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<font color="#FFF">
<font color="#FFF">
▸ '''''Haemophilus influenzae'''''
▸ '''''Haemophilus influenzae'''''
</font>
</div>
<div class="mw-customtoggle-table24" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 300px; background: #4479BA;">
<font color="#FFF">
▸ '''''Nocardia'''''
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</div>
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|-
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| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Trimethoprim/Sulfamethoxazole]] 160mg/800mg PO qd for 1 year'''''
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Trimethoprim/Sulfamethoxazole]] 160mg/800mg PO qd for 1 year'''''
|-
|}
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{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table24" style="background: #FFFFFF;"
| valign=top |
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|''Nocardia'' }}
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | Preferred Regimen
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[['''''
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | Alternative Regimen
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[''''' <BR> OR <BR> ▸ '''''[[
|-
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|}
Revision as of 19:11, 19 May 2014
The treatment for septic arthritis requires an adequate drainage of purulent joint fluid and appropriate antimicrobial therapy.
Empiric therapy should be started after the collection joint fluid and blood sample, and these should be send for culture.
Empiric Therapy Adapted from Lancet 375:846, 2010. [1]
▸ Click on the following categories to expand treatment regimens.
▸ Children (3 mo - 14 yr)
Infants (1- 3 months)
Preferred Regimen
High suspicion of MRSA
▸ Vancomycin 40 mg/kg/day divided q6-8h
PLUS
▸ Cefotaxime 50 mg/kg IV q8h
Low suspicion of MRSA
▸ Nafcillin 37 mg/kg q6h (max 8-12 g/day) OR ▸ Oxacillin 37 mg/kg q6h (max 8-12 g/day)
PLUS
▸ Cefotaxime 50 mg/kg IV q8h
Alternative Regimen
▸ Clindamycin 7.5mg/kg q6h
Chronic Monoarticular
Empirical therapy is not recommended. Treatment should be addressed for the specific etiology
Polyarticular
Preferred Regimen
▸ Ceftriaxone 1 gm IV q24h
CSF Gram Stain-Based Therapy Adapted from Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases[2]
▸ Click on the following categories to expand treatment regimens.
Gram-Positive Cocci
Preferred Regimen
▸ Vancomycin 15-20 mg/kg IV q8—12h (trough 15—20 μg/mL)
Alternative Regimen (For patients allergic to vancomycin)
▸ Linezolid OR ▸ Daptomycin
Gram-Negative Cocci
Preferred Regimen
▸ Ceftriaxone 1 g IV q24h
Pathogen-Based Therapy — Bacteria Adapted from
▸ Click on the following categories to expand treatment regimens.
▸ Staphylococcus epidermidis
▸ Streptococcus groups A, B, C, G
▸ Mycobacterium tuberculosis
Staphylococcus aureus, Methicillin sensitive
Preferred Regimen
▸ Nafcillin 1.5-2 g IV q4h OR ▸ Oxacillin 1.5-2 g IV q4h OR ▸ Cefazolin 1 g IV q8h
Alternative Regimen
▸ Dicloxacillin 500 mg PO q6h' OR ▸ Cephalexin 500 mg PO q6h OR ▸ Clindamycin 300 mg PO q8h OR ▸ TMP-SMX 160-800 mg PO q12h
Staphylococcus aureus, Methicillin resistant
Preferred Regimen
▸ Vancomycin 15-20 mg/kg IV q8-12h
Alternative Regimen
▸ Daptomycin 6 mg IV qd OR ▸ Linezolid 600 mg IV/PO q12h
Adapted from IDSA Guidelines for MRSA[3]
Staphylococcus epidermidis
Preferred Regimen
▸ Nafcillin 1.5-2 g IV q4h OR ▸ Oxacillin 1.5-2 g IV q4h OR ▸ Cefazolin 1 g IV q8h
Alternative Regimen Methicillin-resistant
▸ Vancomycin 15-20 mg/kg IV q8h |}
Streptococcus groups A, B, C, G
Preferred Regimen
▸ Penicillin G 20 MU IV q24h or divided in 6 doses/day OR ▸ Ceftriaxone 2 g IV or IM q24h OR ▸ Cefazolin 1 g IV q8h
Alternative Regimen
▸ Vancomycin 15mg/kg IV q12h
E. coli
Preferred Regimen
▸
Alternative Regimen
▸ [
Neisseria gonorrhoeae
Preferred Regimen
▸ Ceftriaxone 1 g IV q24h for 1-2 days after clinical improvement
FOLLOWED BY
▸ Cefixime 400 mg po q12h for 1 week OR ▸ Ciprofloxacin 500 mg po q12h for 1 week OR ▸ Ofloxacin 400 mg PO q12h for 1 week
Alternative Regimen
▸ Ciprofloxacin 400 mg IV q12h for 1-2 days after clinical improvement OR ▸ Ofloxacin 400 mg iv q12h for 1-2 days after clinical improvement OR ▸ Spectinomycin 2 g IM q12h for 1-2 days after clinical improvement
FOLLOWED BY
▸ Ciprofloxacin 500 mg po q12h for 1 week OR ▸ Ofloxacin 400 mg po q12h for 1 week
Mycobacterium tuberculosis
Intensive Phase
▸ Isoniazid 5mg/kg PO qd for 2 months OR ▸ Isoniazid 10 mg/kg PO 3 times per week × 2 months
PLUS
▸ Rifampicin 10 mg/kg PO qd for 2 months OR ▸ Rifampicin 10 mg/kg PO 3 times per week × 2 months
PLUS
▸ Pyrazinamide 25mg/kg PO qd for 2 months OR ▸ Pyrazinamide 35 mg/kg PO 3 times per week × 2 months
PLUS
▸ Ethambutol 15mg/kg PO qd for 2 months
Continuation Phase
▸ Isoniazid 5mg/kg PO for 4-7 months OR ▸ Isoniazid 10 mg/kg PO 3 times per week × 4-7 months
PLUS
▸ Rifampicin 10 mg/kg PO qd for 4-7 months OR ▸ Rifampicin 10 mg/kg PO 3 times per week for 4-7 months
Adapted from Treatment of Tuberculosis: Guidelines. [4]
Borrelia burgdorferi
Preferred Regimen
▸ Amoxicillin 500 mg q8h for 28 days OR ▸ Doxycycline 100 mg q12h for 28 days OR ▸ Cefuroxime 500 mg q12h for 28 days
Alternative Regimen
▸ Azithromycin 500 mg PO qd for 7–10 days OR ▸ Clarithromycin 500 mg PO q12h for 14–21 days OR ▸ Erythromycin 500 mg PO q6h for 14–21 days
Adapted from IDSA Guidelines: The Clinical Assessment, Treatment, and Prevention of Lyme Disease, Human Granulocytic Anaplasmosis, and Babesiosis: [5]
Treponema pallidum
Preferred Regimen
▸ Penicilin G 2.4 MU IM single dose
Alternative Regimen
▸ Doxycycline 100 mg PO q12h x 14 days OR ▸ Tetracycline 500 mg PO q6h x 14 days OR ▸ Ceftriaxone 1 g IM/IV q24h x 10 -14 days
Adapted from Adapted from MMWR Recomm Rep. 2006;55(RR-11):1-94[6]
Pathogen-Based Therapy — Fungi
▸ Click on the following categories to expand treatment regimens.
Candida
Preferred Regimen
▸ Amphotericin B deoxycholate 0.5-1 mg/kg/day for 2-3 weeks
FOLLOWED BY
▸ Fluconazole to complete a total duration of therapy of 6-12 months.
Preferred Regimen
▸ Itraconazole 400 mg/day for at least 12 months
Pathogen-Based Therapy in Patients with Prosthetic Joint — Bacteria Adapted from Diagnosis and Management of Prosthetic Joint Infection CID 2013:56[7]
▸ Click on the following categories to expand treatment regimens.
▸ Staphylococci, oxacillin-susceptible
▸ Staphylococci, oxacillin-resistant
▸ Enterococcus spp, penicillin-susceptible
▸ Enterococcus spp, penicillin-resistant
Staphylococci, oxacillin-resistant
Preferred Regimen
▸ Vancomycin 15 mg/kg IV q12h
Alternative Regimen
▸ Daptomycin 6 mg/kg IV q24h OR ▸ Linezolid 600 mg PO/IV q12h
Enterococcus spp, penicillin-susceptible
Preferred Regimen
▸ Penicillin G 20-40 MU IV q24h continuously or divided in 6 doses
Alternative Regimen
▸ Vancomycin IV 15 mg/kg q12h OR ▸ Daptomycin 6 mg/kg IV q24h OR ▸ Linezolid 600 mg PO/IV q12h
Enterococcus spp, penicillin-resistant
Preferred Regimen
▸ Vancomycin IV 15 mg/kg q12h
Alternative Regimen
▸ Daptomycin 6 mg/kg IV q24h OR ▸ Linezolid 600 mg PO/IV q12h
Enterobacter spp
Preferred Regimen
▸ Cefepime 2 g IV q12h OR ▸ Ertapenem 1 g IV q24 h
Alternative Regimen
▸ Ciprofloxacin 750 mg PO q12h or 400 mg IV q12h
Preferred Regimen
▸ [[
Alternative Regimen
▸ [
↑ . doi :10.1016/S0140-6736(09)61595-6. .
↑ Mandell, Gerald L.; Bennett, John E. (John Eugene); Dolin, Raphael. (2010). Mandell, Douglas, and Bennett's principles and practice of infectious disease . Philadelphia, PA: Churchill Livingstone/Elsevier. ISBN [[Special:BookSources/<!DOCTYPE|<!DOCTYPE]].
↑ Liu, C.; Bayer, A.; Cosgrove, S. E.; Daum, R. S.; Fridkin, S. K.; Gorwitz, R. J.; Kaplan, S. L.; Karchmer, A. W.; Levine, D. P.; Murray, B. E.; Rybak, M. J.; Talan, D. A.; Chambers, H. F. (2011). "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 . 52 (3): e18–e55. doi :10.1093/cid/ciq146 . ISSN 1058-4838 .
↑ Treatment of tuberculosis : guidelin . Geneva: World Health Organization. 2010. ISBN 978-92-4-154783-3 .
↑ . doi :10.1086/522848 .
↑ "http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5511a1.htm" . Retrieved 19 May 2014 .
↑ Osmon, D. R.; Berbari, E. F.; Berendt, A. R.; Lew, D.; Zimmerli, W.; Steckelberg, J. M.; Rao, N.; Hanssen, A.; Wilson, W. R. (2012). "Diagnosis and Management of Prosthetic Joint Infection: Clinical Practice Guidelines by the Infectious Diseases Society of America". Clinical Infectious Diseases . 56 (1): e1–e25. doi :10.1093/cid/cis803 . ISSN 1058-4838 .