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Latest revision as of 15:53, 23 July 2015

Bacteria – Gram-Negative Bacilli

Achromobacter xylosoxidans Return to Top
Acinetobacter baumannii Return to Top

Acinetobacter baumannii^[1]

Preferred regimen (1): Imipenem 0.5-1 g IV q6h
Preferred regimen (2): Ampicillin/sulbactam 3 g IV q4h
Preferred regimen (3): Cefepime 1-2 g IV q8h
Preferred regimen (4): Colistin 2.5 mg/kg IV q12h
Preferred regimen (5): Tigecycline 100 mg IV single doses THEN 50 mg IV q12h
Preferred regimen (6): Amikacin 7.5 mg/kg IV q12h or 15 mg/kg IV q24h
Preferred regimen (7) (pan-resistant isolates): (Colistin 5 mg/kg/day IV q12h ± Imipenem)
Preferred regimen (8) (pan-resistant isolates): Ampicillin/sulbactam
Alternative regimen (1): Ceftriaxone 1-2 g IV qd
Alternative regimen (2): Cefotaxime 2-3 g IV q6-8h
Alternative regimen (3): Ciprofloxacin 400 mg IV q8-12h or 750 mg PO bid
Alternative regimen (4): TMP-SMX 15-20 mg (TMP)/kg/day IV q6-8h or 2 DS PO bid

Aeromonas hydrophila Return to Top

Aeromonas hydrophila ^[2]

1. Diarrhea

Preferred regimen (if not self-limiting, or if severe): Ciprofloxacin 500 mg PO bid.
Alternate regimen: TMP-SMX 1DS PO bid
Note: High resistance to sulfa agents described in Taiwan and Spain

2. Skin and soft tissue infection

2.1 Mild infection

Preferred regimen(1): Ciprofloxacin 500 mg PO bid
Preferred regimen(2): Levofloxacin 500 mg qd

2.2 Severe infection or sepsis

Preferred regimen(1): Ciprofloxacin 400 mg IV q8h
Preferred regimen(2): Levofloxacin 750 mg IV q24h
Note(1): For suspicion of water-based injury,empiric coverage for Vibrio doxycycline 100 mg bid, although flouroquinolones may also cover and vancomycin 15 mg/kg IV q12h with or without clindamycin or linezolid for inhibition of gram-positive toxin production
Note(2): Alternatives to fluoroquinolones for Aeromonas coverage include carbapenems (ertapenem, doripenem, imipenem or meropenem), ceftriaxone, cefepime and aztreonam.

3. Prevention

Preferred regimen: Frequent recommendations include using a Cephalosporin (e.g.,cefuroxime,ceftriaxone or cefixime) OR a Fluoroquinolone (e.g.,ciprofloxacin or levofloxacin) during treatment with medicinal leeches.
Note (1): Duration of antibiotic use is 3-5 days, some recommend continuing until wound or eschar resolves
Note (2): Aeromonas isolates from leeches have been described as uniformly susceptible to fluoroquinolones.

Bordetella pertussis Return to Top

Bordetella pertussis^[3]

1. Whooping cough

1.1 Adults

Preferred regimen (1): Azithromycin 500 mg PO single dose on day 1 THEN 250 mg PO qd on 2-5 days
Preferred regimen (2): Erythromycin 2 g/day PO qid for 14 days
Preferred regimen (3): Clarithromycin 1 g PO bid for 7 days.
Alternative regimen (intolerant of macrolides): Trimethoprim 320 mg/day AND Sulfamethoxazole 1600 mg/day PO bid for 14 days

1.2 Infants <6 months of age

1.2.1 Infants <1 month

Preferred regimen (1): Azithromycin 10 mg/kg PO qd for 5 days
Preferred regimen (2) (if azithromycin unavailable): Erythromycin 40-50 mg/kg/day PO q6h for 14 days
Note: TMP-SMX contraindicated for infants aged < 2 months

1.2.2 Infants of 1-5 months of age

Preferred regimen (1): Azithromycin 10 mg/kg PO qd for 5 days
Preferred regimen (2): Erythromycin 40-50 mg/kg/day PO qid for 14 days
Preferred regimen (3): Clarithromycin 15 mg/kg PO bid for 7 days
Alternative regimen: For infants aged ≥ 2 months TMP 8 mg/kg q24h AND SMX 40 mg/kg/day PO bid for 14 days

1.3 Infants ≥6 months of age-children

Preferred regimen(1): Azithromycin 10 mg/kg single dose THEN 5 mg/kg (500 mg Maximum) qd for 2-5 days
Preferred regimen(2): Erythromycin 40-50 mg/kg PO (2 g daily Maximum) qid for 14 days
Preferred regimen(3): Clarithromycin 15 mg/kg PO (1 g daily Maximum) bid for 7 days
Preferred regimen(4): TMP 8 mg/kg/day AND SMX 40 mg/kg/day bid for 14 days

2. Post exposure prophylaxis^[4]

Preferred regimen: The antibiotic regimens for post exposure prophylaxis are similar to the regimens used for the treatment of pertussis
Note (1): Post exposure prophylaxis to an asymptomatic contacts within 21 days of onset of cough in the index patient can potentially prevent symptomatic infection
Note (2): Close contacts include persons who have direct contact with respiratory, oral or nasal secretions from a symptomatic patient (eg: cough, sneeze, sharing food, eating utensils, mouth to mouth resuscitation, or performing a medical examination of the mouth, nose, throat.
Note (3): Some close contacts are at high risk for acquiring severe disease following exposure to pertussis. These contacts include infants aged < 1 year , persons with some immunodeficiency conditions, or other underlying medical conditions such as chronic lung disease, respiratory insufficiency and cystic fibrosis.

Burkholderia cepacia Return to Top

Burkholderia cepacia complex^[5]

Preferred regimen (1): Ceftazidime 2 g IV q8h
Preferred regimen (2): Imipenem 1 g IV q6h
Preferred regimen (3): Meropenem 1-2 g IV q8h
Preferred regimen (4): Minocycline 100 mg IV/PO bid

Burkholderia pseudomallei Return to Top

Burkholderia pseudomallei

1. Melioidosis^[6]

1.1 Intial intensive therapy (Minimum of 10-14 days)

Preferred regimen (1): Ceftazidime 50 mg/kg upto 2 g q6h
Preferred regimen (2): Meropenem 25 mg/kg upto 1 g q8h
Preferred regimen (3): Imipenem 25 mg/kg upto 1 g q6h
Note: Any one of the three may be combined with TMP-SMX 6/30 mg/kg upto 320/1600 mg/kg q12h (recommended for neurologic, bone, joint, cutaneous and prostatic melioidosis)

1.2 Eradication therapy (Minimum of 3 months)

Preferred regimen: TMP-SMX 6/30 mg/kg upto 320/1600 mg/kg q12h

Campylobacter fetus Return to Top

Campylobacter fetus^[7]

1. Serious infections

Preferred regimen (1): Gentamicin 5 mg/kg IV q24h
Preferred regimen (2): Imipenem 1 mg IV q6h
Preferred regimen (3): Ceftriaxone 2 g IV q12h

2. Endovascular infections

Preferred regimen: Aminoglycoside 4-6 weeks AND Carbapenem

3. CNS

preferred regimen (1): Ceftriaxone
preferred regimen (2): Chloramphenicol for 2-3 weeks

Campylobacter jejuni Return to Top

Capnocytophaga canimorsus Return to Top

Capnocytophaga canimorsus^[8]

1. Severe cellulitis/sepsis or endocarditis

Preferred regimen (1) (Beta-lactam/beta-lactamase inhibitor): Ampicillin/sulbactam 3 g IV q6h
Preferred regimen (2) (Non-beta-lactamase producing): Penicillin G 2-4 MU IV q24h
Alternative regimen (1): Ceftriaxone 1-2 g IV q24h
Alternative regimen (2): Meropenem 1 g IV q8h
Alternative regimen (3) (complicated infections or immunocompromise): Clindamycin 600 mg IV q8h may be combined with above agents
Note (1): Resistance to aztreonam described, and variable susceptibility reported to TMP-SMX and aminoglycosides
Note (2): For endocarditis, alternatives to penicillins not well established, treated for duration of 6 weeks
Note (3): For non-endocarditis infections, duration not well established, but most authorities recommend at least 14-21 days of therapy

2. Mild cellulitis/dog or cat bites

Preferred regimen (1): Amoxicillin/clavulanate 500 mg PO q8h or 875 mg PO bid
Preferred regimen (2): Amoxicillin 500 mg PO q8h
Alternative regimen (1): Clindamycin 300 mg PO q6h
Alternative regimen (2): Doxycycline 100 mg PO bid
Alternative regimen (3): Clarithromycin 500 mg PO bid
Alternative regimen (4): Moxifloxacin 400 mg PO qd

3. Meningitis or brain abscess

Preferred regimen (1): Ceftriaxone 2 g IV q12h AND Ampicillin 2 g IV q4h
Preferred regimen (2) (if beta-lactamase producing or polymicrobial brain abscess): Imipenem/Cilastin 1000 mg q6-8h AND Clindamycin 600 mg IV q8h

4. Prevention

Although no firm data supports this recommendation, many clinicians do give prophylaxis for dog and cat bites in asplenic patients with Amoxicillin/clavulanate for 7-10 days.

Citrobacter freundii Return to Top

Citrobacter freundii^[9]

Preferred regimen (1): Meropenem 1-2 g IV q8h
Preferred regimen (2): Imipenem 1 g IV q6h
Preferred regimen (3): Doripenem 500 mg IV q8h
Preferred regimen (4): Cefepime 1-2 g IV q8h
Preferred regimen (5): Ciprofloxacin 400 mg IV q12h or 500 mg PO bid for UTI
Preferred regimen (6): Gentamicin 5 mg/kg/day
Alternate regimen (1): Piperacillin/tazobactam 3.375 mg IV q6h
Alternate regimen (2): Aztreonam 1-2 g IV q6h
Alternate regimen (3): TMP-SMX 5 mg/kg q6h IV or DS PO bid for UTI
Note: Usually carbenicillin sensitive, cephalothin resistant

Citrobacter koseri Return to Top

Citrobacter koseri^[10]

Preferred regimen (1): Ceftriaxone 1-2 g IV q12-24h
Preferred regimen (2): Cefotaxime 1-2 g IV q6h
Preferred regimen (3): Cefepime 1-2 IV q8h
Alternate regimen (1): Ciprofloxacin 400 mg IV q12h or 500 mg PO q12h for UTI
Alternate regimen (2): Imipenem 1 g IV q6h
Alternate regimen (3): Doripenem 500 mg IV q8h
Alternate regimen (4): Meropenem 1-2 g IV q8h
Alternate regimen (5): Aztreonam 1-2 g IV q6h
Alternate regimen (6): TMP-SMX 5 mg/kg IV q6h or DS PO bid for UTI
Note: Usually Ampicillin resistant, but may be sensitive to first generation cephalosporins

Elizabethkingia meningoseptica Return to Top
Enterobacter aerogenes Return to Top

Enterobacter species^[11]

1. Severe infections

Preferred regimen (1): Piperacillin-tazobactam 3.375-4.5 g IV q6h AND (Aminoglycoside (gentamicin,tobramycin or amikacin) OR Fluoroquinolone,e.g.,ciprofloxacin 400 mg IV q8-12hrs
Preferred regimen (2) (for coverage of ESBLs): Imipenem 500 mg IV q6h
Preferred regimen (3) (for coverage of ESBLs): Meropenem 500-1000 mg IV q8h
Preferred regimen (4) (for coverage of ESBLs): Doripenem 500 mg IV q8h
Preferred regimen (5) : Cefepime 2 g IV q8h

2. UTI without systemic symptoms

Preferred regimen: Ciprofloxacin 250 mg PO bid OR agent based upon susceptibility profile

Enterobacter cloacae Return to Top

Enterobacter cloacae^[12]

Escherichia coli Return to Top

Escherichia coli^[13]

1. Meningitits^[14]

Preferred regimen (1): Ceftriaxone 4 g IV q12–24h
Preferred regimen (2): Cefotaxime 8–12 g/day IV q4–6h
Alternative regimen (1): Aztreonam 6–8 g/day IV q6–8h
Alternative regimen (2): Gatifloxacin 400 mg/day IV q24h
Alternative regimen (3): Moxifloxacin 400 mg/day IV q24h
Alternative regimen (4): Meropenem 6 g/day IV q8h
Alternative regimen (5): Trimethoprim-Sulfamethoxazole 10–20 mg/kg/day IV q6–12h
Alternative regimen (6): Ampicillin 12 g/day IV q4h

2. Uncomplicated urinary tract infection

Preferred agents (IDSA/AUA Guidelines): TMP-SMX DS PO bid for 3 days
Alternative regimen (1): Ciprofloxacin 250 mg PO bid
Alternative regimen (2): Ciprofloxacin 500 mg XR qd for 3 days
Alternative regimen (3): Levofloxacin 250 mg PO qd for 3 days.
Alternative regimen (4): Nitrofurantoin 100 mg PO q6h
Alternative regimen (5): Nitrofurantoin macrocrystals 100 mg PO bid for 7 days
Alternative regimen (6): Fosfomycin 3 g sachet PO single dose
Note: For older patients, those with comorbidities (e.g., diabetes mellitus) use 7-10 days course.

3. Pyelonephritis

3.1 Acute uncomplicated pyelonephritis

Preferred regimen (1): Ciprofloxacin 500 mg bid PO for 5-7 days
Preferred regimen (2): Ciprofloxacin-Erythromycin 1000 mg q24h
Preferred regimen (3): Levofloxacin 750 mg q24h
Preferred regimen (4): Ofloxacin 400 mg bid
Preferred regimen (5): Moxifloxacin 400 mg q24h
Alternative regimen (1): Amoxicillin-Clavulanic acid 875/125 mg PO q12h or 500/125 mg PO tid or 1000 /125 mg PO bid
Alternative regimen (2): Oral Cephalosporins
Alternative regimen (3): TMP-SMX 2 mg/kg IV q6h PO for 14 days

3.2 Acute pyelonephritis (Hospitalized)

Preferred regimen (1): Ciprofloxacin 400 mg IV q12h
Preferred regimen (2): Ampicillin and Gentamicin
Preferred regimen (3): Piperacillin-Tazobactam 3.375 g IV q4-6h for 14 days
Alternative regimen (1): Ticarcillin-Clavulanate 3.1 g IV q6h
Alternative regimen (2): Ampicillin-Sulbactam 3 g IV q6h
Alternative regimen (3): Piperacillin-Tazobactam 3.375 g IV q4-6h
Alternative regimen (4): Ertapenem 1 g IV q24h
Alternative regimen (5): Doripenem 500 mg q8h for 14 days

4. Traveler’s diarrhea

Preferred regimen (1): Ciprofloxacin 750 mg PO qd for 1-3 days or other Fluoroquinolones
Preferred regimen (2) (pediatrics & pregnancy): Azithromycin 10 mg/kg/day single dose
Preferred regimen (3) (pediatrics & pregnancy): Ceftriaxone 50 mg/kg/day IV qd for 3 days
Note: Avoid fluoroquinolones in pediatrics and pregnancy.

5. Malacoplakia

Preferred regimen (1): Bethanechol chloride AND Ciprofloxacin 400 mg IV q12h
Preferred regimen (2): TMP-SMX 2 mg/kg (TMP component IV q6h)

6. Bacteremia/pneumonia

Preferred regimen (1): Ceftriaxone 1-2 g IV q24h
Preferred regimen (2): Ciprofloxacin 400 mg IV q12h or 500 mg PO q12h
Preferred regimen (3): Levofloxacin 500 mg PO/IV q24h
Preferred regimen (4): Moxifloxacin 400 mg IV/PO q24h
Preferred regimen (5): Ampicillin 2 g IV q6h (if sensitive)
Preferred regimen (6): TMP-SMX 5-10 mg/kg/day for q6-8h IV (if sensitive)
Alternative regimen (1): Imipenem, Meropenem, Ertapenem, Doripenem; Ceftazidime, Cefepime; Cefazolin or Cefuroxime (if sensitive); Aztreonam; Ticarcillin, Piperacillin; Piperacillin-Tazobactam
Alternative regimen (2): Ampicillin-sulbactam 3 g IV q6h AND (Gentamicin 1.5 mg/kg IV q8h or 5-7 mg/kg/day IV OR Tobramycin 5 mg/kg/day IV)
Note (1): A 7- to 14-day course of antibiotic therapy is usually recommended.
Note (2): The choice of antimicrobial agents should be based on susceptibility results.
Note (3): Monotherapy with aminoglycosides is generally not recommended for bacteremia or pneumonia.

Francisella tularensis Return to Top

Francisella tularensis^[15]

1. Tularemia

Preferred regimen (1): Streptomycin 1 g IM bid

Preferred regimen (2): Gentamicin 5 mg/kg IV q24h for 10 days

Preferred regimen (3) (pregnancy): Gentamicin 5 mg/kg IV q24h for 10 days
Alternative regimen (1): Doxycycline 100 mg IV bid

Alternative regimen (2): Chloramphenicol 1 g IV q6h

Alternative regimen (3): Ciprofloxacin 400 mg IV bid until stable THEN PO for 14-21 days (total)

Helicobacter pylori Return to Top

Helicobacter pylori^[16]

1. Peptic ulcer disease

1.1 Regimens for Initial Treatment

1.1.1 Triple therapy

Preferred regimen: PPI (standard dose twice daily) AND Amoxicillin 1 g bid AND Clarithromycin 500 mg bid for 7-14 days

1.1.2 Quadruple therapy

Preferred regimen: PPI (standard dose twice daily) AND Metronidazole 250 mg q6h AND Tetracycline 500 mg q6h AND Bismuth (dose depends on preparation) for 10-14 days

1.1.3 Sequential therapy

Preferred regimen: PPI (standard dose twice daily) AND Amoxicillin 1 g bid for 1-5 days AND Clarithromycin 500 mg bid AND Tinidazole 500 mg bid for 6-10 days

1.2 Second-Line Therapies

1.2.1 Triple therapy

Preferred regimen: PPI (standard dose twice daily) AND Amoxicillin 1 g bid AND Metronidazole 500 mg bid

Alternative regimen (1) (allergy to amoxicillin): (PPI AND Clarithromycin AND Metronidazole)

Alternative regimen (2) (allergy to amoxicillin): (PPI AND Tetracycline AND Metronidazole).

1.2.2 Quadruple therapy

Preferred regimen: PPI (standard dose twice daily) AND Metronidazole 250 mg q6h AND Tetracycline 500 mg q6h AND Bismuth (dose depends on preparation) for 10-14 days

1.2.3 Levofloxacin triple therapy

Preferred regimen: PPI (standard dose twice daily) AND Amoxicillin 1 g bid AND Levofloxacin 500 mg bid for 10 days

1.2.4 Rifabutin triple therapy

Preferred regimen: PPI (standard dose twice daily) AND Amoxicillin 1 g bid AND Rifabutin 150-300 mg/day for 10 days

Klebsiella granulomatis Return to Top

Klebsiella granulomatis (formly known as Calymmatobacterium granulomatis)

1. Granuloma inguinale (donovanosis)^[17]

Preferred regimen: Azithromycin 1 g PO once a week or 500 mg qd for 3 weeks THEN until all lesions have completely healed
Alternative regimen (1): Doxycycline 100 mg PO bid for 3 weeks THEN until all lesions have completely healed
Alternative regimen (2): Ciprofloxacin 750 mg PO bid for at least 3 weeks THEN until all lesions have completely healed
Alternative regimen (3): Erythromycin base 500 mg PO qid for at least 3 weeks THEN until all lesions have completely healed
Alternative regimen (4): Trimethoprim-sulfamethoxazole DS (160 mg/800 mg) tablet PO bid for at least 3 weeks THEN until all lesions have completely healed

Klebsiella pneumoniae Return to Top

Klebsiella pneumoniae^[18]

1. Severe, nosocomial infections

1.1 Non-ESBLs in pneumonia, sepsis, complicated UTI, or intra-abdominal infections

Preferred regimen (1): Cefepime 2 g IV q8h
Preferred regimen (2): Ceftazidime 2 g IV q8h
Preferred regimen (3): Imipenem 500 mg IV q6h
Preferred regimen (4): Meropenem 1 g IV q8h
Preferred regimen (5): Piperacillin-tazobactam 4.5 g IV q6h AND Aminoglycoside
Alternative regimen (1): Ceftriaxone 1 g IV q24h AND Metronidazole 500 mg IV q6h or 1 g IV q12h
Alternative regimen (2): Moxifloxacin 400 mg IV/PO q24h

1.2 ESBLs in pneumonia, sepsis, complicated UTI, or intra-abdominal infections

Preferred regimen (1): Imipenem 500 mg IV q6h
Preferred regimen (2): Meropenem 1 g IV q8h
Preferred regimen (3): Ertapenem 1 g IV q24h
Preferred regimen (4): Doripenem 500 mg IV q8h
Note: In ESBLs, inconsistent activity is seen with aminoglycosides, fluoroquinolones, and piperacillin-tazobactam. Avoid cephalosporins.

Klebsiella rhinoscleromatis Return to Top

1. Rhinoscleroma^[19]^[20]^[21]

Preferred regimen (1): Ciprofloxacin 500–750 mg PO bid for 2–3 months
Preferred regimen (2): Levofloxacin 750 mg PO qd for 2–3 months
Preferred regimen (3): Trimethoprim-Sulfamethoxazole 1 DS tab PO bid for 3 months AND Rifampicin 300 mg PO bid for 3 months
Alternative regimen: Tetracycline OR Streptomycin OR Doxycycline OR Ceftriaxone OR Ofloxacin
Note (1): The optimal duration of antimicrobial therapy remains unclear. A 6-week to 6-month course of antibiotics until histology exams and cultures are negative may be required.
Note (2): Use of topical antiseptics such as Acriflavinium and Rifampin ointment has been reported with resolution of symptoms.^[22]

Legionella pneumophila Return to Top

Legionella pneumophila^[23]

1. Pneumonia

Preferred regimen (1): Levofloxacin 750 mg PO/IV qd for 7-10 days
Preferred regimen (2): Moxifloxacin 400 mg PO/IV qd for 7-10 days
Preferred regimen (3): Azithromycin 500 mg PO/IV qd for 7-10 days
Preferred regimen (4): Rifampin 300 mg PO/IV bid AND any other agents listed
Alternative regimen (1): Erythromycin 1 g IV q6h and THEN 500 mg PO q6h for 7-10 days (total)
Alternative regimen (2): Ciprofloxacin 400 mg IV q12h THEN 750 mg PO bid 7-10 days (total)

2. Pontiac fever

Preferred regimen: no antibiotic treatment, usually self limited, and usually only diagnosed by delayed serologic testing

3. Endocarditis

Preferred regimen: (Fluoroquinolones, Levofloxacin 750 mg PO/IV qd for 7-10 days OR Moxifloxacin 400 mg PO/IV qd for 7-10 days) AND Rifampin 300 mg PO bid for 4-6 weeks

Moraxella catarrhalis Return to Top

Moraxella catarrhalis^[24]

Preferred regimen (1): TMP-SMX 1DS PO bid
Preferred regimen (2): Erythromycin 500 mg PO q6h
Preferred regimen (3): Clarithromycin 500 mg bid or XL 1 g PO qd
Preferred regimen (4): Azithromycin 500 mg single dose THEN 250 mg PO qd
Preferred regimen (5): Doxycycline 100 mg PO/IV bid
Preferred regimen (6): Parenteral cephalosporins such as Cefuroxime OR Cefotaxime OR Ceftriaxone
Preferred regimen (7): Cefprozil 200-500 mg PO bid
Preferred regimen (8): Cefpodoxime 200-400 mg PO bid
Preferred regimen (9): Cefuroxime 250-500 mg PO bid

Preferred regimen (10): Cefdinir 300 mg bid
Preferred regimen (11): Moxifloxacin 400 mg IV/PO qd
Preferred regimen (12): Levofloxacin 500 mg IV/PO qd
Preferred regimen (13): Amoxicillin-Clavulanate 875/125 mg PO bid or XL 2000/125 PO bid

Morganella morganii Return to Top

Morganella morganii^[25]

Preferred regimen (1): Imipenem 500 mg IV q6h
Preferred regimen (2): Meropenem 1.0 g IV q8h (adjust dose if necessary for renal function).
Note (1): Carbapenems are considered first line therapy due to inducible cephalosporinases, and presence of extended-spectrum beta-lactamases in some isolates.
Note (2): Duration of treatment for UTI (generally complicated) is 7 days and duration of treatment for bacteremia is 14 days.
Note (3): Tigecycline is not reliably effective
Alternative Regimen (1): Cefepime 2.0 g IV q8-12h
Alternative Regimen (2): Ciprofloxacin 500 mg PO/400 mg IV q12h
Alternative Regimen (3): Piperacillin 3 g IV q6h
Alternative Regimen (4): Ticarcillin 3 g IV q4h
Alternative Regimen (5): Gentamicin
Alternative Regimen (6): Tobramycin 1 mg/kg IV q24h
Alternative Regimen (7): Amikacin 3 mg/kg IV q24h
Note: Aminoglycosides can be used alone for treatment of UTI

Plesiomonas shigelloides Return to Top

Plesiomonas shigelloides^[26]

1. Immunocompetent hosts or severe Infection

Preferred regimen: Ciprofloxacin 500 mg PO bid OR 400 mg IV q12h
Alternative regimen (1): Ofloxacin 300 mg PO bid

Alternative regimen (2): Norfloxacin 400 mg PO bid

Alternative regimen (3): TMP-SMX DS PO bid for 3 days
Alternative regimen (4): Ceftriaxone 1-2 g IV qd in severe cases

2. Immunocompromised hosts

Preferred regimen: Ciprofloxacin 500 mg PO bid for 3 days.
Alternative regimen (1): Ofloxacin 300 mg PO bid

Alternative regimen (2): Norfloxacin 400 mg PO bid

Alternative regimen (3): TMP-SMX DS PO bid for 3 days if susceptible

Proteus mirabilis Return to Top

Proteus mirabilis^[27]

Preferred regimen (1): Ampicillin 500 mg PO q6h or 2 g IV q6h
Preferred regimen (2): Cefuroxime 250 mg PO bid or 750 mg IV q8h
Preferred regimen (3): Ciprofloxacin 250-500 mg PO bid or 400 mg IV q12h
Preferred regimen (4): Levofloxacin 500 mg PO OD or 500 mg IV q24h
Note: Duration of treatment for uncomplicated UTI 3 days, pyelonephritis 7-14 days, complicated UTI 10-21 days and bacteremia is 7-14 days

Indole positive Proteus species Return to Top

Indole positive Proteus species^[28]

Preferred regimen (1): Ceftriaxone 1 g IV q24h
Preferred regimen (2): Imipenem 500 mg IV q6h
Preferred regimen (3): Ciprofloxacin 400 mg IV q12h or 250-500 mg PO bid
Preferred regimen (4): Levofloxacin 500 mg IV/PO q24h

Providencia Return to Top

Providencia^[29]

1. Complicated uti/bacteremia/acute prostatitis

Preferred regimen (1): Ciprofloxacin 500-750 mg PO q12h or 400 mg IV q8-12h
Preferred regimen (2): Levofloxacin 500 mg IV/PO q24h
Preferred regimen (3): Piperacillin-Tazobactam 3.375 mg IV q6h
Preferred regimen (4): Ceftriaxone 1-2 g IV q24h (donot use if ESBL suspected or critically ill)
Preferred regimen (5): Meropenem 1 g IV q8h (consider if critically ill or ESBL suspected)
Preferred regimen (6): Amikacin 7.5 mg/kg IV q12h
Preferred regimen (7): Gentamicin
Preferred regimen (8): Tobramycin acceptable if susceptible but many species are resistant.
Note (1): Duration of treatment for (UTI) is 7 days common or 3-5 days after defervescence or control/elimination of complicating factors (e.g.,removal of foreign material catheter).
Note (2): Duration of treatment for (bacteremia) is 10-14 days or 3-5 days after defervescence or control/elimination of complicating factors.
Note (3): Duration for acute prostatitis (2 weeks), shorter than chronic prostatitis (4-6 weeks)
Alternative regimen: TMP-SMX DS PO q12h for 10-14 days or TMP 5-10 mg/kg/day IV q6h.

Pseudomonas aeruginosa Return to Top

Pseudomonas aeruginosa^[30]

Preferred regimen (1): Cefepime 2 g IV q8h
Preferred regimen (2): Ceftazidime 2 g IV q8h
Preferred regimen (3): Piperacillin 3-4 g IV q4h in (no benefit for pseudomonas from beta-lactamase inhibitor)
Preferred regimen (4): Ticarcillin 3-4 g IV q4h (no benefit for pseudomonas from beta-lactamase inhibitor)
Preferred regimen (5): Imipenem 500 mg—1 g IV q6h
Preferred regimen (6): Meropenem 1 g IV q8h
Preferred regimen (7): Doripenem 500 mg IV q8h
Preferred regimen (8): Ciprofloxacin 400 mg IV q8h or 750 mg PO q12h (for less serious infections)
Preferred regimen (9): Aztreonam 2 g IV q6-8h
Preferred regimen (10): Colistin 2.5 mg/kg IV q12h
Preferred regimen (11): Polymyxin B 0.75-1.25 mg/kg IV q12h
Preferred regimen (12): Gentamicin
Preferred regimen (13): Tobramycin 1.7-2.0 mg/Kg IV q8h or 5-7 mg/kg IV
Preferred regimen (14): Amikacin 2.5 mg/kg IV q12h
Note: Amikacin > Tobramycin > Gentamicin with respect to P.aeruginosa susceptibility percentages at most institutions.

Salmonella

Salmonella Return to Top

1. Salmonellosis in immunocompetent hosts^[31]

1.1 Gastroenteritis

Antimicrobial therapy is usually not recommended for uncomplicated diarrheal illness.
1.1.1 Indications for antimicrobial therapy

severedisease,
Age > 50 yrs
Prosthesis
Presence of valvular heart disease
Severe atherosclerosis
Cancer
Uremia
Immunosuppression

1.1.2 Treatment regimens

Preferred regimen (1): TMP-SMX DS PO bid for 5-7 days
Preferred regimen (2): Ciprofloxacin 500 mg PO bid for 5-7 days
Preferred regimen (3): Ceftriaxone 2 g IV q24h for 5-7 days

1.2 Typhoid fever^[32]

1.2.1 Uncomplicated typhoid

Preferred regimen (1) (fully susceptible): Fluoroquinolone (e.g., Ofloxacin 15 mg/kg PO qd for 5–7 days)
Preferred regimen (2) (multi drug-resistant): Fluoroquinolone (Ofloxacin 15 mg/kg PO qd for 5–7 days)
Preferred regimen (3) (quinolone-resistant): Azithromycin 8–10 mg/kg PO qd for 7 days
Preferred regimen (4) (quinolone-resistant): Fluoroquinolone 20 mg/kg PO qd for 10-14 days
Alternative regimen (1) (fully susceptible): Chloramphenicol 50–75 mg/kg PO qd for 14-21 days
Alternative regimen (2) (fully susceptible): Amoxicillin 75–100 mg/kg PO qd for 14 days
Alternative regimen (3) (fully susceptible): Trimethoprim–Sulfamethoxazole, 8 mg/kg (trimethoprim)– 40 mg/kg (sulfamethoxazole) PO qd for 14 days
Alternative regimen (4) (multi drug-resistant): Azithromycin 8–10 mg/kg PO for 7 days
Alternative regimen (5) (multi drug-resistant): Third-generation cephalosporin, e.g., cefixime 20 mg/kg PO qd for 7-14 days
Alternative regimen (6) (quinolone-resistant): Third-generation cephalosporin, e.g., cefixime 20 mg/kg PO qd for 7-14 days

1.2.2 Severe typhoid

Preferred regimen (1) (fully susceptible): Fluoroquinolone (e.g., Ofloxacin 15 mg/kg IV qd for 10-14 days)
Preferred regimen (2) (multi drug-resistant): Fluoroquinolone (Ofloxacin 15 mg/kg IV qd for 10-14 days)
Preferred regimen (3) (quinolone-resistant): Ceftriaxone 60 mg/kg IV qd for 10-14 days
Preferred regimen (4) (quinolone-resistant): Cefotaxime 80 mg/kg IV qd for 10-14 days
Alternative regimen (1) (fully susceptible): Chloramphenicol 100 mg/kg PO qd for 14-21 days
Alternative regimen (2) (fully susceptible): Ampicillin 100 mg/kg PO qd for 14-21 days
Alternative regimen (3) (fully susceptible): Trimethoprim–Sulfamethoxazole, 8 mg/kg (trimethoprim)– 40 mg/kg (sulfamethoxazole) IV qd for 10-14 days
Alternative regimen (4) (multi drug-resistant): Ceftriaxone 60 mg/kg IV qd for 10-14 days
Alternative regimen (5) (multi drug-resistant): Cefotaxime 80 mg/kg IV qd for 10-14 days
Alternative regimen (6) (quinolone-resistant): Fluoroquinolone 20 mg/kg IV qd for 10-14 days

1.3 Non-typhoid (serious infection)

Preferred regimen (1): 3rd generation cephalosporin (Ceftriaxone/Cefotaxime)
Preferred regimen (2): Fluoroquinolone (Ciprofloxacin, Levofloxacin)

1.4 Bacteremia

Preferred regimen (1): Ceftriaxone 2 g IV q24h

Preferred regimen (2): Cefotaxime 2 g IV q6-8h for 7-14 days

Preferred regimen (3): Ciprofloxacin 400 mg IV q12h for 7-14 days

1.5 Vascular prosthesis infection

Preferred regimen (1): Ceftriaxone

Preferred regimen (2): Cefotaxime

Preferred regimen (3): Ciprofloxacin 400 mg IV q12h for 6 weeks

1.6 Osteomyelitis

Preferred regimen (1): Ceftriaxone 2 g IV q24h

Preferred regimen (2): Cefotaxime 2 g IV q6-8h

Preferred regimen (3): Ciprofloxacin 750 mg PO bid for ≥ 4 weeks

1.7 Arthritis

Preferred regimen (1): Ceftriaxone 2 g IV q24h

Preferred regimen (2): Cefotaxime 2 g IV q6-8h for 6 weeks

1.8 Endocarditis

Preferred regimen (1): Ceftriaxone 2 g IV q24h

Preferred regimen (2): Cefotaxime 2 g IV q6-8h for 6 weeks

1.9 UTI

Preferred regimen (1): Ceftriaxone

Preferred regimen (2): Cefotaxime

Preferred regimen (3): Ciprofloxacin IV for 1-2 weeks THEN (oral Ciprofloxacin OR TMP-SMX for 6 weeks)

1.10 Carrier state

Preferred regimen (1): Ciprofloxacin 500 mg PO bid for 4-6 weeks
Preferred regimen (2): TMP-SMX 1DS bid PO for 6 weeks
Preferred regimen (3): Amoxicillin 500 mg PO for 6 weeks

2. Salmonellosis in immunocompromised hosts

2.1 HIV and salmonellosis^[33]

2.1.1 Gastroenteritis

Preferred regimen: Ciprofloxacin 500-750 mg PO bid or 400 mg IV q12h, if susceptible
Alternative regimen (1): Levofloxacin 750 mg PO/IV q24h
Alternative regimen (2): Moxifloxacin 400 mg PO/IV q24h
Alternative regimen (3): TMP 160 mg AND SMX 800 mg PO/IV q12h
Alternative regimen (4): Ceftriaxone 1 g IV q24h
Alternative regimen (5): Cefotaxime 1 g IV q8h
Duration of treatment for gastroenteritis without bacteremia

If CD4 count ≥ 200 cells/μL: Duration of treatment is 7–14 days
If CD4 count < 200 cells/μL: Duration of treatment is 2–6 weeks

Duration of treatment for gastroenteritis with bacteremia

If CD4 count ≥ 200/μL: Duration of treatment is 14 days; longer duration if bacteremia persists or if the infection is complicated (e.g., if metastatic foci of infection are present)
If CD4 count < 200 cells/μL: Duration of treatment is 2–6 weeks

Note (1): Secondary prophylaxis should be considered for

Patients with recurrent Salmonella gastroenteritis with or without bacteremia
Patients with CD4 < 200 cells/μL with severe diarrhea

Serratia marcescens Return to Top

Serratia marcescens^[34]

1. Bacteremia, pneumonia or serious infections

Preferred regimen (1): Cefepime 1-2 g IV q8h
Preferred regimen (2): Imipenem 0.5-1.0 g IV q6h
Preferred regimen (3): Ciprofloxacin 400 mg IV q8h
Alternative regimen (1): Aztreonam
Alternative regimen (2): Gentamicin
Alternative regimen (3): Amikacin
Alternative regimen (4): Piperacillin-tazobactam also often effective
Note: Duration depends on clinical response, usually 7-14 days

2. Endocarditis

Note: Choice dictated by sensitivities. 4 to 6 week duration of parenteral therapy.

3. Osteomyelitis

Note (1): Choice dictated by sensitivity profile. Treat for 6-12 weeks depending upon response.

Note (2): Use IV treatment until stable/clinically improved (10-14 days Minimum) then may convert to PO therapy if appropriate

4. UTI

Preferred regimen (1): Ciprofloxacin 250 mg PO bid or 400 mg IV q12h

Preferred regimen (2): Levofloxacin 250 mg PO qd or 500 mg IV q24h
Note: Fluoroquinolones often sensitive but in seriously ill patient consider empiric coverage with two drugs(e.g.,beta-lactam and aminoglycoside or fluoroquinolones and carbapenem)until susceptibilities known.

Shigella Return to Top

1. Shigellosis ^[35]

1.1 Pediatrics

Preferred regimen (1): Ciprofloxacin 15 mg/kg PO bid for 3 days
Alternative regimen (1): Pivmecillinam 20 mg/kg PO qid for 5 days
Alternative regimen (2): Ceftriaxone 50-100 mg/kg IM qd for 2 to 5 days
Alternative regimen (3): Azithromycin 6-20 mg/kg PO qd for 1 to 5 days

1.2 Adults

Preferred regimen (1): Ciprofloxacin 500 mg PO bid for 3 days
Alternative regimen (1): Pivmecillinam 100 mg PO qid for 5 days
Alternative regimen (2): Azithromycin 1-1.5 g PO qd for 1 to 5 days

Stenotrophomonas maltophilia Return to Top

Stenotrophomonas maltophilia^[36]

Preferred treatment: TMP-SMX 15-20 mg/kg/day (TMP component) IV/PO q8h
Alternative treatment (1): Ceftazidime 2 g IV q8h

Alternative treatment (2): Ticarcillin-clavulanate 3.1 g IV q4h

Alternative treatment (3): Tigecycline 100 mg IV single dose THEN 50 mg IV q12h
Alternative treatment (4): Ciprofloxacin 500-750 mg PO/400 mg IV q12h

Alternative treatment (5): Moxifloxacin 400 mg PO/IV
Alternative treatment (6): Levofloxacin 750 mg PO/IV
Alternative treatment (7) (multiply-resistance): Colistin 2.5 mg/kg IV q12h
Note: Treatment duration uncertain, but usually ≥ 14 days

Vibrio cholerae Return to Top
Vibrio parahaemolyticus Return to Top
Vibrio vulnificus Return to Top

References

↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
↑ "Recommended Antimicrobial Agents for the Treatment and Postexposure Prophylaxis of Pertussis 2005 CDC Guidelines".
↑ "Recommended Antimicrobial Agents for the Treatment and Post exposure Prophylaxis of Pertussis 2005 CDC Guidelines".
↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
↑ Wiersinga WJ, Currie BJ, Peacock SJ (2012). "Melioidosis". N. Engl. J. Med. 367 (11): 1035–44. doi:10.1056/NEJMra1204699. PMID 22970946.
↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
↑ Tunkel AR, Hartman BJ, Kaplan SL, Kaufman BA, Roos KL, Scheld WM et al. (2004) Practice guidelines for the management of bacterial meningitis. Clin Infect Dis 39 (9):1267-84. DOI:10.1086/425368 PMID: [1]
↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
↑ Lua error: expandTemplate: template "citation error" does not exist.
↑ Workowski, Kimberly A.; Bolan, Gail A. (2015-06-05). "Sexually transmitted diseases treatment guidelines, 2015". MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control. 64 (RR-03): 1–137. ISSN 1545-8601. PMID 26042815.
↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
↑ Mukara, B. K.; Munyarugamba, P.; Dazert, S.; Löhler, J. (2014-07). "Rhinoscleroma: a case series report and review of the literature". European archives of oto-rhino-laryngology: official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS): affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 271 (7): 1851–1856. doi:10.1007/s00405-013-2649-z. ISSN 1434-4726. PMID 23904142. Check date values in: |date= (help)
↑ de Pontual, Loïc; Ovetchkine, Philippe; Rodriguez, Diana; Grant, Audrey; Puel, Anne; Bustamante, Jacinta; Plancoulaine, Sabine; Yona, Laurent; Lienhart, Pierre-Yves; Dehesdin, Danièle; Huerre, Michel; Tournebize, Régis; Sansonetti, Philippe; Abel, Laurent; Casanova, Jean Laurent (2008-12-01). "Rhinoscleroma: a French national retrospective study of epidemiological and clinical features". Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. 47 (11): 1396–1402. doi:10.1086/592966. ISSN 1537-6591. PMID 18947330.
↑ Gaafar, Hazem A.; Gaafar, Alaa H.; Nour, Yasser A. (2011-04). "Rhinoscleroma: an updated experience through the last 10 years". Acta Oto-Laryngologica. 131 (4): 440–446. doi:10.3109/00016489.2010.539264. ISSN 1651-2251. PMID 21198342. Check date values in: |date= (help)
↑ Mukara, B. K.; Munyarugamba, P.; Dazert, S.; Löhler, J. (2014-07). "Rhinoscleroma: a case series report and review of the literature". European archives of oto-rhino-laryngology: official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS): affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 271 (7): 1851–1856. doi:10.1007/s00405-013-2649-z. ISSN 1434-4726. PMID 23904142. Check date values in: |date= (help)
↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
↑ "TYPHOID FEVER".
↑ "Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents" (PDF).
↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
↑ "Guidelines for the control of shigellosis, including epidemics due to Shigella dysenteriae type 1" (PDF).
↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.

[1] Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.

[2] Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.

[3] "Recommended Antimicrobial Agents for the Treatment and Postexposure Prophylaxis of Pertussis 2005 CDC Guidelines".

[4] "Recommended Antimicrobial Agents for the Treatment and Post exposure Prophylaxis of Pertussis 2005 CDC Guidelines".

[5] Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.

[pmid22970946-6] Wiersinga WJ, Currie BJ, Peacock SJ (2012). "Melioidosis". N. Engl. J. Med. 367 (11): 1035–44. doi:10.1056/NEJMra1204699. PMID 22970946.

[7] Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.

[8] Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.

[9] Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.

[10] Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.

[11] Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.

[12] Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.

[13] Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.

[pmid15494903-14] Tunkel AR, Hartman BJ, Kaplan SL, Kaufman BA, Roos KL, Scheld WM et al. (2004) Practice guidelines for the management of bacterial meningitis. Clin Infect Dis 39 (9):1267-84. DOI:10.1086/425368 PMID: [1]

[15] Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.

[pmid22491499-16] Lua error: expandTemplate: template "citation error" does not exist.

[17] Workowski, Kimberly A.; Bolan, Gail A. (2015-06-05). "Sexually transmitted diseases treatment guidelines, 2015". MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control. 64 (RR-03): 1–137. ISSN 1545-8601. PMID 26042815.

[18] Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.

[19] Mukara, B. K.; Munyarugamba, P.; Dazert, S.; Löhler, J. (2014-07). "Rhinoscleroma: a case series report and review of the literature". European archives of oto-rhino-laryngology: official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS): affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 271 (7): 1851–1856. doi:10.1007/s00405-013-2649-z. ISSN 1434-4726. PMID 23904142. Check date values in: |date= (help)

[20] Pontual, Loïc; Ovetchkine, Philippe; Rodriguez, Diana; Grant, Audrey; Puel, Anne; Bustamante, Jacinta; Plancoulaine, Sabine; Yona, Laurent; Lienhart, Pierre-Yves; Dehesdin, Danièle; Huerre, Michel; Tournebize, Régis; Sansonetti, Philippe; Abel, Laurent; Casanova, Jean Laurent (2008-12-01). "Rhinoscleroma: a French national retrospective study of epidemiological and clinical features". Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. 47 (11): 1396–1402. doi:10.1086/592966. ISSN 1537-6591. PMID 18947330.

[21] Gaafar, Hazem A.; Gaafar, Alaa H.; Nour, Yasser A. (2011-04). "Rhinoscleroma: an updated experience through the last 10 years". Acta Oto-Laryngologica. 131 (4): 440–446. doi:10.3109/00016489.2010.539264. ISSN 1651-2251. PMID 21198342. Check date values in: |date= (help)

[22] Mukara, B. K.; Munyarugamba, P.; Dazert, S.; Löhler, J. (2014-07). "Rhinoscleroma: a case series report and review of the literature". European archives of oto-rhino-laryngology: official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS): affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 271 (7): 1851–1856. doi:10.1007/s00405-013-2649-z. ISSN 1434-4726. PMID 23904142. Check date values in: |date= (help)

[23] Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.

[24] Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.

[25] Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.

[26] Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.

[27] Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.

[28] Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.

[29] Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.

[30] Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.

[31] Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.

[32] "TYPHOID FEVER".

[33] "Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents" (PDF).

[34] Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.

[35] "Guidelines for the control of shigellosis, including epidemics due to Shigella dysenteriae type 1" (PDF).

[36] Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.

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@@ Line 1: / Line 1: @@
-:*1. '''Bacteremia'''<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
+====Bacteria – Gram-Negative Bacilli====
-::*1.1 '''Ampicillin or Penicillin susceptible'''
+{{PBI|Achromobacter xylosoxidans}}
-:::* Preferred regimen (1): [[Ampicillin]] 2 g IV q4-6h
+{{PBI|Acinetobacter baumannii}}
-:::* Preferred regimen (2): [[Ampicillin]] 2 g IV q4-6h {{and}} [[Gentamicin]] 1 mg/kg IV/IM q8h
+:* Acinetobacter baumannii<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
-::*1.2 '''Ampicillin resistant and vancomycin susceptible or Penicillin allergy'''
+::* Preferred regimen (1): [[Imipenem]] 0.5-1 g IV q6h
-:::* Preferred regimen (1): [[Vancomycin]] 15 mg/kg IV q12h {{and}} [[Gentamicin]] 1 mg/kg IV/IM q8h
+::* Preferred regimen (2): [[Ampicillin/sulbactam]] 3 g IV q4h
-:::* Preferred regimen (2): [[Linezolid]] 600 mg IV q12h
+::* Preferred regimen (3): [[Cefepime]] 1-2 g IV q8h
-:::* Preferred regimen (3): [[Daptomycin]] 6 mg/kg IV q24h
+::* Preferred regimen (4): [[Colistin]] 2.5 mg/kg IV q12h
-::*1.3 '''Ampicillin and Vancomycin resistant'''
+::* Preferred regimen (5): [[Tigecycline]] 100 mg IV single doses {{then}} 50 mg IV q12h
-:::* Preferred regimen (1): [[Linezolid]] 600 mg IV q12h
+::* Preferred regimen (6): [[Amikacin]] 7.5 mg/kg IV q12h or 15 mg/kg IV q24h
-:::* Preferred regimen (2): [[Daptomycin]] 6 mg/kg IV q24h
+::* Preferred regimen (7) (pan-resistant isolates): ([[Colistin]] 5 mg/kg/day IV q12h {{withorwithout}} [[Imipenem]])
-:*2. '''Endocarditis'''<ref name="Baddour-2005">{{Cite journal  | last1 = Baddour | first1 = LM. | last2 = Wilson | first2 = WR. | last3 = Bayer | first3 = AS. | last4 = Fowler | first4 = VG. | last5 = Bolger | first5 = AF. | last6 = Levison | first6 = ME. | last7 = Ferrieri | first7 = P. | last8 = Gerber | first8 = MA. | last9 = Tani | first9 = LY. | title = Infective endocarditis: diagnosis, antimicrobial therapy, and management of complications: a statement for healthcare professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association: endorsed by the Infectious Diseases Society of America. | journal = Circulation | volume = 111 | issue = 23 | pages = e394-434 | month = Jun | year = 2005 | doi = 10.1161/CIRCULATIONAHA.105.165564 | PMID = 15956145 }}</ref><ref>{{Cite web | title =Infective Endocarditis Diagnosis, Antimicrobial Therapy, and Management of Complications A Statement for Healthcare Professionals From the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association| url =http://circ.ahajournals.org/content/111/23/e394.full.pdf+html}}</ref>
+::* Preferred regimen (8) (pan-resistant isolates): [[Ampicillin/sulbactam]]
-::*2.1 '''Endocarditis in Adults'''
+::* Alternative regimen (1): [[Ceftriaxone]] 1-2 g IV qd
-:::*2.1.1 '''Strains Susceptible to Penicillin, Gentamicin, and Vancomycin'''
+::* Alternative regimen (2): [[Cefotaxime]] 2-3 g IV q6-8h
-::::* Preferred regimen: ([[Ampicillin|Ampicillin]] 12 g IV q24h for 4–6 weeks {{or}} [[Penicillin G|Aqueous crystalline penicillin G sodium]] 18–30 MU IV q24h for 4–6 weeks) {{and}} [[Gentamicin|Gentamicin sulfate]] 3 mg/kg IV/IM q24h for 4–6 weeks
+::* Alternative regimen (3): [[Ciprofloxacin]] 400 mg IV q8-12h or 750 mg PO bid
-::::* Alternative regimen: [[Vancomycin|Vancomycin hydrochloride]] 30 mg/kg IV q24h for 6 weeks {{and}} [[Gentamicin|Gentamicin sulfate]] 3 mg/kg IV/IM q24h for 6 weeks
+::* Alternative regimen (4): [[TMP-SMX]] 15-20 mg (TMP)/kg/day IV q6-8h or 2 DS PO bid
-::::* Note (1): In case of native valve endocarditis with symptoms ≤ 3 months, a 4-week course of therapy is recommended.
-::::* Note (2): In case of native valve endocarditis with symptoms > 3 months, a 6-week course of therapy is recommended.
-::::* Note (3): In case of prosthetic valve or other prosthetic cardiac material, a minimum of 6-week course of therapy is recommended.
-:::*2.1.2 '''Strains Susceptible to Penicillin, Streptomycin, and Vancomycin and Resistant to Gentamicin'''
-::::* Preferred regimen: ([[Ampicillin]] 12 g IV q24h for 4–6 weeks {{or}} [[Penicillin G|Aqueous crystalline penicillin G sodium]] 24 MU IV q24h for 4–6 weeks) {{and}}[[Streptomycin|Streptomycin sulfate]] 15 mg/kg IV/IM q24h for 4–6 weeks
-::::* Alternate regimen: [[Vancomycin|Vancomycin hydrochloride]] 30 mg/kg IV q24h  for 6 weeks {{and}} [[Streptomycin|Streptomycin sulfate]] 15 mg/kg IV/IM q24h for 6 weeks
-:::*2.1.3 '''Strains Resistant to Penicillin and Susceptible to Aminoglycoside and Vancomycin'''
-::::*2.1.3.1 '''β Lactamase–producing strain'''
-:::::* Preferred regimen: [[Ampicillin-sulbactam]] 12 g IV q24h for 6 weeks {{and}} [[Gentamicin|Gentamicin sulfate]] 3 mg/kg IV/IM q24h 6 weeks
-:::::* Alternate regimen: [[Vancomycin|Vancomycin hydrochloride]] 30 mg/kg IV q24h for 6 weeks {{and}} [[Gentamicin|Gentamicin sulfate]] 3 mg/kg IV/IM q24h for 6 weeks
-::::*2.1.3.2 '''Intrinsic penicillin resistance'''
-:::::* Preferred regimen: [[Vancomycin|Vancomycin hydrochloride]] 30 mg/kg IV q24h for 6 weeks {{and}} [[Gentamicin|Gentamicin sulfate]] 3 mg/kg IV/IM q24h for 6 weeks
-:::*2.1.4 '''Strains Resistant to Penicillin, Aminoglycoside, and Vancomycin'''
-::::* Preferred regimen (1): ([[Imipenem]] {{or}} [[Cilastatin]] 2 g/day IV for ≥ 8weeks {{and}} [[Ampicillin|Ampicillin]] 12 g/day IV for ≥ 8weeks)
-::::* Preferred regimen (2): ([[Ceftriaxone sodium]] 4 g IV/IM q24h for ≥ 8weeks {{and}} [[ampicillin|Ampicillin]] 12 g IV q24h for ≥ 8weeks)
-::*2.2 '''Endocarditis in Pediatrics'''
-:::*2.2.1 '''Strains Susceptible to Penicillin, Gentamicin, and Vancomycin'''
-::::* Preferred regimen: ([[Ampicillin]] 300 mg/kg IV q24h for 4–6 weeks {{or}} [[Penicillin]] 0.3 MU/kg IV q24h for 4–6 weeks) {{and}} [[Gentamicin]] 3 mg/kg IV/IM q24h 4–6 weeks
-::::*Note (1): In case of native valve endocarditis with symptoms ≤ 3 months, a 4-week course of therapy is recommended.
-::::*Note (2): In case of native valve endocarditis with symptoms > 3 months, a 6-week course of therapy is recommended.
-::::*Note (3): In case of prosthetic valve or other prosthetic cardiac material, a minimum of 6-week course of therapy is recommended.
-::::* Alternate regimen : [[Vancomycin]] 40 mg/kg IV q24h for 6 weeks {{and}} [[Gentamicin]] 3 mg/kg IV/IM q24h for 6 weeks
-:::*2.2.2 '''Strains Susceptible to Penicillin, Streptomycin, and Vancomycin and Resistant to Gentamicin'''
-::::* Preferred regimen: ([[Ampicillin]] 300 mg/kg IV q24h for 4–6 weeks {{or}} [[Penicillin]] 0.3 MU/kg IV q24h for 4–6 weeks) {{and}} [[Streptomycin]] 20–30 mg/kg IV/IM q24h for 4–6 weeks
-::::* Alternate regimen: [[Vancomycin|Vancomycin hydrochloride]] 40 mg/kg IV q24h for 6 weeks {{and}} [[Streptomycin|Streptomycin sulfate]] 15 mg/kg IV/IM q24h for 6 weeks
-:::*2.2.3 '''Strains Resistant to Penicillin and Susceptible to Aminoglycoside and Vancomycin'''
-::::*2.2.3.1 '''β Lactamase–producing strain'''
-:::::* Preferred regimen: [[Ampicillin-sulbactam]] 300 mg/kg IV q24h for 6 weeks {{and}} [[Gentamicin]] 3 mg/kg IV/IM q24h for 6 weeks
-:::::* Alternate regimen: [[Vancomycin]] 40 mg/kg IV q24h for 6 weeks {{and}} [[Gentamicin]] 3 mg/kg IV/IM q24h for 6 weeks
-::::*2.2.3.2 '''Intrinsic penicillin resistance'''
-:::::*Preferred regimen: [[Vancomycin]] 40 mg/kg IV q24h {{and}} [[Gentamicin]] 3 mg/kg IV/IM q24h for 6 weeks
-:::*2.2.4 '''Strains Resistant to Penicillin, Aminoglycoside, and Vancomycin'''
-::::*Preferred regimen: [[Imipenem]]/[[Cilastatin]] 60–100 mg/kg IV q24h for ≥ 8weeks {{and}} [[Ampicillin]] 300 mg/kg IV q24h for ≥ 8 weeks
-::::*Alternate regimen: [[Ceftriaxone]] 100 mg/kg IV/IM q24h {{and}} [[Ampicillin]] 300 mg/kg IV q24h for ≥ 8 weeks
-:*3. '''Meningitis'''<ref name="pmid15494903">{{cite journal| author=Tunkel AR, Hartman BJ, Kaplan SL, Kaufman BA, Roos KL, Scheld WM et al.| title=Practice guidelines for the management of bacterial meningitis. | journal=Clin Infect Dis | year= 2004 | volume= 39 | issue= 9 | pages= 1267-84 | pmid=15494903 | doi=10.1086/425368 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15494903  }}</ref>
-::*3.1 '''Ampicillin susceptible'''
-:::* Preferred regimen: [[Ampicillin]] 12 g/day IV q4h {{and}} [[Gentamicin]] 5 mg/kg/day IV q8h
-::*3.2 '''Ampicillin resistant'''
-:::* Preferred regimen: [[Vancomycin]] 30–45 mg/kg/day IV q8–12h {{and}} [[Gentamicin]] 5 mg/kg/day IV q8h
-::*3.3 '''Ampicillin and vancomycin resistant'''
-:::* Preferred regimen: [[Linezolid]] 600 mg IV q12h
-:*4. '''Urinary tract infections''' <ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
-::* Preferred regimen (1): [[Nitrofurantoin]] 100 mg PO q6h for 5 days
-::* Preferred regimen (2): [[Fosfomycin]] 3 g PO single dose
-::* Preferred regimen (3): [[Amoxicillin]] 875 mg to 1 g PO q12h for 5 days
-:*5. '''Intra abdominal or Wound infections''' <ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
-::* Preferred regimen(1): [[Penicillin]]
-::* Preferred regimen(2): [[Ampicillin]]
-::* Alternative regimen(Penicillin allergy or high-level Penicillin resistance): [[Vancomycin]]
-::* Alternative regimen(For complicated skin-skin structure and intra-abdominal infection): [[Tigecycline]] 100 mg IV single dose and 50 mg IV q12h
-* [[Enterococcus faecium]]
-:*1. '''Bacteremia'''<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
-::*1.1 '''Ampicillin or Penicillin susceptible'''
-:::* Preferred regimen (1): [[Ampicillin]] 2 g IV q4-6h
-:::* Preferred regimen (2): [[Ampicillin]] 2 g IV q4-6h {{and}} [[Gentamicin]] 1 mg/kg IV/IM q8h
-::*1.2 '''Ampicillin resistant and vancomycin susceptible or Penicillin allergy'''
-:::* Preferred regimen (1): [[Vancomycin]] 15 mg/kg IV q12h {{and}} [[Gentamicin]] 1 mg/kg IV/IM q8h
-:::* Preferred regimen (2): [[Linezolid]] 600 mg IV q12h
-:::* Preferred regimen (3): [[Daptomycin]] 6 mg/kg IV q24h.
-::*1.3 '''Ampicillin and Vancomycin resistant'''
-:::* Preferred regimen (1): [[Linezolid]] 600 mg IV q12h
-:::* Preferred regimen (2): [[Daptomycin]] 6 mg/kg IV q24h
-:*2. '''Endocarditis'''
-::*2.1 '''Endocarditis in Adults'''
-:::*2.1.1 '''Strains Susceptible to Penicillin, Gentamicin, and Vancomycin'''
-::::*Preferred regimen: ([[Ampicillin|Ampicillin]] 12 g/day IV for 4–6 weeks {{or}} [[Penicillin G|Aqueous crystalline penicillin G sodium]] 18–30 MU/day IV for 4–6 weeks) {{and}} [[Gentamicin|Gentamicin sulfate]] 3 mg/kg IV/IM q24h for 4–6 weeks
-::::* Alternative regimen: [[Vancomycin|Vancomycin hydrochloride]] 30 mg/kg IV q24h for 6 weeks {{and}} [[Gentamicin|Gentamicin sulfate]] 3 mg/kg IV/IM q24h for 6 weeks
-::::* Alternate regimen: [[Vancomycin|Vancomycin hydrochloride]] 30 mg/kg IV q24h for 6 weeks {{and}} [[Gentamicin|Gentamicin sulfate]] 3 mg/kg IV/IM q24h for 6 weeks
-::::*Note (1): In case of native valve endocarditis with symptoms ≤ 3 months, a 4-week course of therapy is recommended.
-::::*Note (2): In case of native valve endocarditis with symptoms > 3 months, a 6-week course of therapy is recommended.
-::::*Note (3): In case of prosthetic valve or other prosthetic cardiac material, a minimum of 6-week course of therapy is recommended.
-:::*2.1.2 '''Strains Susceptible to Penicillin, Streptomycin, and Vancomycin and Resistant to Gentamicin'''
-::::* Preferred regimen: ([[Ampicillin]] 12 g/day IV for 4–6 weeks {{or}} [[Penicillin G|Aqueous crystalline penicillin G sodium]] 24 MU/day IV q24h for 4–6 weeks) {{and}}[[Streptomycin|Streptomycin sulfate]] 15 mg/kg IV/IM q24h for 4–6 weeks
-::::* Alternate regimen: [[Vancomycin|Vancomycin hydrochloride]] 30 mg/kg IV q24h for 6 weeks {{and}} [[Streptomycin|Streptomycin sulfate]] 15 mg/kg IV/IM q24h for 6 weeks
-:::*2.1.3 '''Strains Resistant to Penicillin and Susceptible to Aminoglycoside and Vancomycin'''
-::::*2.1.3.1 '''β Lactamase–producing strain'''
-:::::* Preferred regimen: [[Ampicillin-sulbactam]] 12 g IV q24h for 6 weeks {{and}} [[Gentamicin|Gentamicin sulfate]] 3 mg/kg IV/IM q24h for 6 weeks
-:::::* Alternate regimen: [[Vancomycin|Vancomycin hydrochloride]] 30 mg/kg IV q24h for 6 weeks {{and}} [[Gentamicin|Gentamicin sulfate]] 3 mg/kg IV/IM q24h for 6 weeks
-::::*2.1.3.2 '''Intrinsic penicillin resistance'''
-:::::* Preferred regimen: [[Vancomycin|Vancomycin hydrochloride]] 30 mg/kg IV q24h for 6 weeks {{and}} [[Gentamicin|Gentamicin sulfate]] 3 mg/kg IV/IM q24h for 6 weeks
-:::*2.1.4 '''Strains Resistant to Penicillin, Aminoglycoside, and Vancomycin'''
-::::*Preferred regimen(1): [[Linezolid]] 1200 mg IV/PO q24h ≥8 weeks
-::::*Preferred regimen(2): [[Quinupristin]]-[[Dalfopristin]] 22.5 mg/kg IV q24h ≥ 8 weeks
-::*2.2 '''Endocarditis in Pediatrics'''
-:::*2.2.1 '''Strains Susceptible to Penicillin, Gentamicin, and Vancomycin'''
-::::* Preferred regimen: ([[Ampicillin]] 300 mg/kg IV q24h for 4–6 weeks {{or}} [[Penicillin]] 0.3MU/kg IV q24h for 4–6 weeks) {{and}} [[Gentamicin]] 3 mg/kg IV/IM q24h 4–6 weeks
-::::* Alternate regimen : [[Vancomycin]] 40 mg/kg IV q24h for 6 weeks {{and}} [[Gentamicin]] 3 mg/kg IV/IM q24h for 6 weeks
-::::*Note (1): In case of native valve endocarditis with symptoms ≤ 3 months, a 4-week course of therapy is recommended.
-::::*Note (2): In case of native valve endocarditis with symptoms > 3 months, a 6-week course of therapy is recommended.
-::::*Note (3): In case of prosthetic valve or other prosthetic cardiac material, a minimum of 6-week course of therapy is recommended.
-:::*2.2.2 '''Strains Susceptible to Penicillin, Streptomycin, and Vancomycin and Resistant to Gentamicin'''
-::::* Preferred regimen: ([[Ampicillin]] 300 mg/kg IV q24h for 4–6 weeks {{or}} [[Penicillin]] 0.3MU/kg IV q24h for 4–6 weeks) {{and}} [[Streptomycin]] 20–30 mg/kg IV/IM q24h for 4–6 weeks
-::::* Alternate regimen: [[Vancomycin|Vancomycin hydrochloride]] 40 mg/kg IV q24h for 6 weeks {{and}}[[Streptomycin|Streptomycin sulfate]] 15 mg/kg IV/IM q24h for 6 weeks
-:::*2.2.3 '''Strains Resistant to Penicillin and Susceptible to Aminoglycoside and Vancomycin'''
-::::*2.2.3.1 '''β Lactamase–producing strain'''
-:::::* Preferred regimen: [[Ampicillin-sulbactam]] 300 mg/kg IV q24h for 6 weeks {{and}} [[Gentamicin]] 3 mg/kg IV/IM q24h for 6 weeks
-:::::* Alternate regimen: [[Vancomycin]] 40 mg/kg IV q24h for 6 weeks {{and}} [[Gentamicin]] 3 mg/kg IV/IM q24h for 6 weeks
-::::*2.2.3.2 '''Intrinsic penicillin resistance'''
-::::*Preferred regimen: [[Vancomycin]] 40 mg/kg IV q24h {{and}} [[Gentamicin]] 3 mg/kg IV/IM q24h for 6 weeks
-:::*2.2.4 '''Strains Resistant to Penicillin, Aminoglycoside, and Vancomycin'''
-::::*Preferred regimen(1): [[Linezolid]] 30 mg/kg IV/PO q24h ≥ 8 weeks
-::::*Preferred regimen(2): [[Quinupristin]]-[[Dalfopristin]] 22.5 mg/kg IV q24h ≥ 8 weeks
-:*3. '''Meningitis'''<ref name="pmid15494903">{{cite journal| author=Tunkel AR, Hartman BJ, Kaplan SL, Kaufman BA, Roos KL, Scheld WM et al.| title=Practice guidelines for the management of bacterial meningitis. | journal=Clin Infect Dis | year= 2004 | volume= 39 | issue= 9 | pages= 1267-84 | pmid=15494903 | doi=10.1086/425368 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15494903  }}</ref>
-::*3.1 '''Ampicillin susceptible'''
-:::* Preferred regimen: [[Ampicillin]] 12 g/day IV q4h {{and}} [[Gentamicin]] 5 mg/kg/day IV q8h
-::*3.2 '''Ampicillin resistant'''
-:::* Preferred regimen: [[Vancomycin]] 30–45 mg/kg/day IV q8–12h {{and}} [[Gentamicin]] 5 mg/kg/day IV q8h
-::*3.3 '''Ampicillin and vancomycin resistant'''
-:::* Preferred regimen: [[Linezolid]] 600 mg IV q12h
-:*4. '''Urinary tract infections'''<ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
-::* Preferred regimen (1): [[Nitrofurantoin]] 100 mg PO q6h for 5 days
-::* Preferred regimen (2): [[Fosfomycin]] 3 g PO single dose
-::* Preferred regimen (3): [[Amoxicillin]] 875 mg to 1 g PO q12h for 5 days
-:*5. '''Intra abdominal or Wound infections''' <ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
-::* Preferred regimen(1): [[Penicillin]]
-::* Preferred regimen(2): [[Ampicillin]]
-::* Alternative regimen(Penicillin allergy or high-level Penicillin resistance): [[Vancomycin]]
-::* Alternative regimen(For complicated skin-skin structure and intra-abdominal infection): [[Tigecycline]] 100 mg IV single dose and 50 mg IV q12h
+{{PBI|Aeromonas hydrophila}}
 :* Aeromonas hydrophila <ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
 ::*1. '''Diarrhea'''
-:::* Preferred regimen(if not self-limiting, or if severe): [[Ciprofloxacin]] 500 mg PO bid.
+:::* Preferred regimen (if not self-limiting, or if severe): [[Ciprofloxacin]] 500 mg PO bid.
-:::* Alternate regimen: [[TMP-SMX]] single dose PO bid
+:::* Alternate regimen: [[TMP-SMX]] 1DS PO bid
 :::* Note: High resistance to sulfa agents described in Taiwan and Spain
 ::*2. '''Skin and soft tissue infection'''
 :::*2.1 '''Mild infection'''
 ::::* Preferred regimen(1): [[Ciprofloxacin]] 500 mg PO bid
-::::* Preferred regimen(2): [[Levofloxacin]] 500 mg qd.
+::::* Preferred regimen(2): [[Levofloxacin]] 500 mg qd
 :::*2.2 '''Severe infection or sepsis'''
 ::::* Preferred regimen(1): [[Ciprofloxacin]] 400 mg IV q8h
 ::::* Preferred regimen(2): [[Levofloxacin]] 750 mg IV q24h
-::::*Note(1): For suspicion of water-based injury,empiric coverage for Vibrio [[Doxycycline]] 100mg bid, although Flouroquinolones may also cover {{and}} [[Vancomycin]] 15mg/kg IV q12h {{with or without}} [[Clindamycin]] {{or}} [[Linezolid]] for inhibition of Gram-positive toxin production
+::::*Note(1): For suspicion of water-based injury,empiric coverage for Vibrio doxycycline 100 mg bid, although flouroquinolones may also cover and vancomycin 15 mg/kg IV q12h with or without clindamycin or linezolid for inhibition of gram-positive toxin production
-::::* Note(2): Alternatives to [[Fluoroquinolones]] for Aeromonas coverage include [[carbapenems]] ([[ertapenem]], [[doripenem]], [[imipenem]] or [[meropenem]]),[[ceftriaxone]], [[cefepime]] and [[Aztreonam]].
+::::* Note(2): Alternatives to fluoroquinolones for Aeromonas coverage include carbapenems (ertapenem, doripenem, imipenem or meropenem), ceftriaxone, cefepime and aztreonam.
 ::*3. '''Prevention'''
 :::*Preferred regimen: Frequent recommendations include using a [[Cephalosporin]] (e.g.,cefuroxime,ceftriaxone or cefixime) {{or}} a [[Fluoroquinolone]] (e.g.,ciprofloxacin or levofloxacin) during treatment with medicinal leeches.
-:::*Note (1): Duration of antibiotic use is 3-5days, some recommend continuing until wound or eschar resolves
+:::*Note (1): Duration of antibiotic use is 3-5 days, some recommend continuing until wound or eschar resolves
 :::*Note (2): Aeromonas isolates from leeches have been described as uniformly susceptible to fluoroquinolones.
-====Bacteria – Gram-Negative Bacilli====
-{{PBI|Achromobacter xylosoxidans}}
-{{PBI|Acinetobacter baumannii}}
-::* Preferred regimen (1): [[Imipenem]] 0.5-1 g IV q6h
-::* Preferred regimen (2): [[Ampicillin/sulbactam]] (Unasyn) 3g q4h
-::* Preferred regimen (3): [[Cefepime]] 1-2 g IV q8h
-::* Preferred regimen (4): [[Colistin]] 2.5 mg/kg IV q12h
-::* Preferred regimen (5): [[Tigecycline]] (Tygacil) 100 mg IV, then 50 mg IV q12h
-::* Preferred regimen (6): [[Amikacin]] 7.5 mg/kg q12h IV or 15 mg/kg/day IV
-::* Alternative regimen (1): [[Ceftriaxone]] 1-2g IV every day
-::* Alternative regimen (2): [[Cefotaxime]] 2-3g IV q6-8h
-::* Alternative regimen (3): [[Ciprofloxacin]] 400 mg IV q8-12h or 750 mg PO bid
-::* Alternative regimen (4): [[TMP-SMX]] 15-20 mg (TMP)/kg/day IV divided 3 or 4 doses/day or 2 DS PO bid
-{{PBI|Aeromonas hydrophila}}
-{{PBI|Bartonella}}
-:* Bartonella<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
-::*1. '''Cat scratch disease'''
-:::*1.1 '''If extensive adenopathy'''
-::::* Preferred regimen: [[Azithromycin]] 500 mg single dose
-::*2. '''Retinitis'''
-:::* Preferred regimen: [[Doxycycline]] 100 mg bid {{and}}  [[Rifampin]] 300 mg bid PO for 4-6 weeks.
-::*3. '''Bacillary angiomatosis'''
-:::* Preferred regimen (1): [[Erythromycin]] 500 mg PO qid
-:::* Preferred regimen (2): [[Doxycycline]] 100mg PO bid for >3 months.
-::*4. '''Peliosis hepatitis'''
-:::* Preferred regimen (1): [[Erythromycin]] 500 mg PO qid
-:::* Preferred regimen (2): [[Doxycycline]] 100 mg PO bid for 4 months.
-::*5. '''Oroya fever'''
-:::* Preferred regimen: [[Ciprofloxacin]] 500 mg PO bid for 10 days.
-::*6. '''Endocarditis'''
-:::* Preferred regimen: [[Gentamicin]] 3 mg/kg/day IV q8h for 14 days {{and}} [[Ceftriaxone]] 2 g/day IV for 6weeks {{with or without}} [[Doxycycline]] 100 mg PO bid for 6 weeks.
 {{PBI|Bordetella pertussis}}
-:*Bordetella pertussis<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
+:*Bordetella pertussis<ref>{{Cite web | title = Recommended Antimicrobial Agents for the Treatment and Postexposure Prophylaxis of Pertussis 2005 CDC Guidelines
- ::*1. '''Whooping cough'''
+ | url = http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5414a1.htm#tab4}}</ref>
-:::*1.1 '''Adults'''
+::* 1. '''Whooping cough'''
-::::* Preferred regimen (1): [[Azithromycin]] 500 mg PO single dose on day 1 {{then}} 250 mg PO qd on 2-5days
+:::* 1.1 '''Adults'''
+::::* Preferred regimen (1): [[Azithromycin]] 500 mg PO single dose on day 1 {{then}} 250 mg PO qd on 2-5 days
 ::::* Preferred regimen (2): [[Erythromycin]] 2 g/day PO qid for 14 days
 ::::* Preferred regimen (3): [[Clarithromycin]] 1 g PO bid for 7 days.
-::::* Alternative regimen (Intolerant of macrolides): [[Trimethoprim]] 320 mg/day {{and}} [[Sulfamethoxazole]] 1600 mg/day PO bid for 14 days
+::::* Alternative regimen (intolerant of macrolides): [[Trimethoprim]] 320 mg/day {{and}} [[Sulfamethoxazole]] 1600 mg/day PO bid for 14 days
-:::*1.2 '''Infants <6 months of age'''
+:::* 1.2 '''Infants <6 months of age'''
-::::*1.2.1 '''Infants <1 month'''
+::::* 1.2.1 '''Infants <1 month'''
 :::::* Preferred regimen (1): [[Azithromycin]] 10 mg/kg PO qd for 5 days
-:::::* Preferred regimen (2) (If azithromycin unavailable): [[Erythromycin]] 40-50 mg/kg/day PO q6h for 14 days
+:::::* Preferred regimen (2) (if azithromycin unavailable): [[Erythromycin]] 40-50 mg/kg/day PO q6h for 14 days
-:::::* Note: [[TMP-SMX]] contraindicated for infants aged <2 months
+:::::* Note: TMP-SMX contraindicated for infants aged < 2 months
-::::*1.2.2 '''Infants of 1-5 months of age'''
+::::* 1.2.2 '''Infants of 1-5 months of age'''
 :::::* Preferred regimen (1): [[Azithromycin]] 10 mg/kg PO qd for 5 days
-:::::* Preferred regimen (2): [[Erythromycin]] 40-50 mg/kg/day qid for 14 days
+:::::* Preferred regimen (2): [[Erythromycin]] 40-50 mg/kg/day PO qid for 14 days
-:::::* Preferred regimen (3): [[Clarithromycin]] 15 mg/kg PO bid for 7 days,
+:::::* Preferred regimen (3): [[Clarithromycin]] 15 mg/kg PO bid for 7 days
-:::::* Note: [[TMP-SMX]] contraindicated at age <2 months, for infants aged ≥2 months TMP 8 mg/kg/day SMX 40 mg/kg/day bid for 14 days
+:::::* Alternative regimen: For infants aged ≥ 2 months [[TMP]] 8 mg/kg q24h {{and}} [[Sulfamethoxazole|SMX]] 40 mg/kg/day PO bid for 14 days
-:::*1.3 '''Infants >6 months of age-children'''
+:::* 1.3 '''Infants ≥6 months of age-children'''
-:::::* Preferred regimen(1): [[Azithromycin]] 10 mg/kg (500 mg max) qd for 5 days
+:::::* Preferred regimen(1): [[Azithromycin]] 10 mg/kg single dose {{then}} 5 mg/kg (500 mg Maximum) qd for 2-5 days
-:::::* Preferred regimen(2): [[Clarithromycin]] 15 mg/kg (1 g daily max) bid for 7 days
+:::::* Preferred regimen(2): [[Erythromycin]] 40-50 mg/kg PO (2 g daily Maximum) qid for 14 days
-:::::* Preferred regimen(3): [[Erythromycin]] 10mg/kg PO (2g daily max) qid for 14 days
+:::::* Preferred regimen(3): [[Clarithromycin]] 15 mg/kg PO (1 g daily Maximum) bid for 7 days
-:::::* Preferred regimen(4): [[TMP-SMX]] 4 mg/40 mg/kg bid for 14 days.
+:::::* Preferred regimen(4): [[TMP]] 8 mg/kg/day {{and}} [[Sulfamethoxazole|SMX]] 40 mg/kg/day bid for 14 days
-:::::* Note(1): [[TMP-SMX]] should only be used in patients ≥2 months of age who are allergic or intolerant of macrolides or who have a macrolide-resistant strain.
+::* 2. '''Post exposure prophylaxis'''<ref>{{Cite web | title = Recommended Antimicrobial Agents for the Treatment and Post exposure Prophylaxis of Pertussis 2005 CDC Guidelines
-:::::* Note(2): Although fluoroquinolones have excellent in vitro sensitivity profiles, clinical experience for B. pertussis is limited.
+ | url = http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5414a1.htm#tab4}}</ref>
-:::*1.4 '''Post exposure prophylaxis'''
+:::* Preferred regimen: The antibiotic regimens for post exposure prophylaxis are similar to the regimens used for the treatment of pertussis
+:::* Note (1):  Post exposure prophylaxis to an asymptomatic contacts within 21 days of onset of cough in the index patient can potentially prevent symptomatic infection
+:::* Note (2): Close contacts include persons who have direct contact with respiratory, oral or nasal secretions from a symptomatic patient (eg: cough, sneeze, sharing food, eating utensils, mouth to mouth resuscitation, or performing a medical examination of the mouth, nose, throat.
+:::* Note (3): Some close contacts are at high risk for acquiring severe disease following exposure to pertussis. These contacts include infants aged < 1 year , persons with some immunodeficiency conditions, or other underlying medical conditions such as chronic lung disease, respiratory insufficiency and cystic fibrosis.
 {{PBI|Burkholderia cepacia}}
-::* Burkholderia cepacia<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
+:* Burkholderia cepacia complex<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
-:::* Preferred regimen (1): [[Ceftazidime]] 2 g IV q8h
+::* Preferred regimen (1): [[Ceftazidime]] 2 g IV q8h
+::* Preferred regimen (2): [[Imipenem]] 1 g IV q6h
+::* Preferred regimen (3): [[Meropenem]] 1-2 g IV q8h
+::* Preferred regimen (4): [[Minocycline]] 100 mg IV/PO bid
-:::* Preferred regimen (2): [[Imipenem]] 1 g IV q6h
+{{PBI|Burkholderia pseudomallei}}
+:* Burkholderia pseudomallei
+::* 1. '''Melioidosis'''<ref name="pmid22970946">{{vcite2 journal |vauthors=Wiersinga WJ, Currie BJ, Peacock SJ |title=Melioidosis |journal=N. Engl. J. Med. |volume=367 |issue=11 |pages=1035–44 |year=2012 |pmid=22970946 |doi=10.1056/NEJMra1204699 |url= |issn=}}</ref>
+:::* 1.1 '''Intial intensive therapy''' (Minimum of 10-14 days)
+::::* Preferred regimen (1): [[Ceftazidime]] 50 mg/kg upto 2 g q6h
+::::* Preferred regimen (2): [[Meropenem]] 25 mg/kg upto 1 g q8h
+::::* Preferred regimen (3): [[Imipenem]] 25 mg/kg upto 1 g q6h
+::::* Note: Any one of the three may be combined with [[TMP-SMX]] 6/30 mg/kg upto 320/1600 mg/kg q12h (recommended for neurologic, bone, joint, cutaneous and prostatic melioidosis)
+:::* 1.2 '''Eradication therapy''' (Minimum of 3 months)
+::::* Preferred regimen: [[TMP-SMX]] 6/30 mg/kg upto 320/1600 mg/kg q12h
-:::* Preferred regimen (3): [[Meropenem]] 1-2 g IV q8h
-:::* Preferred regimen (4): [[Minocycline]] 100 mg IV/PO bid.
-{{PBI|Burkholderia pseudomallei}}
-::* Burkholderia pseudomallei
-:::*'''1.Melioidosis'''<ref name="pmid22970946">{{vcite2 journal |vauthors=Wiersinga WJ, Currie BJ, Peacock SJ |title=Melioidosis |journal=N. Engl. J. Med. |volume=367 |issue=11 |pages=1035–44 |year=2012 |pmid=22970946 |doi=10.1056/NEJMra1204699 |url= |issn=}}</ref>
-::::*1.1.Intial intensive therapy (Minimum of 10-14 days)
-:::::* Preferred regimen : [[Ceftazidime]] 50 mg/kg upto 2 g q6h {{or}} [[Meropenem]] 25mg/kg upto 1g q8h {{or}} [[Imipenem]] 25 mg/kg upto 1g
-:::::* Note : Any one of the three may be combined with [[TMP-SMX]]6/30 mg/kg upto 320/1600 mg/kg q12h (recommended for neurologic, bone, joint, cutaneous and prostatic melioidosis)
-::::*1.2.Eradication therapy (Minimum of 3months)
-:::::* Preferred regimen : [[TMP-SMX]]6/30 mg/kg upto 320/1600 mg/kg q12h
-{{PBI|Campylobacter}}
 {{PBI|Campylobacter fetus}}
-::*Campylobacter fetus<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
+:* Campylobacter fetus<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
-:::*Serious infections
+::* 1. '''Serious infections'''
-::::*Preferred regimen : [[Gentamicin]] 5mg/kg/day IV {{or}} [[Imipenem]] 1mg IV q6h {{or}} [[Ceftriaxone]] 2g IV q12h.
+:::* Preferred regimen (1): [[Gentamicin]] 5 mg/kg IV q24h
-:::*Endovascular infections
+:::* Preferred regimen (2): [[Imipenem]] 1 mg IV q6h
-::::*Preferred regimen : [[Aminoglycoside]] 4-6weeks combined with [[Carbapenem]].
+:::* Preferred regimen (3): [[Ceftriaxone]] 2 g IV q12h
-:::*CNS
+::* 2. '''Endovascular infections'''
-::::*preferred regimen : [[Ceftriaxone]] {{or}} [[Chloramphenicol]] for 2-3weeks.
+:::* Preferred regimen: [[Aminoglycoside]] 4-6 weeks {{and}} [[Carbapenem]]
+::* 3. '''CNS'''
+:::* preferred regimen (1): [[Ceftriaxone]]
+:::* preferred regimen (2): [[Chloramphenicol]] for 2-3 weeks
 {{PBI|Campylobacter jejuni}}
 {{PBI|Capnocytophaga canimorsus}}
-::*Capnocytophaga canimorsus<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
+:* Capnocytophaga canimorsus<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
-:::*'''1.Severe Cellulitis/Sepsis or Endocarditis'''
+::* 1. '''Severe cellulitis/sepsis or endocarditis'''
-::::*Preferred regimen
+:::* Preferred regimen (1) (Beta-lactam/beta-lactamase inhibitor): [[Ampicillin]]/[[sulbactam]] 3 g IV q6h
-:::::*Beta-lactam/beta-lactamase inhibitor : [[Ampicillin]]/[[sulbactam]] 3 g IV q6h
+:::* Preferred regimen (2) (Non-beta-lactamase producing): [[Penicillin G]] 2-4 MU IV q24h
-:::::*Non-beta-lactamase producing : [[Penicillin G]] 2-4MU q4h IV
+:::* Alternative regimen (1): [[Ceftriaxone]] 1-2 g IV q24h
-::::*Alternative regimen : [[Ceftriaxone]] 1-2 g IV q24h {{or}} [[Meropenem]] 1 g IV q8h.
+:::* Alternative regimen (2): [[Meropenem]] 1 g IV q8h
-:::*'''2.Complicated infections or Immunocompromise'''
+:::* Alternative regimen (3) (complicated infections or immunocompromise): [[Clindamycin]] 600 mg IV q8h may be combined with above agents
-::::*Preferred regimen : [[Clindamycin]] 600 mg IV q8h may be combined with above agents
+:::* Note (1): Resistance to aztreonam described, and variable susceptibility reported to TMP-SMX and aminoglycosides
-::::*Note (1): Resistance to aztreonam described, and variable susceptibility reported to [[TMP-SMX]] and aminoglycosides.
+:::* Note (2): For endocarditis, alternatives to penicillins not well established, treated for duration of 6 weeks
-::::*Note (2): For endocarditis, alternatives to penicillins not well established, treated for duration of 6 weeks. For non-endocarditis infections, duration not well established, but most authorities recommend at least 14-21 days of therapy.
+:::* Note (3): For non-endocarditis infections, duration not well established, but most authorities recommend at least 14-21 days of therapy
-:::*'''3.Mild Cellulitis/Dog or Cat Bites'''
+::* 2. '''Mild cellulitis/dog or cat bites'''
-::::*Preferred regimen : [[Amoxicillin/clavulanate]] 500 mg PO q8h or 875 mg PO bid {{or}} [[Amoxicillin]] 500 mg PO q8h.
+:::* Preferred regimen (1): [[Amoxicillin/clavulanate]] 500 mg PO q8h or 875 mg PO bid
-::::*Alternative regimen : [[Clindamycin]] 300 mg PO q6h {{or}} [[Doxycycline]] 100 mg PO bid {{or}} [[Clarithromycin]] 500 mg PO bid {{or}} [[Moxifloxacin]] 400 mg PO OD.
+:::* Preferred regimen (2): [[Amoxicillin]] 500 mg PO q8h
-:::*'''4.Meningitis or brain abscess'''
+:::* Alternative regimen (1): [[Clindamycin]] 300 mg PO q6h
-::::*Preferred regimen : Use [[Ceftriaxone]] 2 g IV q12h {{and}} [[Ampicillin]] 2 g IV q4h
+:::* Alternative regimen (2): [[Doxycycline]] 100 mg PO bid
-::::*If Beta-lactamase producing or polymicrobial brain abscess : [[Imipenem]]/[[cilastin]] 1000 mg q6-8h {{and}} [[Clindamycin]] 600 mg IV q8h
+:::* Alternative regimen (3): [[Clarithromycin]] 500 mg PO bid
-:::*'''5.Prevention'''
+:::* Alternative regimen (4): [[Moxifloxacin]] 400 mg PO qd
-::::*Although no firm data supports this recommendation, many clinicians do give prophylaxis for dog and cat bites in asplenic patients with [[amoxicillin/clavulanate]] for 7-10 days.
+::* 3. '''Meningitis or brain abscess'''
+:::* Preferred regimen (1): [[Ceftriaxone]] 2 g IV q12h {{and}} [[Ampicillin]] 2 g IV q4h
+:::* Preferred regimen (2) (if beta-lactamase producing or polymicrobial brain abscess): [[Imipenem]]/[[Cilastin]] 1000 mg q6-8h {{and}} [[Clindamycin]] 600 mg IV q8h
+::* 4. '''Prevention'''
+:::* Although no firm data supports this recommendation, many clinicians do give prophylaxis for dog and cat bites in asplenic patients with [[Amoxicillin/clavulanate]] for 7-10 days.
 {{PBI|Citrobacter freundii}}
-::* Citrobacter freundii<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
+:* Citrobacter freundii<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
-:::* Preferred regimen: [[Meropenem]] 1-2 g IV q8h {{or}} [[Imipenem]] 1 g IV q6h {{or}} [[Doripenem]] 500 mg IVq8h{{or}} [[Cefepime]] 1-2 g IV q8h {{or}} [[Ciprofloxacin]] 400 mg IV q12h(or 500 mg PO bid for UTI) {{or}} [[Gentamicin]] 5 mg/kg/day.
+::* Preferred regimen (1): [[Meropenem]] 1-2 g IV q8h
-:::* Alternate regimen: [[Piperacillin]]/[[tazobactam]] 3.375 mg q6h IV {{or}} [[Aztreonam]] 1-2 g IV q6h {{or}} [[TMP-SMX]] 5 mg/kg q6h IV (or DS PO bid for UTI).
+::* Preferred regimen (2): [[Imipenem]] 1 g IV q6h
+::* Preferred regimen (3): [[Doripenem]] 500 mg IV q8h
+::* Preferred regimen (4): [[Cefepime]] 1-2 g IV q8h
+::* Preferred regimen (5): [[Ciprofloxacin]] 400 mg IV q12h or 500 mg PO bid for UTI
+::* Preferred regimen (6): [[Gentamicin]] 5 mg/kg/day
+::* Alternate regimen (1): [[Piperacillin]]/[[tazobactam]] 3.375 mg IV q6h
+::* Alternate regimen (2): [[Aztreonam]] 1-2 g IV q6h
+::* Alternate regimen (3): [[TMP-SMX]] 5 mg/kg q6h IV or DS PO bid for UTI
+::*Note: Usually carbenicillin sensitive, cephalothin resistant
 {{PBI|Citrobacter koseri}}
-::* Citrobacter koseri<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
+:* Citrobacter koseri<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
-:::* Preferred regimen: [[Ceftriaxone]] 1-2 g IV q12-24 {{or}} [[Cefotaxime]] 1-2 g IV q6h {{or}} [[Cefepime]] 1-2 IV q8h.
+::* Preferred regimen (1): [[Ceftriaxone]] 1-2 g IV q12-24h
-:::* Alternate regimen: [[Ciprofloxacin]] 400 mg IV q12h (or 500 mg PO q12h for UTI){{or}} [[Imipenem]] 1 g IV q6h {{or}} [[Doripenem]] 500 mg IV q8h {{or}} [[Meropenem]] 1-2 g IV q8h {{or}} [[Aztreonam]] 1-2 g IV q6h{{or}} [[TMP-SMX]] 5 mg/kg q6h IV (or DS PO bid for UTI).
+::* Preferred regimen (2): [[Cefotaxime]] 1-2 g IV q6h
-:::*Note: Usually [[Ampicillin]] resistant, but may be sensitive to [[Cephalosporins|first generation cephalosporins]]
+::* Preferred regimen (3): [[Cefepime]] 1-2 IV q8h
+::* Alternate regimen (1): [[Ciprofloxacin]] 400 mg IV q12h or 500 mg PO q12h for UTI
+::* Alternate regimen (2): [[Imipenem]] 1 g IV q6h
+::* Alternate regimen (3): [[Doripenem]] 500 mg IV q8h
+::* Alternate regimen (4): [[Meropenem]] 1-2 g IV q8h
+::* Alternate regimen (5): [[Aztreonam]] 1-2 g IV q6h
+::* Alternate regimen (6): [[TMP-SMX]] 5 mg/kg IV q6h  or DS PO bid for UTI
+::* Note: Usually Ampicillin resistant, but may be sensitive to first generation cephalosporins
 {{PBI|Elizabethkingia meningoseptica}}
 {{PBI|Enterobacter aerogenes}}
-:* [[Enterobacter aerogenes]]
+:* Enterobacter species<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
-::*'''1.UTI'''<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
+::* 1. '''Severe infections'''
-:::*Preferred regimen: [[Ciprofloxacin]] 250 mg PO bid
+:::* Preferred regimen (1): [[Piperacillin-tazobactam]] 3.375-4.5 g IV q6h {{and}} ([[Aminoglycoside]] (gentamicin,tobramycin or amikacin) {{or}} [[Fluoroquinolone]],e.g.,ciprofloxacin 400 mg IV q8-12hrs
+:::* Preferred regimen (2) (for coverage of ESBLs): [[Imipenem]] 500 mg IV q6h
+:::* Preferred regimen (3) (for coverage of ESBLs): [[Meropenem]] 500-1000 mg IV q8h
+:::* Preferred regimen (4) (for coverage of ESBLs): [[Doripenem]] 500 mg IV q8h
+:::* Preferred regimen (5) : [[Cefepime]] 2 g IV q8h
+::* 2. '''UTI without systemic symptoms'''
+:::* Preferred regimen: [[Ciprofloxacin]] 250 mg PO bid {{or}} agent based upon susceptibility profile
 {{PBI|Enterobacter cloacae}}
-:* [[Enterobacter cloacae]]
+:* Enterobacter cloacae<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
-::*'''1.UTI'''<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
-:::*Preferred regimen: [[Ciprofloxacin]] 250 mg PO bid {{PBI|Escherichia coli}}
+{{PBI|Escherichia coli}}
-::* Escherichia coli<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
+:* Escherichia coli<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
-:::*1.'''Meningitits'''
+::* 1. '''Meningitits'''<ref name="pmid15494903">Tunkel AR, Hartman BJ, Kaplan SL, Kaufman BA, Roos KL, Scheld WM et al. (2004) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=15494903 Practice guidelines for the management of bacterial meningitis.] ''Clin Infect Dis'' 39 (9):1267-84. [http://dx.doi.org/10.1086/425368 DOI:10.1086/425368] PMID: [http://pubmed.gov/1549490315494903]</ref>
-::::*1.1.Preferred regimen: [[Ceftriaxone]] 4 g IV q12–24h {{or}} [[Cefotaxime]] 8–12 g/day q4–6h
+:::* Preferred regimen (1): [[Ceftriaxone]] 4 g IV q12–24h
-::::*1.2.Alternative regimen: [[Aztreonam]] 6–8 g/day IV q6–8h {{or}} [[Gatifloxacin]] 400 mg/day IV q24h {{or}} [[Moxifloxacin]] 400 mg/day IV q24h {{or}} [[Meropenem]] 6 g/day IV q8h {{or}} [[Trimethoprim-Sulfamethoxazole]] 10–20 mg/kg/day q6–12h {{or}}  [[Ampicillin]] 12 g/day IV q4h
+:::* Preferred regimen (2): [[Cefotaxime]] 8–12 g/day IV q4–6h
-:::*'''2.Uncomplicated urinary tract infection'''
+:::* Alternative regimen (1): [[Aztreonam]] 6–8 g/day IV q6–8h
-::::*2.1.Preferred agents (IDSA/AUA Guidelines): [[TMP-SMX]] DS PO bid for 3-day
+:::* Alternative regimen (2): [[Gatifloxacin]] 400 mg/day IV q24h
-::::*2.2.Alternative regimen(1): [[Ciprofloxacin]] 250 mg PO bid {{or}} [[Ciprofloxacin]] 500 mg XR once daily for 3 days {{or}} [[Levofloxacin]] 250 mg PO OD for 3 days.
+:::* Alternative regimen (3): [[Moxifloxacin]] 400 mg/day IV q24h
-::::*2.3.Alternative regimen(2): [[Nitrofurantoin]] 100 mg PO q6h {{or}} [[Nitrofurantoin]] macrocrystals (Macrobid) 100 mg PO bid for 7 days.
+:::* Alternative regimen (4): [[Meropenem]] 6 g/day IV q8h
-::::*2.4.Alternative regimen(3): [[Fosfomycin]] 3 g sachet PO single dose.
+:::* Alternative regimen (5): [[Trimethoprim-Sulfamethoxazole]] 10–20 mg/kg/day IV q6–12h
-::::: Note: For older patients, those with comorbidities (e.g., diabetes mellitus) use 7-10 days course.
+:::* Alternative regimen (6): [[Ampicillin]] 12 g/day IV q4h
-:::*'''3.Pyelonephritis'''
+::* 2. '''Uncomplicated urinary tract infection'''
-::::*3.1.'''Acute uncomplicated pyelonephritis'''
+:::* Preferred agents (IDSA/AUA Guidelines): [[TMP-SMX]] DS PO bid for 3 days
-:::::*Preferred regimen: [[Ciprofloxacin]] 500 mg bid PO for 5-7 days {{or}} [[Ciprofloxacin]]-[[Erythromycin]] 1000 mg q24h {{or}} [[Levofloxacin]] 750 mg q24h {{or}} [[Ofloxacin]] 400 mg bid, [[Moxifloxacin]] 400 mg q24h
+:::* Alternative regimen (1): [[Ciprofloxacin]] 250 mg PO bid
-:::::*Alternative regimen: [[Amoxicillin-Clavulanic acid]]875/125 mg PO q12h or 500/125 mg PO tid or 1000 /125 mg PO bid {{or}} Oral Cephalosporins {{or}} [[TMP-SMX]] 2 mg/kg IV q6h PO for 14 days
+:::* Alternative regimen (2): [[Ciprofloxacin]] 500 mg XR qd for 3 days
-::::*3.1.'''Acute pyelonephritis (Hospitalized)'''
+:::* Alternative regimen (3): [[Levofloxacin]] 250 mg PO qd for 3 days.
-:::::*Preferred regimen: [[Ciprofloxacin]] 400 mg IV q12h {{or}} [[Ampicillin]] and [[Gentamicin]] {{or}} [[Piperacillin-Tazobactam]] 3.375 gm IV q4-6h for 14 days.
+:::* Alternative regimen (4): [[Nitrofurantoin]] 100 mg PO q6h
-:::::*Alternative regimen: [[Ticarcillin-Clavulanate]]3.1 gm IV q6h or [[Ampicillin]]-[[Sulbactam]] 3 gm IV q6h or [[Piperacillin-Tazobactam]] 3.375 gm IV q4-6h {{or}} [[Ertapenem]] 1 gm IV q24h or [[Doripenem]] 500 mg q8h for 14 days.
+:::* Alternative regimen (5): [[Nitrofurantoin]] macrocrystals 100 mg PO bid for 7 days
-:::*4.'''Traveler’s diarrhea'''
+:::* Alternative regimen (6): [[Fosfomycin]] 3 g sachet PO single dose
-::::*Preferred regimen : [[Ciprofloxacin]] 750 mg PO OD for 1-3 days or other Fluoroquinolones
+:::* Note: For older patients, those with comorbidities (e.g., diabetes mellitus) use 7-10 days course.
-::::*Pediatrics & pregnancy: [[Azithromycin]] 10 mg/kg/day single dose {{or}} [[Ceftriaxone]] 50 mg/kg/day IV OD for 3 days.
+::* 3. '''Pyelonephritis'''
-::::Avoid Fluoroquinolones in Pediatrics and pregnancy.
+:::* 3.1 '''Acute uncomplicated pyelonephritis'''
-:::*5.'''Malacoplakia'''
+::::* Preferred regimen (1): [[Ciprofloxacin]] 500 mg bid PO for 5-7 days
-::::*[[Bethanechol chloride]] {{and}} ([[Ciprofloxacin]] 400 mg IV q12h {{or}} [[TMP-SMX]] 2 mg/kg (TMP component) IV q6h)
+::::* Preferred regimen (2): [[Ciprofloxacin]]-[[Erythromycin]] 1000 mg q24h
-:::*'''6.Bacteremia/Pneumonia'''
+::::* Preferred regimen (3): [[Levofloxacin]] 750 mg q24h
-::::*Preferred regimen : [[Ceftriaxone]] 1-2g IV q24h {{or}} other third or fourth generation cephalosporin {{or}} [[Ciprofloxacin]] 400mg IV q12h or 500mg PO q12h {{or}} [[Levofloxacin]] 500mg PO/IV q24h {{or}} [[Moxifloxacin]] 400mg IV/PO q24h {{or}} [[Ampicillin]](if sensitive) 2g IV q6h {{or}} [[TMP-SMX]](if sensitive) 5-10mg/kg/day for q6-8hIV
+::::* Preferred regimen (4): [[Ofloxacin]] 400 mg bid
-::::*Alternative regimen (1): [[Imipenem]], [[Meropenem]], [[Ertapenem]], [[Doripenem]], [[Ceftazidime]], [[Cefepime]], [[Cefazolin]] or [[Cefuroxime]](if sensitive), [[Aztreonam]], [[Ticarcillin]], [[Piperacillin]], [[Piperacillin]]-[[Tazobactam]], [[Aminoglycosides]], [[Tigecycline]](intra-abd or skin/softtissue).
+::::* Preferred regimen (5): [[Moxifloxacin]] 400 mg q24h
-::::*Alternative regimen (2): [[Ampicillin-sulbactam]] 3g IV q6h {{and}}[[Gentamicin]] 1.5mg/kg/q8h or 5-7mg/kg/dayIV {{or}} [[Gentamicin]] 5mg/kg/day {{or}} [[Tobramycin]] 5mg/kg/dayIV for 7-14days
+::::* Alternative regimen (1): [[Amoxicillin-Clavulanic acid]] 875/125 mg PO q12h or 500/125 mg PO tid or 1000 /125 mg PO bid
-::::*Note: Monotherapy generally not recommended for bacteremia/pneumonia
+::::* Alternative regimen (2): [[Cephalosporins|Oral Cephalosporins]]
+::::* Alternative regimen (3): [[TMP-SMX]] 2 mg/kg IV q6h PO for 14 days
+:::* 3.2 '''Acute pyelonephritis (Hospitalized)'''
+::::* Preferred regimen (1): [[Ciprofloxacin]] 400 mg IV q12h
+::::* Preferred regimen (2): [[Ampicillin]] and [[Gentamicin]]
+::::* Preferred regimen (3): [[Piperacillin-Tazobactam]] 3.375 g IV q4-6h for 14 days
+::::* Alternative regimen (1): [[Ticarcillin-Clavulanate]] 3.1 g IV q6h
+::::* Alternative regimen (2): [[Ampicillin]]-[[Sulbactam]] 3 g IV q6h
+::::* Alternative regimen (3): [[Piperacillin-Tazobactam]] 3.375 g IV q4-6h
+::::* Alternative regimen (4): [[Ertapenem]] 1 g IV q24h
+::::* Alternative regimen (5): [[Doripenem]] 500 mg q8h for 14 days
+::*4. '''Traveler’s diarrhea'''
+:::* Preferred regimen (1): [[Ciprofloxacin]] 750 mg PO qd for 1-3 days or other Fluoroquinolones
+:::* Preferred regimen (2) (pediatrics & pregnancy): [[Azithromycin]] 10 mg/kg/day single dose
+:::* Preferred regimen (3) (pediatrics & pregnancy): [[Ceftriaxone]] 50 mg/kg/day IV qd for 3 days
+:::* Note: Avoid fluoroquinolones in pediatrics and pregnancy.
+::*5. '''Malacoplakia'''
+:::* Preferred regimen (1): [[Bethanechol chloride]] {{and}} [[Ciprofloxacin]] 400 mg IV q12h
+:::* Preferred regimen (2): [[TMP-SMX]] 2 mg/kg (TMP component IV q6h)
+::*6. '''Bacteremia/pneumonia'''
+:::* Preferred regimen (1): [[Ceftriaxone]] 1-2 g IV q24h
+:::* Preferred regimen (2): [[Ciprofloxacin]] 400 mg IV q12h or 500 mg PO q12h
+:::* Preferred regimen (3): [[Levofloxacin]] 500 mg PO/IV q24h
+:::* Preferred regimen (4): [[Moxifloxacin]] 400 mg IV/PO q24h
+:::* Preferred regimen (5): [[Ampicillin]] 2 g IV q6h (if sensitive)
+:::* Preferred regimen (6): [[TMP-SMX]] 5-10 mg/kg/day for q6-8h IV (if sensitive)
+:::* Alternative regimen (1): [[Imipenem]], [[Meropenem]], [[Ertapenem]], [[Doripenem]]; [[Ceftazidime]], [[Cefepime]]; [[Cefazolin]] or [[Cefuroxime]] (if sensitive); [[Aztreonam]]; [[Ticarcillin]], [[Piperacillin]]; [[Piperacillin-Tazobactam]]
+:::* Alternative regimen (2): [[Ampicillin-sulbactam]] 3 g IV q6h {{and}} ([[Gentamicin]] 1.5 mg/kg IV q8h or 5-7 mg/kg/day IV {{or}} [[Tobramycin]] 5 mg/kg/day IV)
+:::* Note (1): A 7- to 14-day course of antibiotic therapy is usually recommended.
+:::* Note (2): The choice of antimicrobial agents should be based on susceptibility results.
+:::* Note (3): Monotherapy with aminoglycosides is generally not recommended for bacteremia or pneumonia.
+----
 {{PBI|Francisella tularensis}}
-::*Francisella tularensis<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
+:* Francisella tularensis<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
-:::*'''1.Tularemia'''
+::* 1. '''Tularemia'''
-::::*Preferred regimen : [[Streptomycin]] 1 g IM bid {{or}} [[Gentamicin]] 5 mg/kg/day IV for 10 days.
+:::* Preferred regimen (1): [[Streptomycin]] 1 g IM bid
-::::*Alternative regimen : [[Doxycycline]] 100 mg IV  bid {{or}} [[Chloramphenicol]] 1 g IV q6h {{or}} [[Ciprofloxacin]] 400 mg IV bid until stable then PO for 14-21 days (total).
-::::*1.1.Pregnancy
+:::* Preferred regimen (2): [[Gentamicin]] 5 mg/kg IV q24h for 10 days
-:::::*Preferred regimen : [[Gentamicin]] 5 mg/kg/day IV for 10 days.
-:::::*Alternative regimen : [[Ciprofloxacin]].
+:::* Preferred regimen (3) (pregnancy): [[Gentamicin]] 5 mg/kg IV q24h for 10 days
+:::* Alternative regimen (1): [[Doxycycline]] 100 mg IV  bid
+:::* Alternative regimen (2): [[Chloramphenicol]] 1 g IV q6h
+:::* Alternative regimen (3): [[Ciprofloxacin]] 400 mg IV bid until stable {{then}} PO for 14-21 days (total)
 {{PBI|Helicobacter pylori}}
-::* Helicobacter pylori<ref name="pmid22491499">{{vcite2 journal |vauthors=Malfertheiner P, Megraud F, O'Morain CA, et al. |title=Management of Helicobacter pylori infection--the Maastricht IV/ Florence Consensus Report |journal=Gut |volume=61 |issue=5 |pages=646–64 |year=2012 |pmid=22491499 |doi=10.1136/gutjnl-2012-302084 |url= |issn=}}</ref>
+:* Helicobacter pylori<ref name="pmid22491499">{{vcite2 journal |vauthors=Malfertheiner P, Megraud F, O'Morain CA, et al. |title=Management of Helicobacter pylori infection--the Maastricht IV/ Florence Consensus Report |journal=Gut |volume=61 |issue=5 |pages=646–64 |year=2012 |pmid=22491499 |doi=10.1136/gutjnl-2012-302084 |url= |issn=}}</ref>
-:::* '''1.Peptic ulcer disease'''
+::* 1. '''Peptic ulcer disease'''
-::::*1.1.Regimens for Initial Treatment
+:::* 1.1 '''Regimens for Initial Treatment'''
-:::::*1.1.1.Triple therapy : PPI(standard dose twice daily) {{and}} [[Amoxicillin]] 1 g bid {{and}} [[Clarithromycin]] 500 mg bid  for 7-14 days
+::::* 1.1.1 '''Triple therapy'''
-:::::*1.1.2.Quadruple therapy: PPI (standard dose twice daily) {{and}} [[Metronidazole]]  250 mg q6h {{and}} [[Tetracycline]] 500 mg q6h {{and}} Bismuth (dose depends on preparation) for 10-14 days
-:::::*1.1.3.Sequential therapy: PPI (standard dose twice daily){{and}} [[Amoxicillin]]  1 g bid for 1-5 days followed by PPI (standard dose twice daily){{and}} [[Clarithromycin]] 500 mg bid {{and}} [[Tinidazole]] 500 mg bid for  6-10 days
+:::::* Preferred regimen: [[PPI]] (standard dose twice daily) {{and}} [[Amoxicillin]] 1 g bid {{and}} [[Clarithromycin]] 500 mg bid  for 7-14 days
-::::*1.2. Second-Line Therapies
+::::* 1.1.2 '''Quadruple therapy'''
-:::::*1.2.1.Triple therapy: PPI (standard dose twice daily) {{and}} [[Amoxicillin]] 1 g bid {{and}} [[Metronidazole]] 500 mg bid
-:::::*1.2.2.Quadruple therapy: PPI (standard dose twice daily){{and}} [[Metronidazole]] 250 mg q6h {{and}} [[Tetracycline]] 500 mg q6h {{and}} Bismuth (dose depends on preparation) for 10-14 days
+:::::* Preferred regimen: [[PPI]] (standard dose twice daily) {{and}} [[Metronidazole]] 250 mg q6h {{and}} [[Tetracycline]] 500 mg q6h {{and}} [[Bismuth]] (dose depends on preparation) for 10-14 days
-:::::*1.2.3.Levofloxacin triple therapy: PPI (standard dose twice daily) {{and}} [[Amoxicillin]] 1 g bid  {{and}}  [[Levofloxacin]] 500 mg bid for 10 days
+::::* 1.1.3 '''Sequential therapy'''
-:::::*1.2.4.Rifabutin triple therapy: PPI (standard dose twice daily)  and  [[Amoxicillin]]  1 g bid {{and}} [[Rifabutin]] 150-300 mg/day  for 10 days
-::::*1.3.Alternative triple therapies appropriate for patients with an allergy to Amoxicillin include (PPI {{and}} [[Clarithromycin]] {{and}} [[Metronidazole]]){{ or}} ([[PPI]] {{and}} [[Tetracycline]] {{and}} [[Metronidazole]]).
+:::::* Preferred regimen: [[PPI]] (standard dose twice daily) {{and}} [[Amoxicillin]] 1 g bid for 1-5 days {{and}} [[Clarithromycin]] 500 mg bid {{and}} [[Tinidazole]] 500 mg bid for  6-10 days
+:::* 1.2 '''Second-Line Therapies'''
+::::* 1.2.1 '''Triple therapy'''
+:::::* Preferred regimen: [[PPI]] (standard dose twice daily) {{and}} [[Amoxicillin]] 1 g bid {{and}} [[Metronidazole]] 500 mg bid
+:::::* Alternative regimen (1) (allergy to amoxicillin): ([[PPI]] {{and}} [[Clarithromycin]] {{and}} [[Metronidazole]])
+:::::* Alternative regimen (2) (allergy to amoxicillin): ([[PPI]] {{and}} [[Tetracycline]] {{and}} [[Metronidazole]]).
+::::* 1.2.2 '''Quadruple therapy'''
+:::::* Preferred regimen: [[PPI]] (standard dose twice daily) {{and}} [[Metronidazole]] 250 mg q6h {{and}} [[Tetracycline]] 500 mg q6h {{and}} [[Bismuth]] (dose depends on preparation) for 10-14 days
+::::* 1.2.3 '''Levofloxacin triple therapy'''
+:::::* Preferred regimen: [[PPI]] (standard dose twice daily) {{and}} [[Amoxicillin]] 1 g bid  {{and}}  [[Levofloxacin]] 500 mg bid for 10 days
+::::* 1.2.4 '''Rifabutin triple therapy'''
+:::::* Preferred regimen: [[PPI]] (standard dose twice daily)  {{and}} [[Amoxicillin]]  1 g bid {{and}} [[Rifabutin]] 150-300 mg/day for 10 days
 ----
 {{PBI|Klebsiella granulomatis}}
-:* '''Klebsiella granulomatis''' (formly known as Calymmatobacterium granulomatis)
+:* Klebsiella granulomatis (formly known as Calymmatobacterium granulomatis)
 ::*1. '''Granuloma inguinale (donovanosis)'''<ref>{{Cite journal| issn = 1545-8601| volume = 64| issue = RR-03| pages = 1–137| last1 = Workowski| first1 = Kimberly A.| last2 = Bolan| first2 = Gail A.| title = Sexually transmitted diseases treatment guidelines, 2015| journal = MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control| date = 2015-06-05| pmid = 26042815}}</ref>
-:::* Preferred regimen: [[Azithromycin]] 1 g PO once a week or 500 mg qd for 3 weeks and until all lesions have completely healed
+:::* Preferred regimen: [[Azithromycin]] 1 g PO once a week or 500 mg qd for 3 weeks {{then}} until all lesions have completely healed
-:::* Alternative regimen (1): [[Doxycycline]] 100 mg PO bid for 3 weeks and until all lesions have completely healed
+:::* Alternative regimen (1): [[Doxycycline]] 100 mg PO bid for 3 weeks {{then}} until all lesions have completely healed
-:::* Alternative regimen (2): [[Ciprofloxacin]] 750 mg PO bid for at least 3 weeks and until all lesions have completely healed
+:::* Alternative regimen (2): [[Ciprofloxacin]] 750 mg PO bid for at least 3 weeks {{then}} until all lesions have completely healed
-:::* Alternative regimen (3): [[Erythromycin]] base 500 mg PO qid for at least 3 weeks and until all lesions have completely healed
+:::* Alternative regimen (3): [[Erythromycin]] base 500 mg PO qid for at least 3 weeks {{then}} until all lesions have completely healed
-:::* Alternative regimen (4): [[Trimethoprim-sulfamethoxazole]] one double-strength (160 mg/800 mg) tablet PO bid for at least 3 weeks and until all lesions have completely healed
+:::* Alternative regimen (4): [[Trimethoprim-sulfamethoxazole]] DS (160 mg/800 mg) tablet PO bid for at least 3 weeks {{then}} until all lesions have completely healed
 ----
 {{PBI|Klebsiella pneumoniae}}
-::* Klebsiella pneumoniae<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
+:* '''Klebsiella pneumoniae'''<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
-:::*'''1.Severe,nosocomial infection'''
+::* 1. '''Severe, nosocomial infections'''
-::::*Preferred regimen : [[Cefepime]] 2g IV q8h {{or}} [[Ceftazidime]] 2g IV q8h {{or}} [[Imipenem]] 500mg IV q6h {{or}} [[Meropenem]] 1g IV q8h {{or}} [[Piperacillin]]-[[tazobactam]] 4.5 g IV q6h {{and}} [[Aminoglycoside]] {{or}} Respiratory fluoroquinolone
+:::* 1.1 '''Non-ESBLs in pneumonia, sepsis, complicated UTI, or intra-abdominal infections'''
-::::*For coverage of ESBLs in pneumonia,sepsis,complicated UTI or intra-abdominal infections :[[Imipenem]] 500mg IV q6h {{or}} [[Meropenem]] 1g IV q8h {{or}} [[Ertapenem]] 1g IV q24h {{or}} [[Doripenem]] 500mg IV q8h
+::::* Preferred regimen (1): [[Cefepime]] 2 g IV q8h
-::::*In ESBLs,inconsistent activity seen with aminoglycosides, fluoroquinolones, and piperacillin-tazobactam. Avoid cephalosporins
+::::* Preferred regimen (2): [[Ceftazidime]] 2 g IV q8h
-::::*Alternate regimen : ([[Ceftriaxone]] 1 gm IV q24h {{and}} [[Metronidazole]] 500 mg IV q6h or 1 gm IV q12h) {{or}} [[Moxifloxacin]] 400 mg IV/po q24h
+::::* Preferred regimen (3): [[Imipenem]] 500 mg IV q6h
+::::* Preferred regimen (4): [[Meropenem]] 1 g IV q8h
+::::* Preferred regimen (5): [[Piperacillin-tazobactam]] 4.5 g IV q6h {{and}} [[Aminoglycoside]]
+::::* Alternative regimen (1): [[Ceftriaxone]] 1 g IV q24h {{and}} [[Metronidazole]] 500 mg IV q6h or 1 g IV q12h
+::::* Alternative regimen (2): [[Moxifloxacin]] 400 mg IV/PO q24h
+:::* 1.2 '''ESBLs in pneumonia, sepsis, complicated UTI, or intra-abdominal infections'''
+::::* Preferred regimen (1): [[Imipenem]] 500 mg IV q6h
+::::* Preferred regimen (2): [[Meropenem]] 1 g IV q8h
+::::* Preferred regimen (3): [[Ertapenem]] 1 g IV q24h
+::::* Preferred regimen (4): [[Doripenem]] 500 mg IV q8h
+::::* Note: In ESBLs, inconsistent activity is seen with aminoglycosides, fluoroquinolones, and piperacillin-tazobactam. Avoid cephalosporins.
 ----
 {{PBI|Klebsiella rhinoscleromatis}}
-::* '''1. Rhinoscleroma'''<ref>{{Cite journal| doi = 10.1007/s00405-013-2649-z| issn = 1434-4726| volume = 271| issue = 7| pages = 1851–1856| last1 = Mukara| first1 = B. K.| last2 = Munyarugamba| first2 = P.| last3 = Dazert| first3 = S.| last4 = Löhler| first4 = J.| title = Rhinoscleroma: a case series report and review of the literature| journal = European archives of oto-rhino-laryngology: official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS): affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery| date = 2014-07| pmid = 23904142}}</ref><ref>{{Cite journal| doi = 10.1086/592966| issn = 1537-6591| volume = 47| issue = 11| pages = 1396–1402| last1 = de Pontual| first1 = Loïc| last2 = Ovetchkine| first2 = Philippe| last3 = Rodriguez| first3 = Diana| last4 = Grant| first4 = Audrey| last5 = Puel| first5 = Anne| last6 = Bustamante| first6 = Jacinta| last7 = Plancoulaine| first7 = Sabine| last8 = Yona| first8 = Laurent| last9 = Lienhart| first9 = Pierre-Yves| last10 = Dehesdin| first10 = Danièle| last11 = Huerre| first11 = Michel| last12 = Tournebize| first12 = Régis| last13 = Sansonetti| first13 = Philippe| last14 = Abel| first14 = Laurent| last15 = Casanova| first15 = Jean Laurent| title = Rhinoscleroma: a French national retrospective study of epidemiological and clinical features| journal = Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America| date = 2008-12-01| pmid = 18947330}}</ref><ref>{{Cite journal| doi = 10.3109/00016489.2010.539264| issn = 1651-2251| volume = 131| issue = 4| pages = 440–446| last1 = Gaafar| first1 = Hazem A.| last2 = Gaafar| first2 = Alaa H.| last3 = Nour| first3 = Yasser A.| title = Rhinoscleroma: an updated experience through the last 10 years| journal = Acta Oto-Laryngologica| date = 2011-04| pmid = 21198342}}</ref>
+:* 1. '''Rhinoscleroma'''<ref>{{Cite journal| doi = 10.1007/s00405-013-2649-z| issn = 1434-4726| volume = 271| issue = 7| pages = 1851–1856| last1 = Mukara| first1 = B. K.| last2 = Munyarugamba| first2 = P.| last3 = Dazert| first3 = S.| last4 = Löhler| first4 = J.| title = Rhinoscleroma: a case series report and review of the literature| journal = European archives of oto-rhino-laryngology: official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS): affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery| date = 2014-07| pmid = 23904142}}</ref><ref>{{Cite journal| doi = 10.1086/592966| issn = 1537-6591| volume = 47| issue = 11| pages = 1396–1402| last1 = de Pontual| first1 = Loïc| last2 = Ovetchkine| first2 = Philippe| last3 = Rodriguez| first3 = Diana| last4 = Grant| first4 = Audrey| last5 = Puel| first5 = Anne| last6 = Bustamante| first6 = Jacinta| last7 = Plancoulaine| first7 = Sabine| last8 = Yona| first8 = Laurent| last9 = Lienhart| first9 = Pierre-Yves| last10 = Dehesdin| first10 = Danièle| last11 = Huerre| first11 = Michel| last12 = Tournebize| first12 = Régis| last13 = Sansonetti| first13 = Philippe| last14 = Abel| first14 = Laurent| last15 = Casanova| first15 = Jean Laurent| title = Rhinoscleroma: a French national retrospective study of epidemiological and clinical features| journal = Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America| date = 2008-12-01| pmid = 18947330}}</ref><ref>{{Cite journal| doi = 10.3109/00016489.2010.539264| issn = 1651-2251| volume = 131| issue = 4| pages = 440–446| last1 = Gaafar| first1 = Hazem A.| last2 = Gaafar| first2 = Alaa H.| last3 = Nour| first3 = Yasser A.| title = Rhinoscleroma: an updated experience through the last 10 years| journal = Acta Oto-Laryngologica| date = 2011-04| pmid = 21198342}}</ref>
-:::* Preferred regimen (1): [[Ciprofloxacin]] 500–750 mg PO bid for 2–3 months {{or}} [[Levofloxacin]] 750 mg PO qd for 2–3 months
+::* Preferred regimen (1): [[Ciprofloxacin]] 500–750 mg PO bid for 2–3 months
-:::* Preferred regimen (2): [[Trimethoprim-Sulfamethoxazole]] 1 DS tab PO bid for 3 months {{and}} [[Rifampicin]] 300 mg PO bid for 3 months
+::* Preferred regimen (2): [[Levofloxacin]] 750 mg PO qd for 2–3 months
-:::* Alternative regimen: [[Tetracycline]] {{or}} [[Streptomycin]] {{or}} [[Doxycycline]]  {{or}} [[Ceftriaxone]] {{or}} [[Ofloxacin]]
+::* Preferred regimen (3): [[Trimethoprim-Sulfamethoxazole]] 1 DS tab PO bid for 3 months {{and}} [[Rifampicin]] 300 mg PO bid for 3 months
-:::* Note (1): The optimal duration of antimicrobial therapy remains unclear. A 6-week to 6-month cours of antibiotics until histology exams and cultures are negative may be required.
+::* Alternative regimen: [[Tetracycline]] {{or}} [[Streptomycin]] {{or}} [[Doxycycline]]  {{or}} [[Ceftriaxone]] {{or}} [[Ofloxacin]]
-:::* Note (2): Use of topical antiseptics such as [[Acriflavinium]] and [[Rifampin]] ointment has been reported with resolution of symptoms.<ref>{{Cite journal| doi = 10.1007/s00405-013-2649-z| issn = 1434-4726| volume = 271| issue = 7| pages = 1851–1856| last1 = Mukara| first1 = B. K.| last2 = Munyarugamba| first2 = P.| last3 = Dazert| first3 = S.| last4 = Löhler| first4 = J.| title = Rhinoscleroma: a case series report and review of the literature| journal = European archives of oto-rhino-laryngology: official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS): affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery| date = 2014-07| pmid = 23904142}}</ref>
+::* Note (1): The optimal duration of antimicrobial therapy remains unclear. A 6-week to 6-month course of antibiotics until histology exams and cultures are negative may be required.
+::* Note (2): Use of topical antiseptics such as Acriflavinium and Rifampin ointment has been reported with resolution of symptoms.<ref>{{Cite journal| doi = 10.1007/s00405-013-2649-z| issn = 1434-4726| volume = 271| issue = 7| pages = 1851–1856| last1 = Mukara| first1 = B. K.| last2 = Munyarugamba| first2 = P.| last3 = Dazert| first3 = S.| last4 = Löhler| first4 = J.| title = Rhinoscleroma: a case series report and review of the literature| journal = European archives of oto-rhino-laryngology: official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS): affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery| date = 2014-07| pmid = 23904142}}</ref>
 ----
-{{PBI|Legionella pneumophila}}<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
+{{PBI|Legionella pneumophila}}
-:::* Preferred regimen: [[Levofloxacin]] 750mg PO/IV OD for 7-10days {{or}} [[Moxifloxacin]] 400mg PO/IV OD for 7-10 days {{or}} [[Azithromycin]] 500mg PO/IV OD for 7-10days {{or}} [[Rifampin]] 300mg PO/IV bid(optional) {{and}} any other agent listed.
+:* Legionella pneumophila<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
-:::* Alternative regimen: [[Erythromycin]] 1g IV q6h and then 500mg PO q6h for 7-10days {{or}} [[Ciprofloxacin]]400mg IV q12h then 750mg PO bid 7-10days
+::* 1. '''Pneumonia'''
+:::* Preferred regimen (1): [[Levofloxacin]] 750 mg PO/IV qd for 7-10 days
+:::* Preferred regimen (2): [[Moxifloxacin]] 400 mg PO/IV qd for 7-10 days
+:::* Preferred regimen (3): [[Azithromycin]] 500 mg PO/IV qd for 7-10 days
+:::* Preferred regimen (4): [[Rifampin]] 300 mg PO/IV bid {{and}} any other agents listed
+:::* Alternative regimen (1): [[Erythromycin]] 1 g IV q6h and {{then}} 500 mg PO q6h for 7-10 days (total)
+:::* Alternative regimen (2): [[Ciprofloxacin]] 400 mg IV q12h {{then}} 750 mg PO bid 7-10 days (total)
+::* 2. '''Pontiac fever'''
+:::* Preferred regimen: no antibiotic treatment, usually self limited, and usually only diagnosed by delayed serologic testing
+::* 3. '''Endocarditis'''
+:::* Preferred regimen: (Fluoroquinolones, [[Levofloxacin]] 750 mg PO/IV qd for 7-10 days {{or}} [[Moxifloxacin]] 400 mg PO/IV qd for 7-10 days) {{and}} [[Rifampin]] 300 mg PO bid for 4-6 weeks
 {{PBI|Moraxella catarrhalis}}
-:::* Pneumonia
-::::* Preferred regimen:[[Amoxicillin-Clavulanate]](Augmentin)875/125mg PO bid or XL 2000/125 PO bid {{or}}Oral cephalosporins such as [[Cefprozil]](Cefzil)200-500mg bid {{or}} [[Cefpodoxime]](Vantin)200-400mg bid {{or}} [[Cefuroxime]](Ceftin)250-500mg bid {{or}} [[Cefdinir]](Omnicef)300mg bid {{or}} Parenteral cephalosporins such as [[Cefuroxime]] {{or}} [[Cefotaxime]] {{or}} [[Ceftriaxone]] {{or}} Macrolides such as [[Erythromycin]] 500mg PO q6h  {{or}} [[Clarithromycin]] 500mg bid or XL 1g PO {{or}} [[Azithromycin]] 500mg single dose then 250mg PO, {{or}} Flouroquinolones such as [[Moxifloxacin]](Avelox) 400mg IV/PO OD {{or}} [[Levofloxacin]](Levaquin)500mg IV/PO OD {{or}} [[TMP-SMX]] DS PO bid
+:Moraxella catarrhalis<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
+::* Preferred regimen (1): [[TMP-SMX]] 1DS PO bid
+::* Preferred regimen (2): [[Erythromycin]] 500 mg PO q6h
+::* Preferred regimen (3): [[Clarithromycin]] 500 mg bid or XL 1 g PO qd
+::* Preferred regimen (4): [[Azithromycin]] 500 mg single dose {{then}} 250 mg PO qd
+::* Preferred regimen (5): [[Doxycycline]] 100 mg PO/IV bid
+::* Preferred regimen (6): Parenteral cephalosporins such as [[Cefuroxime]] {{or}} [[Cefotaxime]] {{or}} [[Ceftriaxone]]
+::* Preferred regimen (7): [[Cefprozil]] 200-500 mg PO bid
+::* Preferred regimen (8): [[Cefpodoxime]] 200-400 mg PO bid
+::* Preferred regimen (9): [[Cefuroxime]] 250-500 mg PO bid
+::* Preferred regimen (10): [[Cefdinir]] 300 mg bid
+::* Preferred regimen (11): [[Moxifloxacin]] 400 mg IV/PO qd
+::* Preferred regimen (12): [[Levofloxacin]] 500 mg IV/PO qd
+::* Preferred regimen (13): [[Amoxicillin-Clavulanate]] 875/125 mg PO bid or XL 2000/125 PO bid
 {{PBI|Morganella morganii}}
-::*Morganella morganii<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
+:* Morganella morganii<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
-:::*Preferred regimen : [[Imipenem]] 500mg IV q6h {{or}} [[Meropenem]] 1.0g IV q8h (adjustdose if necessary for renalfunction).
+::* Preferred regimen (1): [[Imipenem]] 500 mg IV q6h
-:::*Note (1): [[Carbapenems]] are considered first line therapy due to inducible cephalosporinases, and presence of extended-spectrum beta-lactamases in some isolates.
+::* Preferred regimen (2): [[Meropenem]] 1.0 g IV q8h (adjust dose if necessary for renal function).
-:::*Note (2): Duration of treatment for UTI(generallycomplicated) is 7days and Duration of treatment for bacteremia is 14days.
+::* Note (1): [[Carbapenems]] are considered first line therapy due to inducible cephalosporinases, and presence of extended-spectrum beta-lactamases in some isolates.
-:::*Note (3): [[Tigecycline]] is not reliably effective
+::* Note (2): Duration of treatment for UTI (generally complicated) is 7 days and duration of treatment for bacteremia is 14 days.
-:::*Alternative Regimen (1) : [[Cefepime]] 2.0 g IV q8-12h {{or}} [[Ciprofloxacin]] 500 mg PO/400mg IV q12h {{or}} [[Piperacillin]] 3g IV q6h {{or}} [[Ticarcillin]] 3g IV q4h
+::* Note (3): [[Tigecycline]] is not reliably effective
-:::*Alternative Regimen (2) : [[Aminoglycosides]] can be used alone for treatment of UTI,[[Gentamicin]] {{or}} [[Tobramycin]] 1mg/kg/day IV {{or}} [[Amikacin]] 3mg/kg/day
+::* Alternative Regimen (1): [[Cefepime]] 2.0 g IV q8-12h
+::* Alternative Regimen (2): [[Ciprofloxacin]] 500 mg PO/400 mg IV q12h
+::* Alternative Regimen (3): [[Piperacillin]] 3 g IV q6h
+::* Alternative Regimen (4): [[Ticarcillin]] 3 g IV q4h
+::* Alternative Regimen (5): [[Gentamicin]]
+::* Alternative Regimen (6): [[Tobramycin]] 1 mg/kg IV q24h
+::* Alternative Regimen (7): [[Amikacin]] 3 mg/kg IV q24h
+::* Note: Aminoglycosides can be used alone for treatment of UTI
 {{PBI|Plesiomonas shigelloides}}
-::*Plesiomonas shigelloides<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
+:* Plesiomonas shigelloides<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
-:::*'''1.Immunocompetent Hosts or Severe Infection'''
+::* 1. '''Immunocompetent hosts or severe Infection'''
-::::*Preferred regimen : [[Ciprofloxacin]] 500mg PO bid or 400mg IV q12h.
+:::* Preferred regimen: [[Ciprofloxacin]] 500 mg PO bid {{or}} 400 mg IV q12h
-::::*Alternative regimen (1): [[Ofloxacin]] 300mg PO bid {{or}} [[Norfloxacin]] 400mg PO bid {{or}} [[TMP-SMX]] DS PO bid for 3days.
+:::* Alternative regimen (1): [[Ofloxacin]] 300 mg PO bid
-::::*Alternative regimen (2): [[Ceftriaxone]] 1-2g IV OD used successfully in severe cases.
-:::*'''2.Immunocompromised Hosts'''
+:::* Alternative regimen (2): [[Norfloxacin]] 400 mg PO bid
-::::*Preferred regimen : [[Ciprofloxacin]] 500mg PO bid for 3days.
-::::*Alternative regimen : [[Ofloxacin]] 300mg PO bid {{or}} [[Norfloxacin]] 400mg PO bid {{or}} [[TMP-SMX]] DS PO(if susceptible) bid for 3days
+:::* Alternative regimen (3): [[TMP-SMX]] DS PO bid for 3 days
+:::* Alternative regimen (4): [[Ceftriaxone]] 1-2 g IV qd in severe cases
+::* 2. '''Immunocompromised hosts'''
+:::* Preferred regimen: [[Ciprofloxacin]] 500 mg PO bid for 3 days.
+:::* Alternative regimen (1): [[Ofloxacin]] 300 mg PO bid
+:::* Alternative regimen (2): [[Norfloxacin]] 400 mg PO bid
+:::* Alternative regimen (3): [[TMP-SMX]] DS PO bid for 3 days if susceptible
 {{PBI|Proteus mirabilis}}
-::*Proteus mirabilis<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
+:* Proteus mirabilis<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
-:::* Preferred regimen (1): [[Ampicillin]] 500 mg PO q6h or 2 g IV q6h.
+::* Preferred regimen (1): [[Ampicillin]] 500 mg PO q6h or 2 g IV q6h
-:::* Preferred regimen (2): [[Cefuroxime]] 250 mg PO bid or 750 mg IV q8h.
+::* Preferred regimen (2): [[Cefuroxime]] 250 mg PO bid or 750 mg IV q8h
-:::* Preferred regimen (3): [[Ciprofloxacin]] 250-500 mg PO bid or 400 mg IV q12h.
+::* Preferred regimen (3): [[Ciprofloxacin]] 250-500 mg PO bid or 400 mg IV q12h
-:::* Preferred regimen (4): [[Levofloxacin]] 500 mg PO OD or 500 mg IV q24h.
+::* Preferred regimen (4): [[Levofloxacin]] 500 mg PO OD or 500 mg IV q24h
-:::* Note: Uncomplicated UTI 3 days, pyelonephritis 7-14 days, complicated UTI 10-21 days and bacteremia 7-14 days.
+::* Note: Duration of treatment for uncomplicated UTI 3 days, pyelonephritis 7-14 days, complicated UTI 10-21 days and bacteremia is 7-14 days
 {{PBI|Indole positive Proteus species}}
 ::*Indole positive Proteus species<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
-:::* Preferred regimen (1): [[Ceftriaxone]] 1 g IV q24h.
+:::* Preferred regimen (1): [[Ceftriaxone]] 1 g IV q24h
-:::* Preferred regimen (2): [[Imipenem]] 500 mg IV q6h.
+:::* Preferred regimen (2): [[Imipenem]] 500 mg IV q6h
-:::* Preferred regimen (3): [[Ciprofloxacin]] 400 mg IV q12h or 250-500 mg PO bid.
+:::* Preferred regimen (3): [[Ciprofloxacin]] 400 mg IV q12h or 250-500 mg PO bid
-:::* Preferred regimen (4): [[Levofloxacin]] 500 mg IV/PO q24h.
+:::* Preferred regimen (4): [[Levofloxacin]] 500 mg IV/PO q24h
 {{PBI|Providencia}}
-::*Providencia<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
+:* Providencia<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
-:::*Complicated UTI/Bacteremia/Acute prostatitis
+::* 1. '''Complicated uti/bacteremia/acute prostatitis'''
-::::*Preferred regimen : [[Ciprofloxacin]] 500-750mg PO q12h or 400 mg IV q8-12h {{or}} [[Levofloxacin]] 500mg IV/PO q24h {{or}} [[Piperacillin]]-[[Tazobactam]] 3.375 mg IV q6h {{or}}[[Ceftriaxone]] 1-2g IV q24h (donot use if ESBL suspected or critically ill){{or}} [[Meropenem]] 1g IV q8h (consider if critically ill or ESBL suspected){{or}}[[Amikacin]] 7.5mg/kg IV q12h {{or}} [[Gentamicin]] {{or}} [[Tobramycin]] acceptable if susceptible but many species are resistant.
+:::* Preferred regimen (1): [[Ciprofloxacin]] 500-750 mg PO q12h or 400 mg IV q8-12h
-::::*Note (1) : Duration of treatment for (UTI)is 7days common or 3-5days after defervescence or control/elimination of complicating factors (e.g.,removal of foreign material catheter).
+:::* Preferred regimen (2): [[Levofloxacin]] 500 mg IV/PO q24h
-::::*Note (2) : Duration of treatment for (bacteremia)is 10-14days or 3-5days after defervescence or control/elimination of complicatingfactors.
+:::* Preferred regimen (3): [[Piperacillin-Tazobactam]] 3.375 mg IV q6h
-::::*Note (3) : Duration for acute prostatitis(2weeks), shorter than chronic prostatitis(4-6wks)
+:::* Preferred regimen (4): [[Ceftriaxone]] 1-2 g IV q24h (donot use if ESBL suspected or critically ill)
-::::*Alternative regimen : [[TMP-SMX]](Bactrim)DS1 PO q12h for 10-14days {{or}} TMP 5-10 mg/kg/day IV q6h.
+:::* Preferred regimen (5): [[Meropenem]] 1 g IV q8h (consider if critically ill or ESBL suspected)
+:::* Preferred regimen (6): [[Amikacin]] 7.5 mg/kg IV q12h
+:::* Preferred regimen (7): [[Gentamicin]]
+:::* Preferred regimen (8): [[Tobramycin]] acceptable if susceptible but many species are resistant.
+:::* Note (1): Duration of treatment for (UTI) is 7 days common or 3-5 days after defervescence or control/elimination of complicating factors (e.g.,removal of foreign material catheter).
+:::* Note (2): Duration of treatment for (bacteremia) is 10-14 days or 3-5 days after defervescence or control/elimination of complicating factors.
+:::* Note (3): Duration for acute prostatitis (2 weeks), shorter than chronic prostatitis (4-6 weeks)
+:::* Alternative regimen: [[TMP-SMX]] DS PO q12h for 10-14 days or [[TMP]] 5-10 mg/kg/day IV q6h.
 {{PBI|Pseudomonas aeruginosa}}
-::*Pseudomonas aeruginosa<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
+:*Pseudomonas aeruginosa<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
-:::*Preferred regimen (1) : [[Cefepime]] 2g IV q8h {{or}} [[Ceftazidime]] 2g IV q8h {{or}} [[Piperacillin]] 3-4g IV q4h in (no benefit for pseudomonas from beta-lactamase inhibitor){{or}} [[Ticarcillin]] 3-4g IV q4h(no benefit for pseudomonas from beta-lactamase inhibitor).
+::* Preferred regimen (1): [[Cefepime]] 2 g IV q8h
-:::*Preferred regimen (2) : [[Imipenem]] 500mg—1g IV q6h {{or}} [[Meropenem]] 1g IV q8h {{or}} [[Doripenem]] 500mg IV q8h {{or}} [[Ciprofloxacin]] 400mg IV q8h {{or}}750mg PO q12h(for less serious infections). [[Aztreonam]] 2g IV q6-8h.[[Colistin]] 2.5 mg/kg IV q12h. [[Polymyxin B]] 0.75-1.25 mg/kg IV q12h [[Gentamicin]] {{or}} [[Tobramycin]] 1.7-2.0 mg/Kg IV q8h or 5-7mg/kg IV {{or}} [[Amikacin]] 2.5mg/kg IV q12h.Usually used in combination with other antimicrobials(preferably beta-lactams).
+::* Preferred regimen (2): [[Ceftazidime]] 2 g IV q8h
-::::* Note : [[Amikacin]] > [[Tobramycin]] > [[Gentamicin]] with respect to P.aeruginosa susceptibility percentages at most institutions.
+::* Preferred regimen (3): [[Piperacillin]] 3-4 g IV q4h in (no benefit for pseudomonas from beta-lactamase inhibitor)
+::* Preferred regimen (4): [[Ticarcillin]] 3-4 g IV q4h (no benefit for pseudomonas from beta-lactamase inhibitor)
+::* Preferred regimen (5): [[Imipenem]] 500 mg—1 g IV q6h
+::* Preferred regimen (6): [[Meropenem]] 1 g IV q8h
+::* Preferred regimen (7): [[Doripenem]] 500 mg IV q8h
+::* Preferred regimen (8): [[Ciprofloxacin]] 400 mg IV q8h or 750 mg PO q12h (for less serious infections)
+::* Preferred regimen (9): [[Aztreonam]] 2 g IV q6-8h
+::* Preferred regimen (10): [[Colistin]] 2.5 mg/kg IV q12h
+::* Preferred regimen (11): [[Polymyxin B]] 0.75-1.25 mg/kg IV q12h
+::* Preferred regimen (12): [[Gentamicin]]
+::* Preferred regimen (13): [[Tobramycin]] 1.7-2.0 mg/Kg IV q8h or 5-7 mg/kg IV
+::* Preferred regimen (14): [[Amikacin]] 2.5 mg/kg IV q12h
+::* Note: Amikacin > Tobramycin > Gentamicin with respect to P.aeruginosa susceptibility percentages at most institutions.
+----
+==Salmonella==
 {{PBI|Salmonella}}
-::*Salmonella<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
+:* 1. '''Salmonellosis in immunocompetent hosts'''<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
-:::*'''1.Gastroenteritis'''
+::* 1.1 '''Gastroenteritis'''
-::::*Preferred treatment
+:::* Antimicrobial therapy is usually not recommended for uncomplicated diarrheal illness.
-:::::*Immunocompetent : [[TMP-SMX]] DS PO bid {{or}} [[Ciprofloxacin]] 500mg PO bid {{or}} [[Ceftriaxone]] 2gIV/day for 5-7days.
+:::* 1.1.1 '''Indications for antimicrobial therapy'''
-:::::*Immunosuppressed : [[TMP-SMX]] DS PO bid {{or}} [[Ciprofloxacin]] 500mg PO bid {{or}} [[Ceftriaxone]] 2gIV/day for ≥14days.
+::::* severedisease,
-:::*'''2.Typhoidfever'''
+::::* Age > 50 yrs
-::::*Preferred regimen : [[Ceftriaxone]] 1-2g IV q24h then [[Cefixime]] 400mg PO for 10-14days {{or}} [[Ciprofloxacin]] 400mg IV q12h or 500mg PO bid.
+::::* Prosthesis
-:::*'''3.Non-typhoid(seriousinfection)'''
+::::* Presence of valvular heart disease
-::::*Preferred regimen : [[Cephalosporin|3rd generation Cephalosporin]] (Ceftriaxone/Cefotaxime){{or}} [[Fluoroquinolone]]([[Ciprofloxacin]], [[Levofloxacin]])
+::::* Severe atherosclerosis
-:::*'''4.Bacteremia'''
+::::* Cancer
-::::*Preferred regimen : [[Ceftriaxone]] 2g IV q24h {{or}} [[Cefotaxime]] 2g IV q6-8h for 7-14days {{or}} [[Ciprofloxacin]] 400mg IV q12h for 7-14days
+::::* Uremia
-:::*'''5.Vascular prosthesis infection'''
+::::* Immunosuppression
-::::*Preferred regimen : [[Ceftriaxone]], [[Cefotaxime]] {{or}} [[Ciprofloxacin]] 400mg IV q12h for 6wks
+:::* 1.1.2 Treatment regimens
-:::*'''6.Osteomyelitis'''
+::::* Preferred regimen (1): [[TMP-SMX]] DS PO bid for 5-7 days
-::::*Preferred regimen : [[Ceftriaxone]] 2g IV q24h {{or}} [[Cefotaxime]] 2g IV q6-8h {{or}} [[Ciprofloxacin]] 750mg PO bid for ≥4wks
+::::* Preferred regimen (2): [[Ciprofloxacin]] 500 mg PO bid for 5-7 days
-:::*'''7.Arthritis'''
+::::* Preferred regimen (3): [[Ceftriaxone]] 2 g IV q24h for 5-7 days
-::::*Preferred regimen : [[Ceftriaxone]] 2g IV q24h {{or}} [[Cefotaxime]] 2g IVq 6-8h for 6weeks.
+::* 1.2 '''Typhoid fever'''<ref>{{Cite web | title = TYPHOID FEVER | url = http://www.nejm.org/doi/pdf/10.1056/NEJMra020201}}</ref>
-:::*'''8.Endocarditis'''
+:::* 1.2.1 '''Uncomplicated typhoid'''
-::::*Preferred regimen : [[Ceftriaxone]] 2g IV q24h {{or}} [[Cefotaxime]] 2g IV q6-8h for 6weeks.
+::::* Preferred regimen (1) (fully susceptible): Fluoroquinolone (e.g., [[Ofloxacin]] 15 mg/kg PO qd for 5–7 days)
-:::*'''9.UTI'''
+::::* Preferred regimen (2) (multi drug-resistant): Fluoroquinolone ([[Ofloxacin]] 15 mg/kg PO qd for 5–7 days)
-::::*Preferred regimen : [[Ceftriaxone]], [[Cefotaxime]] {{or}} [[Ciprofloxacin]] IV for 1-2weeks, then [[Ciprofloxacin|oral Ciprofloxacin]] {{or}} [[TMP-SMX]] for 6weeks
+::::* Preferred regimen (3) (quinolone-resistant): [[Azithromycin]] 8–10 mg/kg  PO qd for 7 days
-:::*'''10.HIV and salmonellosis'''
+::::* Preferred regimen (4) (quinolone-resistant): Fluoroquinolone 20 mg/kg PO qd for 10-14 days
-::::*Preferred regimen : IV [[Cephalosporin]] {{or}} IV [[Fluoroquinolone]], then oral Flouroquinolones([[Ciprofloxacin]] 500-750mg PO bid for 4weeks).
+::::* Alternative regimen (1) (fully susceptible): [[Chloramphenicol]] 50–75 mg/kg PO qd for 14-21 days
-::::*Note : If relapse occurs within 6weeks give life-long abx or until immune recovery post-ART
+::::* Alternative regimen (2) (fully susceptible): [[Amoxicillin]] 75–100 mg/kg PO qd for 14 days
-:::*'''11.Carrier state''' : [[Ciprofloxacin]] 500mg PO bid for 4-6weeks {{or}} [[TMP-SMX]] 1DS bid PO for 6weeks{{or}} [[Amoxicillin]] 500mg PO for 6weeks.
+::::* Alternative regimen (3) (fully susceptible): [[Trimethoprim–Sulfamethoxazole]], 8 mg/kg ([[trimethoprim]])– 40 mg/kg ([[sulfamethoxazole]]) PO qd for 14 days
+::::* Alternative regimen (4) (multi drug-resistant): [[Azithromycin]] 8–10 mg/kg PO for 7 days
+::::* Alternative regimen (5) (multi drug-resistant): Third-generation cephalosporin, e.g., [[cefixime]] 20 mg/kg PO qd for 7-14 days
+::::* Alternative regimen (6) (quinolone-resistant): Third-generation cephalosporin, e.g., [[cefixime]] 20 mg/kg PO qd for 7-14 days
+:::* 1.2.2 '''Severe typhoid'''
+::::* Preferred regimen (1) (fully susceptible): Fluoroquinolone (e.g., [[Ofloxacin]] 15 mg/kg IV qd for 10-14 days)
+::::* Preferred regimen (2) (multi drug-resistant): Fluoroquinolone ([[Ofloxacin]] 15 mg/kg IV qd for 10-14 days)
+::::* Preferred regimen (3) (quinolone-resistant): [[Ceftriaxone]] 60 mg/kg IV qd for 10-14 days
+::::* Preferred regimen (4) (quinolone-resistant): [[Cefotaxime]] 80 mg/kg IV qd for 10-14 days
+::::* Alternative regimen (1) (fully susceptible): [[Chloramphenicol]] 100 mg/kg PO qd for 14-21 days
+::::* Alternative regimen (2) (fully susceptible): [[Ampicillin]] 100 mg/kg PO qd for 14-21 days
+::::* Alternative regimen (3) (fully susceptible): [[Trimethoprim–Sulfamethoxazole]], 8 mg/kg ([[trimethoprim]])– 40 mg/kg ([[sulfamethoxazole]]) IV qd for 10-14 days
+::::* Alternative regimen (4) (multi drug-resistant): [[Ceftriaxone]] 60 mg/kg IV qd for 10-14 days
+::::* Alternative regimen (5) (multi drug-resistant): [[Cefotaxime]] 80 mg/kg IV qd for 10-14 days
+::::* Alternative regimen (6) (quinolone-resistant): [[Fluoroquinolone]] 20 mg/kg IV qd for 10-14 days
+::* 1.3 '''Non-typhoid (serious infection)'''
+:::* Preferred regimen (1): [[Cephalosporin|3rd generation cephalosporin]] (Ceftriaxone/Cefotaxime)
+:::* Preferred regimen (2): [[Fluoroquinolone]] ([[Ciprofloxacin]], [[Levofloxacin]])
+::* 1.4 '''Bacteremia'''
+:::* Preferred regimen (1): [[Ceftriaxone]] 2 g IV q24h
+:::* Preferred regimen (2): [[Cefotaxime]] 2 g IV q6-8h for 7-14 days
+:::* Preferred regimen (3): [[Ciprofloxacin]] 400 mg IV q12h for 7-14 days
+::* 1.5 '''Vascular prosthesis infection'''
+:::* Preferred regimen (1): [[Ceftriaxone]]
+:::* Preferred regimen (2): [[Cefotaxime]]
+:::* Preferred regimen (3): [[Ciprofloxacin]] 400 mg IV q12h for 6 weeks
+::* 1.6 '''Osteomyelitis'''
+:::* Preferred regimen (1): [[Ceftriaxone]] 2 g IV q24h
+:::* Preferred regimen (2): [[Cefotaxime]] 2 g IV q6-8h
+:::* Preferred regimen (3): [[Ciprofloxacin]] 750 mg PO bid for ≥ 4 weeks
+::* 1.7 '''Arthritis'''
+:::* Preferred regimen (1): [[Ceftriaxone]] 2 g IV q24h
+:::* Preferred regimen (2): [[Cefotaxime]] 2 g IV q6-8h for 6 weeks
+::* 1.8 '''Endocarditis'''
+:::* Preferred regimen (1): [[Ceftriaxone]] 2 g IV q24h
+:::* Preferred regimen (2): [[Cefotaxime]] 2 g IV q6-8h for 6 weeks
+::* 1.9 '''UTI'''
+:::*Preferred regimen (1): [[Ceftriaxone]]
+:::*Preferred regimen (2): [[Cefotaxime]]
+:::*Preferred regimen (3): [[Ciprofloxacin]] IV for 1-2 weeks {{then}} ([[Ciprofloxacin|oral Ciprofloxacin]] {{or}} [[TMP-SMX]] for 6 weeks)
+::* 1.10 '''Carrier state'''
+:::* Preferred regimen (1): [[Ciprofloxacin]] 500 mg PO bid for 4-6 weeks
+:::* Preferred regimen (2): [[TMP-SMX]] 1DS bid PO for 6 weeks
+:::* Preferred regimen (3): [[Amoxicillin]] 500 mg PO for 6 weeks
+::* 2. '''Salmonellosis in immunocompromised hosts'''
+:::* 2.1 '''HIV and salmonellosis'''<ref>{{Cite web | title = Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents | url = https://aidsinfo.nih.gov/contentfiles/lvguidelines/AdultOITablesOnly.pdf}}</ref>
+::::* 2.1.1 Gastroenteritis
+:::::* Preferred regimen: [[Ciprofloxacin]] 500-750 mg PO bid or 400 mg IV q12h, if susceptible
+:::::* Alternative regimen (1): [[Levofloxacin]] 750 mg PO/IV q24h
+:::::* Alternative regimen (2): [[Moxifloxacin]] 400 mg PO/IV q24h
+:::::* Alternative regimen (3): [[TMP]] 160 mg {{and}} [[sulfamethoxazole|SMX]] 800 mg PO/IV q12h
+:::::* Alternative regimen (4): [[Ceftriaxone]] 1 g IV q24h
+:::::* Alternative regimen (5): [[Cefotaxime]] 1 g IV q8h
+:::::* Duration of treatment for gastroenteritis without bacteremia
+::::::* If CD4 count ≥ 200 cells/μL: Duration of treatment is 7–14 days
+::::::* If CD4 count < 200 cells/μL: Duration of treatment is 2–6 weeks
+:::::* Duration of treatment for gastroenteritis with bacteremia
+::::::* If CD4 count ≥ 200/μL: Duration of treatment is 14 days; longer duration if bacteremia persists or if the infection is complicated (e.g., if metastatic foci of infection are present)
+::::::* If CD4 count < 200 cells/μL: Duration of treatment is 2–6 weeks
+:::::* Note (1): Secondary prophylaxis should be considered for
+::::::* Patients with recurrent Salmonella gastroenteritis with or without bacteremia
+::::::* Patients with CD4 < 200 cells/μL with severe diarrhea
 {{PBI|Serratia marcescens}}
-::*Serratia marcescens<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
+:* Serratia marcescens<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
-:::*'''1.Bacteremia,Pneumonia or SeriousInfections'''
+::* 1. '''Bacteremia, pneumonia or serious infections'''
-::::*Preferred regimen : [[Cefepime]] 1-2 g IV q8h {{or}} [[Imipenem]] 0.5-1.0 g IV q6h {{or}} [[Ciprofloxacin]] 400mg IV q8h.
+:::* Preferred regimen (1): [[Cefepime]] 1-2 g IV q8h
-::::*Alternative regimen : [[Aztreonam]], [[Gentamicin]] {{or}} [[Amikacin]] {{or}} [[Piperacillin]]/[[tazobactam]] also often effective.
+:::* Preferred regimen (2): [[Imipenem]] 0.5-1.0 g IV q6h
-::::*Note : Duration depends on clinical response,usually 7-14days.
+:::* Preferred regimen (3): [[Ciprofloxacin]] 400 mg IV q8h
-:::*'''2.Endocarditis'''
+:::* Alternative regimen (1): [[Aztreonam]]
-::::*Preferred regimen : Choice dictated by sensitivities. 4to6 week duration of parenteral therapy.
+:::* Alternative regimen (2): [[Gentamicin]]
-:::*'''3.Osteomyelitis'''
+:::* Alternative regimen (3): [[Amikacin]]
-::::*Preferred regimen : Choice dictated by sensitivity profile. Treat for 6-12weeks depending upon response. Use IV treatment until stable/clinically improved(10-14days min)then may convert to PO therapy if appropriate
+:::* Alternative regimen (4): [[Piperacillin-tazobactam]] also often effective
-:::*'''4.UTI'''
+:::* Note: Duration depends on clinical response, usually 7-14 days
-::::*Preferred regimen : [[Ciprofloxacin]] 250mg PO bid or 400mg IV q12h {{or}} [[Levofloxacin]] 250mg PO everyday or 500mg IV q24h
+::* 2. '''Endocarditis'''
-::::*Note : Fluoroquinolones often sensitive but in seriously ill patient consider empiric coverage with two drugs(e.g.,[[Beta-lactam]] and [[Aminoglycoside]] {{or}} [[Fluoroquinolones]] {{and}} [[Carbapenem]])until susceptibilities known.
+:::* Note: Choice dictated by sensitivities. 4 to 6 week duration of parenteral therapy.
+::* 3. '''Osteomyelitis'''
+:::* Note (1): Choice dictated by sensitivity profile. Treat for 6-12 weeks depending upon response.
+:::* Note (2): Use IV treatment until stable/clinically improved (10-14 days Minimum) then may convert to PO therapy if appropriate
+::* 4. '''UTI'''
+:::* Preferred regimen (1): [[Ciprofloxacin]] 250 mg PO bid or 400 mg IV q12h
+:::* Preferred regimen (2): [[Levofloxacin]] 250 mg PO qd or 500 mg IV q24h
+:::* Note: Fluoroquinolones often sensitive but in seriously ill patient consider empiric coverage with two drugs(e.g.,beta-lactam and aminoglycoside or fluoroquinolones and carbapenem)until susceptibilities known.
 {{PBI|Shigella}}
-::*Shigella<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
+:* 1. '''Shigellosis''' <ref>{{Cite web | title = Guidelines for the control of shigellosis, including epidemics due to Shigella dysenteriae type 1
-:::*Preferred regimen
+ | url = http://apps.who.int/iris/bitstream/10665/43252/1/924159330X.pdf?ua=1&ua=1}}</ref>
-::::*If known sulfa sensitive : TMP(160mg)/SMX(800mg) PO q12h for 3-5days.
+::* 1.1 '''Pediatrics'''
-::::*Pediatric dose :  TMP5mg/SMX 25mg/kg PO bid.
+:::* Preferred regimen (1): [[Ciprofloxacin]] 15 mg/kg PO bid for 3 days
-::::*If TMP/SMX resistant or unknown susceptibility : [[Ciprofloxacin]] 500mg {{or}} [[Norfloxacin]] 400mg {{or}} [[Ofloxacin]] 200mg PO bid for 3-5days.
+:::* Alternative regimen (1): [[Pivmecillinam]] 20 mg/kg PO qid for 5 days
-:::*Alternative regimen : [[Ceftriaxone]] 1g IV q24h {{or}}} [[Azithromycin]] 500mg PO single dose, then 250mg PO for 4days {{or}} [[Nalidixicacid]] 250mg PO q6h or pediatric dose 55kg/day) {{or}} [[Ampicillin]](500mg PO q6h depending on susceptibility patterns.
+:::* Alternative regimen (2): [[Ceftriaxone]] 50-100 mg/kg IM qd for 2 to 5 days
-:::*Note : In southeast Asia, growing resistance seen to fluoroquinolones, azithromycin maybe preferred.
+:::* Alternative regimen (3): [[Azithromycin]] 6-20 mg/kg PO qd for 1 to 5 days
+::* 1.2 '''Adults'''
+:::* Preferred regimen (1): [[Ciprofloxacin]] 500 mg PO bid for 3 days
+:::* Alternative regimen (1): [[Pivmecillinam]] 100 mg PO qid for 5 days
+:::* Alternative regimen (2): [[Azithromycin]] 1-1.5 g PO qd for 1 to 5 days
 {{PBI|Stenotrophomonas maltophilia}}
-::*Stenotrophomonas maltophilia<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
+:*Stenotrophomonas maltophilia<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
-:::*Preferred treatment : [[TMP-SMX]] 15-20(TMP component)mg/kg/day IV/PO q8h.
+::* Preferred treatment: [[TMP-SMX]] 15-20 mg/kg/day (TMP component) IV/PO q8h
-:::*Alternative treatment (1) : [[Ceftazidime]] 2g IV q8h {{or}} [[Ticarcillin]]/[[clavulanate]] 3.1g IV q4h {{or}} [[Tigecycline]] 100mg IV Single dose,then 50mg IV q12h.
+::* Alternative treatment (1): [[Ceftazidime]] 2 g IV q8h
-:::*Alternative treatment (2) : [[Ciprofloxacin]] 500-750mg PO /400mg IV q12h {{or}} [[Moxifloxacin]] 400mg PO/IV {{or}} [[Levofloxacin]] 750mg PO/IV .
-:::*Alternative treatment (3) : Multiply-resistantance [[Colistin]] 2.5mg/kg q12h IV.
+::* Alternative treatment (2): [[Ticarcillin-clavulanate]] 3.1 g IV q4h
-:::*Note : Treatment duration uncertain,but usually ≥14days
+::* Alternative treatment (3): [[Tigecycline]] 100 mg IV single dose {{then}} 50 mg IV q12h
+::* Alternative treatment (4): [[Ciprofloxacin]] 500-750 mg PO/400 mg IV q12h
+::* Alternative treatment (5): [[Moxifloxacin]] 400 mg PO/IV
+::* Alternative treatment (6): [[Levofloxacin]] 750 mg PO/IV
+::* Alternative treatment (7) (multiply-resistance): [[Colistin]] 2.5 mg/kg IV q12h
+::* Note: Treatment duration uncertain, but usually ≥ 14 days
 {{PBI|Vibrio cholerae}}
 {{PBI|Vibrio parahaemolyticus}}
@@ Line 481: / Line 583: @@
 ----
+==References==
+{{reflist}}

Sandbox aparna: Difference between revisions

Latest revision as of 15:53, 23 July 2015

Bacteria – Gram-Negative Bacilli

Salmonella

References

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