Sandbox/AL

Pathogen-Based Therapy — Bacteria Adapted from

▸ Click on the following categories to expand treatment regimens.

Bacteria

▸ Staphylococcus aureus

▸ Staphylococcus epidermidis

▸ Methicillin-resistant S. aureus

▸ Streptococcus groups A, B, C, G

▸ Enterococcus feacalis

Staphylococcus aureus
Preferred Regimen
▸ Nafcillin 2 g IV q6h
Alternative Regimen
▸ Vancomycin OR ▸ Cefazolin OR ▸ Clindamycin

Staphylococcus epidermidis
Preferred Regimen
▸ Vancomycin 15 mg/kg IV q12h
Alternative Regimen
▸ TMP-SMX OR

Methicillin-resistant S. aureus
Preferred Regimen
▸ Vancomycin 15 mg/kg IV q12h
Alternative Regimen
▸ TMP-SMX OR ▸ Doxycycline OR ▸ Linezolid

Streptococcus groups A, B, C, G
Preferred Regimen
▸ Penicillin G 2 MU IV q4h
Alternative Regimen
▸ Vancomycin OR ▸ Cefazolin OR ▸ Erythromycin

Enterococcus faecalis
Preferred Regimen
▸ Penicillin G 2 MU IV q4h OR ▸ Ampicillin 2 g IV q6h
PLUS
▸ Gentamicin 1 mg/kg IV or IM q8h
Alternative Regimen
Vancomycin
PLUS
▸ Gentamicin 1 mg/kg IV or IM q8h
N. meningitidis, Penicillin MIC ≥0.1 μg/mL
Preferred Regimen
▸ Cefotaxime 2 g IV q4—6h OR ▸ Ceftriaxone 2 g IV q12h
Alternative Regimen
▸ Cefepime 2 g IV q8h OR ▸ Chloramphenicol 1—1.5 g IV q6h OR ▸ Moxifloxacin 400 mg IV q24h OR ▸ Meropenem 2 g IV q8h

Pseudomonas aeruginosa
Preferred Regimen
▸ Ceftazidime 2 g IV q8h OR ▸ Cefepime 2 g IV q8h
PLUS
▸ Gentamicin 1.7 mg/kg IV q8h
Alternative Regimen
▸ Aztreonam 2 g IV q6—8h OR ▸ Meropenem 2 g IV q8h OR ▸ Ciprofloxacin 400 mg IV q8—12h
PLUS
▸ Gentamicin 1.7 mg/kg IV q8h

Staphylococcus aureus, Methicillin sensitive
Preferred Regimen
▸ Nafcillin 1.5—2 g IV q4h OR ▸ Oxacillin 1.5—2 g IV q4h
Alternative Regimen
▸ Vancomycin 15 mg/kg IV q6h (trough 15—20 μg/mL) OR ▸ Linezolid 600 mg IV q12h OR ▸ Daptomycin 6 mg/kg IV q24h
Staphylococcus aureus, Methicillin resistant
Preferred Regimen
▸ Vancomycin 15 mg/kg IV q6h (trough 15—20 μg/mL)
PLUS
▸ Rifampin 600 mg IV q24h
Alternative Regimen
▸ TMP/SMZ 5 mg/kg IV q6—12h (TMP component) OR ▸ Linezolid 600 mg IV q12h OR ▸ Daptomycin 6 mg/kg IV q24h
PLUS
▸ Rifampin 600 mg IV q24h