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Line 24: |
Line 24: |
| *Enterocutaneous fistula formation | | *Enterocutaneous fistula formation |
| *Bowel obstruction | | *Bowel obstruction |
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| ==Antibiotic Regimens==
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| *'''1. Community-acquired infection in adults''' <ref name="pmid20034345">{{cite journal| author=Solomkin JS, Mazuski JE, Bradley JS, Rodvold KA, Goldstein EJ, Baron EJ et al.| title=Diagnosis and management of complicated intra-abdominal infection in adults and children: guidelines by the Surgical Infection Society and the Infectious Diseases Society of America. | journal=Clin Infect Dis | year= 2010 | volume= 50 | issue= 2 | pages= 133-64 | pmid=20034345 | doi=10.1086/649554 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20034345 }} </ref>
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| :*'''1.1. Mild-to-moderate severity (perforated or abscessed appendicitis and other infections of mild-to-moderate severity):'''
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| ::*'''1.1.1. Single agent:'''
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| :::*Preferred regimen (1): [[Cefoxitin]] 2 g IV q6h
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| :::*Preferred regimen (2): [[Ertapenem]] 1 g IV q24h
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| :::*Preferred regimen (3): [[Moxifloxacin]] 400 mg IV q24h
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| :::*Preferred regimen (4): [[Tigecycline]] 100 mg initial dose, {{then}} 50 mg IV q12h
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| :::*Preferred regimen (5): [[Ticarcillin]]-[[clavulanic acid]] 3.1 g IV q6h; FDA labeling indicates 200 mg/kg/day in divided doses every 6 h for moderate infection
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|
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| ::*'''1.1.2. Combination:'''
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| :::*Preferred regimen (1): [[Cefazolin]] 1–2 g IV q8h {{and}} [[Metronidazole]] 500 mg IV q8–12 h {{or}} 1500 mg q24h
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| :::*Preferred regimen (2): [[Cefuroxime]] 1.5 g IV q8h {{and}} [[Metronidazole]] 500 mg IV q8–12 h {{or}} 1500 mg q24h
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| :::*Preferred regimen (3): [[Ceftriaxone]] 1–2 g IV q12–24 h {{and}} [[Metronidazole]] 500 mg IV q8–12 h {{or}} 1500 mg q24h
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| :::*Preferred regimen (4): [[Cefotaxime]] 1–2 g IV q6–8 h {{and}} [[Metronidazole]] 500 mg IV q8–12 h {{or}} 1500 mg q24h
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| :::*Preferred regimen (5): [[Ciprofloxacin]] 400 mg IV q12h {{and}} [[Metronidazole]] 500 mg IV q8–12 h {{or}} 1500 mg q24h
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| :::*Preferred regimen (6): [[Levofloxacin]] 750 mg IV q24h {{and}} [[Metronidazole]] 500 mg IV q8–12 h {{or}} 1500 mg q24h
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|
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| :*'''1.2. High risk or severity (severe physiologic disturbance, advanced age, or immunocompromised state):'''
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| ::*'''1.2.1. Single agent:'''
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| :::*Preferred regimen (1): Imipenem-cilastatin 500 mg IV q6h {{or}} 1 g q8h
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| :::*Preferred regimen (2): [[Meropenem]] 1 g IV q8h
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| :::*Preferred regimen (3): [[Doripenem]] 500 mg IV q8h
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| :::*Preferred regimen (4): [[Piperacillin-tazobactam]] 3.375 g IV q6h
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|
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| ::*'''1.2.2. Combination:'''
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| :::*Preferred regimen (1): [[Cefepime]] 2 g q8–12 h {{and}} [[Metronidazole]] 500 mg IV q8–12 h or 1500 mg q24h
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| :::*Preferred regimen (2): [[Ceftazidime]] 2 g q8h {{and}} [[Metronidazole]] 500 mg IV q8–12 h or 1500 mg q24h
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| :::*Preferred regimen (3): [[Ciprofloxacin]] 400 mg q12h {{and}} [[Metronidazole]] 500 mg IV q8–12 h or 1500 mg q24h
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| :::*Preferred regimen (4): [[Levofloxacin]] 750 mg q24h {{and}} [[Metronidazole]] 500 mg IV q8–12 h or 1500 mg q24h
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| :::*Note: Antimicrobial therapy of established infection should be limited to 4–7 days, unless it is difficult to achieve adequate source control. Longer durations of therapy have not been associated with improved outcome.
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|
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| *'''2. Health Care–Associated Complicated Intra-abdominal Infection''' <ref name="pmid20034345">{{cite journal| author=Solomkin JS, Mazuski JE, Bradley JS, Rodvold KA, Goldstein EJ, Baron EJ et al.| title=Diagnosis and management of complicated intra-abdominal infection in adults and children: guidelines by the Surgical Infection Society and the Infectious Diseases Society of America. | journal=Clin Infect Dis | year= 2010 | volume= 50 | issue= 2 | pages= 133-64 | pmid=20034345 | doi=10.1086/649554 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20034345 }} </ref>
| |
| :*'''2.1. Less than 20% Resistant Pseudomonas aeruginosa, Extended-spectrum B-lactamase-producing Enterobacteriaceae, Acinetobacter, or other multidrug resistant gram-negative bacilli:'''
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| ::*Preferred regimen (1): [[Meropenem]] 1 g IV q8h {{and}} [[Piperacillin-tazobactam]] 3.375 g IV q6h {{and}} [[Ceftazidime]] 2 g IV q8h {{and}} [[Metronidazole]] 500 mg q8–12 h or 1500 mg q24h
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| ::*Preferred regimen (2): Imipenem-cilastatin 500 mg IV 6 h {{or}} 1 g q8h {{and}} [[Piperacillin-tazobactam]] 3.375 g IV q6h {{and}} [[Ceftazidime]] 2 g IV q8h {{and}} [[Metronidazole]] 500 mg IV q8–12 h or 1500 mg q24h
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| ::*Preferred regimen (3): [[Doripenem]] 500 mg IV q8h {{and}} [[Piperacillin-tazobactam]] 3.375 g IV q6h {{and}} [[Ceftazidime]] 2 g IV q8h {{and}} [[Metronidazole]] 500 mg IV every 8–12 h or 1500 mg q24h
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| ::*Preferred regimen (4): [[Meropenem]] 1 g IV q8h {{and}} [[Piperacillin-tazobactam]] 3.375 g IV q6h {{and}} [[Cefepime]] 2 g IV q8–12 h {{and}} [[Metronidazole]] 500 mg q8–12 h or 1500 mg q24h
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| ::*Preferred regimen (5): Imipenem-cilastatin 500 mg IV q6h {{or}} 1 g q8h {{and}} [[Piperacillin-tazobactam]] 3.375 g IV q6h {{and}} [[Cefepime]] 2 g IV q8–12 h {{and}} [[Metronidazole]] 500 mg IV q8–12 h or 1500 mg q24h
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| ::*Preferred regimen (6): [[Doripenem]] 500 mg IV q8h {{and}} [[Piperacillin-tazobactam]] 3.375 g IV q6h {{and}} [[Cefepime]] 2 g IV q8–12 h {{and}} [[Metronidazole]] 500 mg IV q8–12 h or 1500 mg q24h
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|
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| :*'''2.2. Extended-spectrum B-lactamase-producing Enterobacteriaceae:'''
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| ::*Preferred regimen (1): [[Meropenem]] 1 g IV q8h {{and}} [[Piperacillin-tazobactam]] 3.375 g IV q6h {{and}} [[Gentamicin]] 5–7 mg/kg IV q24h
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| ::*Preferred regimen (2): [[Meropenem]] 1 g IV q8h {{and}} [[Piperacillin-tazobactam]] 3.375 g IV q6h {{and}} [[Tobramycin]] 5–7 mg/kg IV q24h
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| ::*Preferred regimen (3): [[Meropenem]] 1 g IV q8h {{and}} [[Piperacillin-tazobactam]] 3.375 g IV q6h {{and}} [[Amikacin]] 15–20 mg/kg IV q24h
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| ::*Preferred regimen (4): Imipenem-cilastatin 500 mg IV q6h {{or}} 1 g q8h {{and}} [[Piperacillin-tazobactam]] 3.375 g IV q6h {{and}} [[Gentamicin]] 5–7 mg/kg IV q24h
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| ::*Preferred regimen (5): Imipenem-cilastatin 500 mg IV q6h {{or}} 1 g q8h {{and}} [[Piperacillin-tazobactam]] 3.375 g IV q6h {{and}} [[Tobramycin]] 5–7 mg/kg IV q24h
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| ::*Preferred regimen (6): Imipenem-cilastatin 500 mg IV q6h {{or}} 1 g q8h {{and}} [[Piperacillin-tazobactam]] 3.375 g IV q6h {{and}} [[Amikacin]] 15–20 mg/kg IV q24h
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| ::*Preferred regimen (7): [[Doripenem]] 500 mg IV q8h {{and}} [[Piperacillin-tazobactam]] 3.375 g IV q6h {{and}} [[Gentamicin]] 5–7 mg/kg IV q24h
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| ::*Preferred regimen (8): [[Doripenem]] 500 mg IV q8h {{and}} [[Piperacillin-tazobactam]] 3.375 g IV q6h {{and}} [[Tobramycin]] 5–7 mg/kg IV q24h
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| ::*Preferred regimen (9): [[Doripenem]] 500 mg IV q8h {{and}} [[Piperacillin-tazobactam]] 3.375 g IV q6h {{and}} [[Amikacin]] 15–20 mg/kg IV q24h
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|
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| :*'''2.3. Pseudomonas aeruginosa with more than 20% resistant to ceftazidime:'''
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| ::*Preferred regimen (1): [[Meropenem]] 1 g IV q8h {{and}} [[Piperacillin-tazobactam]] 3.375 g IV q6h {{and}} [[Gentamicin]] 5–7 mg/kg IV q24h
| |
| ::*Preferred regimen (2): [[Meropenem]] 1 g IV q8h {{and}} [[Piperacillin-tazobactam]] 3.375 g IV q6h {{and}} [[Tobramycin]] 5–7 mg/kg IV q24h
| |
| ::*Preferred regimen (3): [[Meropenem]] 1 g IV q8h {{and}} [[Piperacillin-tazobactam]] 3.375 g IV q6h {{and}} [[Amikacin]] 15–20 mg/kg IV q24h
| |
| ::*Preferred regimen (4): Imipenem-cilastatin 500 mg IV q6h {{or}} 1 g q8h {{and}} [[Piperacillin-tazobactam]] 3.375 g IV q6h {{and}} [[Gentamicin]] 5–7 mg/kg IV q24h
| |
| ::*Preferred regimen (5): Imipenem-cilastatin 500 mg IV q6h {{or}} 1 g q8h {{and}} [[Piperacillin-tazobactam]] 3.375 g IV q6h {{and}} [[Tobramycin]] 5–7 mg/kg IV q24h
| |
| ::*Preferred regimen (6): Imipenem-cilastatin 500 mg IV q6h {{or}} 1 g q8h {{and}} [[Piperacillin-tazobactam]] 3.375 g IV q6h {{and}} [[Amikacin]] 15–20 mg/kg IV q24h
| |
| ::*Preferred regimen (7): [[Doripenem]] 500 mg IV q8h {{and}} [[Piperacillin-tazobactam]] 3.375 g IV q6h {{and}} [[Gentamicin]] 5–7 mg/kg IV q24h
| |
| ::*Preferred regimen (8): [[Doripenem]] 500 mg IV q8h {{and}} [[Piperacillin-tazobactam]] 3.375 g IV q6h {{and}} [[Tobramycin]] 5–7 mg/kg IV q24h
| |
| ::*Preferred regimen (9): [[Doripenem]] 500 mg IV q8h {{and}} [[Piperacillin-tazobactam]] 3.375 g IV q6h {{and}} [[Amikacin]] 15–20 mg/kg IV q24h
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|
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| :*'''2.4.Methicillin-resistant Staphylococcus aureus (MRSA):'''
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| ::*Preferred regimen: [[Vancomycin]] 15–20 mg/kg IV q8–12 h
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| ::*Note: Antimicrobial therapy of established infection should be limited to 4–7 days, unless it is difficult to achieve adequate source control. Longer durations of therapy have not been associated with improved outcome.
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| ==References== | | ==References== |