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  • 1. Methicillin-susceptible strain[1][2]
  • Preferred regimen (1): Nafcillin 1–2 g IV q4-6h (maximum 12 g/day)
  • Preferred regimen (2): Oxacillin 1–2 g IVq4-6h (maximum 12 g/day)
  • Preferred regimen (3): Cefazolin 0.5–2 g IV q6-8h
  • Alternative regimen (1): TMP-SMX 4–5 mg/kg IV q6–12h
  • Alternative regimen (2): Doxycycline 100–200 mg IV q12-24h
  • 2. Methicillin-resistant, Glycopeptide-susceptible strain
  • Preferred regimen: Vancomycin 15–20 mg/kg IV q8–12h
  • 3. Methicillin-resistant, Glycopeptide-resistant strain
  • Preferred regimen (1): Daptomycin 4–6 mg/kg IV q24h
  • Preferred regimen (2): Linezolid 600 mg PO/IV q12h

  • 1. Urinary tract infections[3]

  • 1. Dental abscess[4]
  • 2. Brain abscess
  • Preferred regimen (1): Penicillin G 18–24 MU/day IV q4–6h
  • Preferred regimen (2): Ceftriaxone 2 g IV q12h
  • Alternative regimen: Vancomycin 15–20 mg/kg IV q8–12h

  • 1. Food poisoning[5]
  • Preferred regimen: Food poisoning is usually self-limited and requires no antibiotic therapy.
  • 2. Bacteremia
  • Preferred regimen: Vancomycin 15 mg/kg IV q12h
  • Alternative regimen: Clindamycin 600 mg IV q8h
  • Note (1): Bacillus cereus is commonly resistant to beta-lactams.
  • Note (2): Pseudobacteremia is transient and usually results from contaminated blood cultures, gloves, or syringes.
  • 3. Meningitis or brain abscess
  • Preferred regimen: Vancomycin 15 mg/kg IV q12h
  • Alternative regimen: Clindamycin 600 mg IV q8h
  • Note: Blood culture isolates are mostly contaminates until proven otherwise, especially in intravenous drug user population.
  • 4. Endophthalmitis
  • Preferred regimen: Clindamycin 450 μg intravitreal AND Gentamicin 400 μg intravitreal OR Dexamethasone intravitreal AND Vancomycin 15 mg/kg IV q12h
  • Alternative regimen: Clindamycin 600 mg IV q8h
  • Note: Ophthalmological consultation, culture ocular fluids, early vitrectomy, and intravitreal antibiotics are necessary.
  • 5. Endocarditis
  • Preferred regimen: Vancomycin 15 mg/kg IV q12h
  • Note: Most blood cultures in intravenous drug users are contaminates or represent transient bacteremia.
  • 6. Soft tissue infection
  • 7. Pneumonia

References

  1. Abramowicz, Mark (2011). Handbook of antimicrobial therapy : selected articles from Treatment guidelines with updates from The medical letter. New Rochelle, N.Y: The Medical Letter. ISBN 978-0981527826.
  2. Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
  3. Abramowicz, Mark (2011). Handbook of antimicrobial therapy : selected articles from Treatment guidelines with updates from The medical letter. New Rochelle, N.Y: The Medical Letter. ISBN 978-0981527826.
  4. Abramowicz, Mark (2011). Handbook of antimicrobial therapy : selected articles from Treatment guidelines with updates from The medical letter. New Rochelle, N.Y: The Medical Letter. ISBN 978-0981527826.
  5. Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.