensitive Staphylococcus aureus

Preferred regimen: Cloxacillin 250-500 mg PO q6h (max dose: 4 g/24 hr) OR Nafcillin 4-12 g/24 hr divided IV q4-6hr (max dose: 12 g/24 hr) OR Cefazolin 0.5-2g IV or IM q8h (max dose: 12 g/24 hr), AND Clindamycin 150-600 mg IV, IM, or PO q6-8h (max dose: 5 g/24 hr IV or IM or 2 g/24 hr PO)
Alternative regimen (1):Clarithromycin 250-500 mg PO q12h (max dose: 1 g/24 hr) AND Clindamycin 150-600 mg IV, IM, or PO q6-8h (max dose: 5 g/24 hr IV or IM or 2 g/24 hr PO)
Alternative regimen (1):Rifampicin, AND Linezolid 600 mg IV or PO q12h OR Daptomycin OR Tigecycline 100 mg loading dose followed by 50 mg IV q12h

24.2 Methicillin resistant Staphylococcus aureus

Preferred regimen: Clindamycin 150-600 mg IV, IM, or PO q6-8h (max dose: 5 g/24 hr IV or IM or 2 g/24 hr PO) OR Linezolid 600 mg IV or PO q12h AND Vancomycin 15 to 20 mg/kg IV q8-12h, not to exceed 2 g per dose or Teicoplanin
Alternative regimen (1):Rifampicin, AND Linezolid 600 mg q12h IV or PO OR Daptomycin OR Tigecycline 100 mg loading dose followed by 50 mg q12h IV

24.3 Glycopeptide resistant or intermediate Staphylococcus aureus

Preferred regimen: Linezolid 600 mg IV or PO q12h AND Clindamycin 150-600 mg IV, IM, or PO q6-8h (max dose: 5 g/24 hr IV or IM or 2 g/24 hr PO) (if sensitive)
Alternative regimen (1):Daptomycin OR Tigecycline 100 mg loading dose followed by 50 mg IV q12h

Note: Incidence increasing. Geographical patterns highly variable.

Staphylococcus aureus ,prophylaxis

1. Prophylaxis for coronary artery bypass graft-associated acute mediastinitis^[19]

1.1 Methicillin susceptible staphylococcus aureus (MSSA)

Preferred regimen: A first- or second-generation Cephalosporin is recommended for prophylaxis in patients without methicillin-resistant Staphylococcus aureus colonization.

1.2 Methicillin resistant staphylococcus aureus (MRSA)

Preferred regimen: Vancomycin alone or in combination with other antibiotics to achieve broader coverage is recommended for prophylaxis in patients with proven or suspected methicillin-resistant S. aureus colonization

Note (1): Preoperative antibiotics should be administered to all patients to reduce the risk of mediastinitis in cardiac surgery.

Note (2): The use of intranasal Mupirocin is reasonable in nasal carriers of Staphylococcus aureus.

Bacteria – Gram-Positive Bacilli

Bacteria – Gram-Negative Cocci and Coccobacilli

Chancroid Treatment ^[20]

Preferred Regimen: Azithromycin 1 g PO in a single dose OR Ceftriaxone 250 mg IM in a single dose OR Ciprofloxacin 500 mg PO bid for 3 days OR Erythromycin base 500 mg PO three tid for 7 days
Note(1): Regardless of whether symptoms of the disease are present, sex partners of patients who have chancroid should be examined and treated if they had sexual contact with the patient during the 10 days preceding the patient’s onset of symptoms.
Note(2):Persons with HIV infection might require repeated or longer courses of therapy, and treatment failures can occur with any regimen.

Bacteria – Spirochetes

Bacteria – Gram-Negative Bacilli

Bacteria – Atypical Organisms

Bacteria – Miscellaneous

Bacteria – Anaerobic Gram-Negative Bacilli

Fungi

Mycobacteria

Parasites – Intestinal Protozoa

1.Amebic Liver Abscess

Preferred regiemn: Metronidazole 750 mg PO tid for 10 days OR Tinidazole 2 g PO once daily for 5 days Followed by Paromomycin 30 mg/kg/day PO in three divided doses per day for 5-10 days OR Diloxanide furoate 500 mg PO tid for 10 days

2.Amebic Colitis

Preferred regimen: Tinidazole 2 g PO once daily for 5 days AND Paromomycin 30 mg/kg/day PO in three divided doses per day for 5-10 days OR Diloxanide furoate 500 mg PO tid for 10 days

3.Asymptomatic Intestinal Colonization

Preferred regimen: Paromomycin 30 mg/kg/day PO in three divided doses per day for 5-10 days OR Diloxanide furoate 500 mg PO tid for 10 days

Parasites – Extraintestinal Protozoa

Parasites – Intestinal Nematodes (Roundworms)

Parasites – Extraintestinal Nematodes (Roundworms)

Parasites – Trematodes (Flukes)

Parasites – Cestodes (Tapeworms)

Parasites – Ectoparasites

Viruses

References

↑ Mermel LA, Allon M, Bouza E, Craven DE, Flynn P, O'Grady NP; et al. (2009). "Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 Update by the Infectious Diseases Society of America". Clin Infect Dis. 49 (1): 1–45. doi:10.1086/599376. PMC 4039170. PMID 19489710.
↑ Bennett, John (2015). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Elsevier/Saunders. ISBN 978-1455748013.
↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
↑ Liu, Catherine; Bayer, Arnold; Cosgrove, Sara E.; Daum, Robert S.; Fridkin, Scott K.; Gorwitz, Rachel J.; Kaplan, Sheldon L.; Karchmer, Adolf W.; Levine, Donald P.; Murray, Barbara E.; J Rybak, Michael; Talan, David A.; Chambers, Henry F.; Infectious Diseases Society of America (2011-02-01). "Clinical practice guidelines by the infectious diseases society of america for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children". Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. 52 (3): –18-55. doi:10.1093/cid/ciq146. ISSN 1537-6591. PMID 21208910.
↑ 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.
↑ Kasper, Dennis (2015). Harrison's principles of internal medicine. New York: McGraw Hill Education. ISBN 978-0071802154.
↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
↑ Darouiche, Rabih O. (2006-11-09). "Spinal epidural abscess". The New England Journal of Medicine. 355 (19): 2012–2020. doi:10.1056/NEJMra055111. ISSN 1533-4406. PMID 17093252.
↑ Liu, Catherine; Bayer, Arnold; Cosgrove, Sara E.; Daum, Robert S.; Fridkin, Scott K.; Gorwitz, Rachel J.; Kaplan, Sheldon L.; Karchmer, Adolf W.; Levine, Donald P.; Murray, Barbara E.; J Rybak, Michael; Talan, David A.; Chambers, Henry F.; Infectious Diseases Society of America (2011-02-01). "Clinical practice guidelines by the infectious diseases society of america for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children". Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. 52 (3): –18-55. doi:10.1093/cid/ciq146. ISSN 1537-6591. PMID 21208910.
↑ Liu, Catherine; Bayer, Arnold; Cosgrove, Sara E.; Daum, Robert S.; Fridkin, Scott K.; Gorwitz, Rachel J.; Kaplan, Sheldon L.; Karchmer, Adolf W.; Levine, Donald P.; Murray, Barbara E.; J Rybak, Michael; Talan, David A.; Chambers, Henry F.; Infectious Diseases Society of America (2011-02-01). "Clinical practice guidelines by the infectious diseases society of america for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children". Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. 52 (3): –18-55. doi:10.1093/cid/ciq146. ISSN 1537-6591. PMID 21208910.
↑ Liu, Catherine; Bayer, Arnold; Cosgrove, Sara E.; Daum, Robert S.; Fridkin, Scott K.; Gorwitz, Rachel J.; Kaplan, Sheldon L.; Karchmer, Adolf W.; Levine, Donald P.; Murray, Barbara E.; J Rybak, Michael; Talan, David A.; Chambers, Henry F.; Infectious Diseases Society of America (2011-02-01). "Clinical practice guidelines by the infectious diseases society of america for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children". Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. 52 (3): –18-55. doi:10.1093/cid/ciq146. ISSN 1537-6591. PMID 21208910.
↑ Azari, Amir A.; Barney, Neal P. (2013-10-23). "Conjunctivitis: a systematic review of diagnosis and treatment". JAMA. 310 (16): 1721–1729. doi:10.1001/jama.2013.280318. ISSN 1538-3598. PMC 4049531. PMID 24150468.CS1 maint: PMC format (link)
↑ ^14.0 ^14.1 ^14.2 Solomkin JS, Mazuski JE, Bradley JS, Rodvold KA, Goldstein EJ, Baron EJ; et al. (2010). "Diagnosis and management of complicated intra-abdominal infection in adults and children: guidelines by the Surgical Infection Society and the Infectious Diseases Society of America". Clin Infect Dis. 50 (2): 133–64. doi:10.1086/649554. PMID 20034345.
↑ Mogayzel PJ, Naureckas ET, Robinson KA, Mueller G, Hadjiliadis D, Hoag JB; et al. (2013). "Cystic fibrosis pulmonary guidelines. Chronic medications for maintenance of lung health". Am J Respir Crit Care Med. 187 (7): 680–9. PMID 23540878.
↑ Pasteur MC, Bilton D, Hill AT, British Thoracic Society Bronchiectasis non-CF Guideline Group (2010). "British Thoracic Society guideline for non-CF bronchiectasis". Thorax. 65 Suppl 1: i1–58. doi:10.1136/thx.2010.136119. PMID 20627931.
↑ Stevens DL, Bisno AL, Chambers HF, Dellinger EP, Goldstein EJ, Gorbach SL; et al. (2014). "Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the infectious diseases society of America". Clin Infect Dis. 59 (2): 147–59. doi:10.1093/cid/ciu296. PMID 24947530.
↑ Lappin E, Ferguson AJ (2009). "Gram-positive toxic shock syndromes". Lancet Infect Dis. 9 (5): 281–90. doi:10.1016/S1473-3099(09)70066-0. PMID 19393958.
↑ Hillis LD, Smith PK, Anderson JL, Bittl JA, Bridges CR, Byrne JG; et al. (2011). "2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery. A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Developed in collaboration with the American Association for Thoracic Surgery, Society of Cardiovascular Anesthesiologists, and Society of Thoracic Surgeons". J Am Coll Cardiol. 58 (24): e123–210. doi:10.1016/j.jacc.2011.08.009. PMID 22070836.
↑ Workowski, Kimberly A.; Bolan, Gail A. (2015-06-05). "Sexually transmitted diseases treatment guidelines, 2015". MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control. 64 (RR-03): 1–137. ISSN 1545-8601. PMID 26042815.

[pmid19489710-1] Mermel LA, Allon M, Bouza E, Craven DE, Flynn P, O'Grady NP; et al. (2009). "Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 Update by the Infectious Diseases Society of America". Clin Infect Dis. 49 (1): 1–45. doi:10.1086/599376. PMC 4039170. PMID 19489710.

[2] Bennett, John (2015). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Elsevier/Saunders. ISBN 978-1455748013.

[3] Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.

[4] Liu, Catherine; Bayer, Arnold; Cosgrove, Sara E.; Daum, Robert S.; Fridkin, Scott K.; Gorwitz, Rachel J.; Kaplan, Sheldon L.; Karchmer, Adolf W.; Levine, Donald P.; Murray, Barbara E.; J Rybak, Michael; Talan, David A.; Chambers, Henry F.; Infectious Diseases Society of America (2011-02-01). "Clinical practice guidelines by the infectious diseases society of america for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children". Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. 52 (3): –18-55. doi:10.1093/cid/ciq146. ISSN 1537-6591. PMID 21208910.

[5] 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.

[6] Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.

[7] Kasper, Dennis (2015). Harrison's principles of internal medicine. New York: McGraw Hill Education. ISBN 978-0071802154.

[8] Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.

[9] Darouiche, Rabih O. (2006-11-09). "Spinal epidural abscess". The New England Journal of Medicine. 355 (19): 2012–2020. doi:10.1056/NEJMra055111. ISSN 1533-4406. PMID 17093252.

[10] Liu, Catherine; Bayer, Arnold; Cosgrove, Sara E.; Daum, Robert S.; Fridkin, Scott K.; Gorwitz, Rachel J.; Kaplan, Sheldon L.; Karchmer, Adolf W.; Levine, Donald P.; Murray, Barbara E.; J Rybak, Michael; Talan, David A.; Chambers, Henry F.; Infectious Diseases Society of America (2011-02-01). "Clinical practice guidelines by the infectious diseases society of america for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children". Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. 52 (3): –18-55. doi:10.1093/cid/ciq146. ISSN 1537-6591. PMID 21208910.

[11] Liu, Catherine; Bayer, Arnold; Cosgrove, Sara E.; Daum, Robert S.; Fridkin, Scott K.; Gorwitz, Rachel J.; Kaplan, Sheldon L.; Karchmer, Adolf W.; Levine, Donald P.; Murray, Barbara E.; J Rybak, Michael; Talan, David A.; Chambers, Henry F.; Infectious Diseases Society of America (2011-02-01). "Clinical practice guidelines by the infectious diseases society of america for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children". Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. 52 (3): –18-55. doi:10.1093/cid/ciq146. ISSN 1537-6591. PMID 21208910.

[12] Liu, Catherine; Bayer, Arnold; Cosgrove, Sara E.; Daum, Robert S.; Fridkin, Scott K.; Gorwitz, Rachel J.; Kaplan, Sheldon L.; Karchmer, Adolf W.; Levine, Donald P.; Murray, Barbara E.; J Rybak, Michael; Talan, David A.; Chambers, Henry F.; Infectious Diseases Society of America (2011-02-01). "Clinical practice guidelines by the infectious diseases society of america for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children". Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. 52 (3): –18-55. doi:10.1093/cid/ciq146. ISSN 1537-6591. PMID 21208910.

[13] Azari, Amir A.; Barney, Neal P. (2013-10-23). "Conjunctivitis: a systematic review of diagnosis and treatment". JAMA. 310 (16): 1721–1729. doi:10.1001/jama.2013.280318. ISSN 1538-3598. PMC 4049531. PMID 24150468.CS1 maint: PMC format (link)

[pmid20034345-14] 14.0 ^14.1 ^14.2 Solomkin JS, Mazuski JE, Bradley JS, Rodvold KA, Goldstein EJ, Baron EJ; et al. (2010). "Diagnosis and management of complicated intra-abdominal infection in adults and children: guidelines by the Surgical Infection Society and the Infectious Diseases Society of America". Clin Infect Dis. 50 (2): 133–64. doi:10.1086/649554. PMID 20034345.

[pmid23540878-15] Mogayzel PJ, Naureckas ET, Robinson KA, Mueller G, Hadjiliadis D, Hoag JB; et al. (2013). "Cystic fibrosis pulmonary guidelines. Chronic medications for maintenance of lung health". Am J Respir Crit Care Med. 187 (7): 680–9. PMID 23540878.

[pmid20627931-16] Pasteur MC, Bilton D, Hill AT, British Thoracic Society Bronchiectasis non-CF Guideline Group (2010). "British Thoracic Society guideline for non-CF bronchiectasis". Thorax. 65 Suppl 1: i1–58. doi:10.1136/thx.2010.136119. PMID 20627931.

[pmid24947530-17] Stevens DL, Bisno AL, Chambers HF, Dellinger EP, Goldstein EJ, Gorbach SL; et al. (2014). "Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the infectious diseases society of America". Clin Infect Dis. 59 (2): 147–59. doi:10.1093/cid/ciu296. PMID 24947530.

[pmid19393958-18] Lappin E, Ferguson AJ (2009). "Gram-positive toxic shock syndromes". Lancet Infect Dis. 9 (5): 281–90. doi:10.1016/S1473-3099(09)70066-0. PMID 19393958.

[pmid22070836-19] Hillis LD, Smith PK, Anderson JL, Bittl JA, Bridges CR, Byrne JG; et al. (2011). "2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery. A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Developed in collaboration with the American Association for Thoracic Surgery, Society of Cardiovascular Anesthesiologists, and Society of Thoracic Surgeons". J Am Coll Cardiol. 58 (24): e123–210. doi:10.1016/j.jacc.2011.08.009. PMID 22070836.

[20] Workowski, Kimberly A.; Bolan, Gail A. (2015-06-05). "Sexually transmitted diseases treatment guidelines, 2015". MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control. 64 (RR-03): 1–137. ISSN 1545-8601. PMID 26042815.

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