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 {| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table21" style="background: #FFFFFF;"

Listeria monocytogenes 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)

N. meningitidis, Penicillin MIC <0.1 μg/mL Preferred Regimen ▸ Penicillin G 4 MU IV q4h OR ▸ Ampicillin 2 g IV q4h Alternative Regimen ▸ Cefotaxime 2 g IV q4—6h OR ▸ Ceftriaxone 2 g IV q12h OR ▸ Chloramphenicol 1—1.5 g IV q6h N. meningitidis, Penicillin MIC ≥0.1 μg/mL Preferred Regimen ▸ Cefotaxime 2 g IV q4—6h OR ▸ Ceftriaxone 2 g IV q12h Alternative Regimen Expand▸ 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 Expand▸ 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 Expand▸ Rifampin 600 mg IV q24h

Staphylococcus epidermidis Preferred Regimen ▸ Vancomycin 15 mg/kg IV q6h (trough 15—20 μg/mL) PLUS ▸ Rifampin 600 mg IV q24h Alternative Regimen ▸ Linezolid 600 mg IV q12h PLUS Expand▸ Rifampin 600 mg IV q24h

Streptococcus agalactiae Preferred Regimen ▸ Ampicillin 2 g IV q4h OR ▸ Penicillin G 4 MU IV q4h PLUS ▸ Gentamicin 1.7 mg/kg IV q8h Alternative Regimen Expand▸ Cefotaxime 2 g IV q4—6h OR ▸ Ceftriaxone 2 g IV q12h OR ▸ Vancomycin 15 mg/kg IV q6h (trough 15—20 μg/mL)

S. pneumoniae, Penicillin MIC ≤0.06 μg/mL Preferred Regimen ▸ Penicillin G 4 MU IV q4h OR ▸ Ampicillin 2 g IV q4h Alternative Regimen ▸ Cefotaxime 2 g IV q4—6h OR ▸ Ceftriaxone 2 g IV q12h OR ▸ Chloramphenicol 1—1.5 g IV q6h S. pneumoniae, Penicillin MIC ≥0.12 μg/mL, Cefotaxime/Ceftriaxone MIC <1.0 μg/mL 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 S. pneumoniae, Penicillin MIC ≥0.12 μg/mL, Cefotaxime/Ceftriaxone MIC ≥1.0 μg/mL Preferred Regimen ▸ Vancomycin 15 mg/kg IV q6h (trough 15—20 μg/mL) PLUS ▸ Cefotaxime 2 g IV q4—6h OR ▸ Ceftriaxone 2 g IV q12h PLUS ▸ Rifampin 600 mg IV q24h Alternative Regimen ▸ Vancomycin 15 mg/kg IV q6h (trough 15—20 μg/mL) PLUS Expand▸ Moxifloxacin 400 mg IV q24h

Mycobacterium tuberculosis (New Patients) Intensive Phase ▸ Isoniazid 5 mg/kg PO qd × 2 months OR ▸ Isoniazid 10 mg/kg PO 3 times per week × 2 months PLUS ▸ Rifampicin 10 mg/kg PO qd × 2 months OR ▸ Rifampicin 10 mg/kg PO 3 times per week × 2 months PLUS ▸ Pyrazinamide 25 mg/kg PO qd × 2 months OR ▸ Pyrazinamide 35 mg/kg PO 3 times per week × 2 months PLUS ▸ Streptomycin 15 mg/kg PO qd × 2 months OR ▸ Streptomycin 15 mg/kg PO 3 times per week × 2 months Continuation Phase ▸ Isoniazid 5 mg/kg PO qd × 4 months OR ▸ Isoniazid 10 mg/kg PO 3 times per week × 2 months PLUS ▸ Rifampicin 10 mg/kg PO qd × 4 months OR ▸ Rifampicin 10 mg/kg PO 3 times per week × 2 months ExpandAdapted from Treatment of Tuberculosis: Guidelines.

Borrelia burgdorferi Preferred Regimen ▸ Ceftriaxone 2 g IV q24h × 10—28 days Alternative Regimen ▸ Cefotaxime 2 g IV q8h × 10—28 days OR ▸ Penicillin G 3—4 MU IV q4h × 10—28 days OR ▸ Doxycycline 100—200 mg PO q12h × 10—28 days ExpandAdapted from Clin Infect Dis. 2006;43(9):1089-134.

Treponema pallidum Preferred Regimen ▸ Penicillin G 3—4 MU IV q4h × 10—14 days Alternative Regimen ▸ Procaine penicillin 2.4 MU IM q24h × 10—14 days PLUS ▸ Probenecid 500 mg PO q6h × 10—14 days ExpandAdapted from MMWR Recomm Rep. 2006;55(RR-11):1-94.

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