Sandbox aparna
- 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 ANDGentamicin 1 mg/kg q8h
- 1.2 Ampicillin resistant and vancomycin susceptible or Penicillin allergy
- Preferred regimen (1): Vancomycin 15 mg/kg IV q12h ANDGentamicin 1 mg/kg q8h
- Preferred regimen (2): Linezolid 600 mg q12h
- Preferred regimen (3): Daptomycin 6 mg/kg/day.
- 1.3 Ampicillin and Vancomycin resistant
- Preferred regimen (1): Linezolid 600 mg q12h
- Preferred regimen (2): Daptomycin 6 mg/kg/day IV
- 2.1 Endocarditis in Adults
- 2.1.1 Strains Susceptible to Penicillin, Gentamicin, and Vancomycin
- Preferred regimen: (Ampicillin 12 g/day IV for 4–6weeks ORAqueous crystalline penicillin G sodium 18–30 MU/day IV for 4–6weeks) ANDGentamicin sulfate 3 mg/kg/day IV/IM for 4–6 weeks
- Note : In case of native valve endocarditis, 4-wk therapy recommended for patients with symptoms of illness ≤3 months and 6-wk therapy recommended for patients with symptoms >3 months and prosthetic valve or other prosthetic cardiac material a minimum of 6 wk of therapy recommended
- Alternate regimen: Vancomycin hydrochloride 30 mg/kg/day IV for 6 weeks ANDGentamicin sulfate 3 mg/kg/day IV/IM for 6weeks
- 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 ORAqueous crystalline penicillin G sodium 24 MU/day IV for 4–6weeks)ANDStreptomycin sulfate 15 mg/kg/day IV/IM for 4–6weeks
- Alternate regimen: Vancomycin hydrochloride 30 mg/kg/day IV 6weeks ANDStreptomycin sulfate 15 mg/kg per 24 h IV/IM for 6weeks
- 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/day IV for 6weeks ANDGentamicin sulfate 3 mg/kg/day IV/IM 6weeks
- Alternate regimen: Vancomycin hydrochloride 30 mg/kg/day IV for 6weeks ANDGentamicin sulfate 3 mg/kg/day IV/IM for 6weeks
- 2.1.3.2 Intrinsic penicillin resistance
- Preferred regimen: Vancomycin hydrochloride 30 mg/kg/day IV for 6weeks ANDGentamicin sulfate 3 mg/kg/day IV/IM for 6weeks
- 2.1.4 Strains Resistant to Penicillin, Aminoglycoside, and Vancomycin
- Preferred regimen (1): (Imipenem ORCilastatin 2 g/day IV for ≥ 8weeks ANDAmpicillin 12 g/day IV for ≥ 8weeks)
- Preferred regimen (2): (Ceftriaxone sodium 4 g/day IV/IM for ≥ 8weeks ANDAmpicillin 12 g/day IV for ≥ 8weeks)
- 2.2 Endocarditis in Pediatrics
- 2.2.1 Strains Susceptible to Penicillin, Gentamicin, and Vancomycin
- Preferred regimen: (Ampicillin 300 mg/kg/day IV for 4–6weeks ORPenicillin 300,000 U/kg/day IV for 4–6 weeks) ANDGentamicin 3 mg/kg q24h IV/IM 4–6weeks
- Note : In case of native valve endocarditis, 4-wk therapy recommended for patients with symptoms of illness ≤3 months and 6-wk therapy recommended for patients with symptoms >3 months and prosthetic valve or other prosthetic cardiac material a minimum of 6 wk of therapy recommended
- Alternate regimen : Vancomycin 40 mg/kg/day IV for 6weeks ANDGentamicin 3 mg/kg/day IV/IM for 6weeks
- 2.2.2 Strains Susceptible to Penicillin, Streptomycin, and Vancomycin and Resistant to Gentamicin
- Preferred regimen: (Ampicillin 300 mg/kg/day IV for 4–6weeks ORPenicillin 300,000 U/kg/day IV for 4–6weeks) ANDStreptomycin 20–30 mg/kg/day IV/IM for 4–6 weeks
- Alternate regimen: Vancomycin hydrochloride 40 mg/kg/day IV for 6weeks ANDStreptomycin sulfate 15 mg/kg/day IV/IM for 6weeks
- 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/day IV for 6weeks ANDGentamicin 3 mg/kg/day IV/IM for 6weeks
- Alternate regimen: Vancomycin 40 mg/kg/day IV for 6weeks ANDGentamicin 3 mg/kg/day IV/IM for 6weeks
- 2.2.3.2 Intrinsic penicillin resistance
- Preferred regimen: Vancomycin 40 mg/kg/day IV ANDGentamicin 3 mg/kg/day IV/IM for 6weeks
- 2.2.4 Strains Resistant to Penicillin, Aminoglycoside, and Vancomycin
- Preferred regimen: Imipenem/Cilastatin 60–100 mg/kg/day IV for ≥ 8weeks ANDAmpicillin 300 mg/kg/day IV for ≥ 8weeks
- Alternate regimen: Ceftriaxone 100 mg/kg/day IV/IM ANDAmpicillin 300 mg/kg/day IV for ≥ 8weeks
- 3. Meningitis[4]
- 3.1 Ampicillin susceptible
- Preferred regimen: Ampicillin 12 g/day IV q4h ANDGentamicin 5 mg/kg/day IV q8h
- 3.2 Ampicillin resistant
- Preferred regimen: Vancomycin 30–45 mg/kg/day IV q8–12h ANDGentamicin 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
- Enterococcus faecium
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- 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 ANDGentamicin 1 mg/kg q8h
- 1.2 Ampicillin resistant and vancomycin susceptible or Penicillin allergy
- Preferred regimen (1): Vancomycin 15 mg/kg IV q12h ANDGentamicin 1 mg/kg q8h
- Preferred regimen (2): Linezolid 600 mg q12h
- Preferred regimen (3): Daptomycin 6 mg/kg/day.
- 1.3 Ampicillin and Vancomycin resistant
- Preferred regimen (1): Linezolid 600 mg q12h
- Preferred regimen (2): Daptomycin 6 mg/kg/day IV
- 2. Endocarditis
- 2.1 Endocarditis in Adults [2]
- Strains Susceptible to Penicillin, Gentamicin, and Vancomycin
- Preferred regimen: (Ampicillin 12 g/day IV for 4–6weeks ORAqueous crystalline penicillin G sodium 18–30 MU/day IV for 4–6weeks) ANDGentamicin sulfate 3 mg/kg/day IV/IM for 4–6 weeks
- Note : In case of native valve endocarditis, 4-wk therapy recommended for patients with symptoms of illness ≤3 months and 6-wk therapy recommended for patients with symptoms >3 months and prosthetic valve or other prosthetic cardiac material a minimum of 6 wk of therapy recommended
- Alternate regimen: Vancomycin hydrochloride 30 mg/kg/day IV for 6 weeks ANDGentamicin sulfate 3 mg/kg/day IV/IM for 6weeks
- Strains Susceptible to Penicillin, Streptomycin, and Vancomycin and Resistant to Gentamicin
- Preferred regimen : (Ampicillin 12 g/day IV for 4–6 weeks ORAqueous crystalline penicillin G sodium 24 MU/day IV for 4–6weeks)ANDStreptomycin sulfate 15 mg/kg/day IV/IM for 4–6weeks
- Alternate regimen: Vancomycin hydrochloride 30 mg/kg/day IV 6weeks ANDStreptomycin sulfate 15 mg/kg per 24 h IV/IM for 6weeks
- Strains Resistant to Penicillin and Susceptible to Aminoglycoside and Vancomycin
- β Lactamase–producing strain
- Preferred regimen : Ampicillin-sulbactam 12 g/day IV for 6weeks ANDGentamicin sulfate 3 mg/kg/day IV/IM 6weeks
- Alternate regimen : Vancomycin hydrochloride 30 mg/kg/day IV for 6weeks ANDGentamicin sulfate 3 mg/kg/day IV/IM for 6weeks
- Intrinsic penicillin resistance : Vancomycin hydrochloride 30 mg/kg/day IV for 6weeks ANDGentamicin sulfate 3 mg/kg/day IV/IM for 6weeks
- Strains Resistant to Penicillin, Aminoglycoside, and Vancomycin
- Preferred regimen : Linezolid 1200 mg/day IV/PO ≥8weeks ORQuinupristin-Dalfopristin22.5 mg/kg/day IV ≥8weeks
- 2.2.Endocarditis in Pediatrics
- Strains Susceptible to Penicillin, Gentamicin, and Vancomycin
- Preferred regimen : (Ampicillin 300 mg/kg/day IV for 4–6 weeks ORPenicillin 300,000U/kg/day IV for 4–6 weeks) ANDGentamicin 3 mg/kg per 24 h IV/IM 4–6 weeks
- Note : In case of native valve endocarditis, 4-wk therapy recommended for patients with symptoms of illness ≤3 months and 6-wk therapy recommended for patients with symptoms >3 months and prosthetic valve or other prosthetic cardiac material a minimum of 6 wk of therapy recommended
- Alternate regimen : Vancomycin 40 mg/kg/day IV for 6weeks ANDGentamicin 3 mg/kg/day IV/IM for 6weeks
- Strains Susceptible to Penicillin, Streptomycin, and Vancomycin and Resistant to Gentamicin
- Preferred regimen : (Ampicillin 300 mg/kg/day IV for 4–6 weeks ORPenicillin 300,000 U/kg/day IV for 4–6 weeks) ANDStreptomycin 20–30 mg/kg/day IV/IM for 4–6 weeks
- Alternate regimen: Vancomycin hydrochloride 40 mg/kg/day IV for 6weeks ANDStreptomycin sulfate 15 mg/kg/day IV/IM for 6weeks
- Strains Resistant to Penicillin and Susceptible to Aminoglycoside and Vancomycin
- β Lactamase–producing strain
- Preferred regimen : Ampicillin-sulbactam 300 mg/kg/day IV for 6weeks ANDGentamicin 3 mg/kg/day IV/IM for 6weeks
- Alternate regimen : Vancomycin 40 mg/kg/day IV for 6weeks ANDGentamicin 3 mg/kg/day IV/IM for 6weeks
- Intrinsic penicillin resistance : Vancomycin 40 mg/kg/day IV ANDGentamicin 3 mg/kg/day IV/IM for 6weeks
- Strains Resistant to Penicillin, Aminoglycoside, and Vancomycin
- Preferred regimen : Linezolid 30 mg/kg/day IV/PO ≥ 8weeks ORQuinupristin-Dalfopristin22.5 mg/kg/day IV ≥ 8weeks
- 3.Meningitis[4]
- Ampicillin susceptible
- Preferred regimen: Ampicillin 12 g/day IV q4h ANDGentamicin 5 mg/kg/day IV q8h
- Ampicillin resistant
- Preferred regimen: Vancomycin 30–45 mg/kg/day IV q8–12h ANDGentamicin 5 mg/kg/day IV q8h
- Ampicillin and vancomycin resistant
- Preferred regimen: Linezolid 600 mg IV q12h
- 4.Urinary tract infections [8]
- Preferred regimen : Nitrofurantoin 100 mg PO q6h for 5 days ORFosfomycin 3 g PO single dose ORAmoxicillin 875 mg-1 g PO q12h for 5 days
- 5.Intra abdominal or Wound infections [9]
- Penicillin or Ampicillin are preferred agents, Vancomycin in setting of penicillin allergy or high-level penicillin resistance.
- For complicated skin-skin structure and intra-abdominal infection : Tigecycline 100 mg IV single dose and 50 mg IV q12h
- ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
- ↑ 2.0 2.1 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.
- ↑ 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.