Sandbox/v44

CSF Gram Stain-Based Therapy Adapted from Lancet. 2012;380(9854):1693-702. and Clin Infect Dis. 2004;39(9):1267-84.

Gram-Positive   ▸  Gram-Positive Cocci in Chains   ▸  Gram-Positive Cocci in Pairs   ▸  Gram-Positive (Cocco-)Bacilli Gram-Negative   ▸  Gram-Negative Cocci in Pairs   ▸  Gram-Negative Coccobacilli   ▸  Gram-Negative Bacilli

Gram-Positive Cocci in Chains Preferred Regimen ▸ Vancomycin 15 mg/kg IV q8—12h (trough 15—20 μg/mL) PLUS ▸ Cefotaxime 2 g IV q4—6h OR ▸ Ceftriaxone 2 g IV q12h Alternative Regimen ▸ Meropenem 2 g IV q8h OR ▸ Moxifloxacin 400 mg IV q24h Gram-Positive Cocci in Pairs Preferred Regimen ▸ Ampicillin 2 g IV q4h OR ▸ Penicillin G 4 MU IV q4h PLUS ▸ Gentamicin 1.7 mg/kg IV q8h Alternative Regimen ▸ Cefotaxime 2 g IV q4—6h OR ▸ Ceftriaxone 2 g IV q12h Gram-Positive (Cocco-)Bacilli Preferred Regimen ▸ Ampicillin 2 g IV q4h OR ▸ Penicillin G 4 MU IV q4h PLUS ▸ Gentamicin 1.7 mg/kg IV q8h Alternative Regimen ▸ TMP/SMZ 5 mg/kg IV q6—12h (TMP component) OR ▸ Meropenem 2 g IV q8h Gram-Negative Cocci in Pairs Preferred Regimen ▸ Cefotaxime 2 g IV q4—6h OR ▸ Ceftriaxone 2 g IV q12h Alternative Regimen ▸ Penicillin G 4 MU IV q4h OR ▸ Ampicillin 2 g IV q4h OR ▸ Chloramphenicol 1—1.5 g IV q6h OR ▸ Moxifloxacin 400 mg IV q24h OR ▸ Aztreonam 2 g IV q6—8h Gram-Negative Coccobacilli Preferred Regimen ▸ Cefotaxime 2 g IV q4—6h OR ▸ Ceftriaxone 2 g IV q12h Alternative Regimen ▸ Chloramphenicol 1—1.5 g IV q6h OR ▸ Cefepime 2 g IV q8h OR ▸ Meropenem 2 g IV q8h OR ▸ Moxifloxacin 400 mg IV q24h Gram-Negative Bacilli Preferred Regimen ▸ Cefotaxime 2 g IV q4—6h OR ▸ Ceftriaxone 2 g IV q12h Alternative Regimen ▸ Cefepime 2 g IV q8h OR ▸ Meropenem 2 g IV q8h OR ▸ Aztreonam 2 g IV q6—8h OR ▸ Moxifloxacin 400 mg IV q24h OR ▸ TMP/SMZ 5 mg/kg IV q6—12h (TMP component)