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::::*2.1.3.1 '''β Lactamase–producing strain'''  
::::*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  
:::::* 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
:::::* 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'''  
::::*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
:::::* 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'''  
:::*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 (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/day IV/IM for ≥ 8weeks {{and}}[[ampicillin|Ampicillin]] 12 g/day IV for ≥ 8weeks)
::::* Preferred regimen (2): ([[Ceftriaxone sodium]] 4 g/day IV/IM for ≥ 8weeks {{and}} [[ampicillin|Ampicillin]] 12 g/day IV for ≥ 8weeks)
::*2.2 '''Endocarditis in Pediatrics'''
::*2.2 '''Endocarditis in Pediatrics'''
:::*2.2.1 '''Strains Susceptible to Penicillin, Gentamicin, and Vancomycin'''
:::*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
::::* 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 (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 (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.
::::*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
::::* 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'''
:::*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
::::* 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  
::::* 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 '''Strains Resistant to Penicillin and Susceptible to Aminoglycoside and Vancomycin'''
::::*2.2.3.1 '''β Lactamase–producing strain'''   
::::*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
:::::* 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
:::::* 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'''  
::::*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
:::::*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'''
:::*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/day IV for ≥ 8 weeks
::::*Preferred regimen: [[Imipenem]]/[[Cilastatin]] 60–100 mg/kg IV q24h for ≥ 8weeks {{and}} [[Ampicillin]] 300 mg/kg/day IV for ≥ 8 weeks
::::*Alternate regimen: [[Ceftriaxone]] 100 mg/kg IV/IM q24h {{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


Line 54: Line 54:


::*3.1 '''Ampicillin susceptible'''
::*3.1 '''Ampicillin susceptible'''
:::* Preferred regimen: [[Ampicillin]] 12 g/day IV q4h {{and}}[[Gentamicin]] 5 mg/kg/day IV q8h
:::* Preferred regimen: [[Ampicillin]] 12 g/day IV q4h {{and}} [[Gentamicin]] 5 mg/kg/day IV q8h
::*3.2 '''Ampicillin resistant'''
::*3.2 '''Ampicillin resistant'''
:::* Preferred regimen: [[Vancomycin]] 30–45 mg/kg/day IV q8–12h {{and}}[[Gentamicin]] 5 mg/kg/day IV q8h
:::* 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'''
::*3.3 '''Ampicillin and vancomycin resistant'''
:::* Preferred regimen: [[Linezolid]] 600 mg IV q12h
:::* Preferred regimen: [[Linezolid]] 600 mg IV q12h
Line 74: Line 74:
::*1.1 '''Ampicillin or Penicillin susceptible'''
::*1.1 '''Ampicillin or Penicillin susceptible'''
:::* Preferred regimen (1): [[Ampicillin]] 2 g IV q4-6h
:::* Preferred regimen (1): [[Ampicillin]] 2 g IV q4-6h
:::* Preferred regimen (2): [[Ampicillin]] 2 g IV q4-6h {{and}} [[Gentamicin]] 1 mg/kg q8h
:::* 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'''
::*1.2 '''Ampicillin resistant and vancomycin susceptible or Penicillin allergy'''
:::* Preferred regimen (1): [[Vancomycin]] 15 mg/kg IV q12h {{and}} [[Gentamicin]] 1 mg/kg q8h
:::* Preferred regimen (1): [[Vancomycin]] 15 mg/kg IV q12h {{and}} [[Gentamicin]] 1 mg/kg IV/IM q8h
:::* Preferred regimen (2): [[Linezolid]] 600 mg q12h  
:::* Preferred regimen (2): [[Linezolid]] 600 mg IV q12h  
:::* Preferred regimen (3): [[Daptomycin]] 6 mg/kg/day.
:::* Preferred regimen (3): [[Daptomycin]] 6 mg/kg IV q24h.
::*1.3 '''Ampicillin and Vancomycin resistant'''
::*1.3 '''Ampicillin and Vancomycin resistant'''
:::* Preferred regimen (1): [[Linezolid]] 600 mg q12h  
:::* Preferred regimen (1): [[Linezolid]] 600 mg IV q12h  
:::* Preferred regimen (2): [[Daptomycin]] 6 mg/kg/day IV  
:::* Preferred regimen (2): [[Daptomycin]] 6 mg/kg IV q24h
:*2. '''Endocarditis'''
:*2. '''Endocarditis'''
::*2.1 '''Endocarditis in Adults'''  
::*2.1 '''Endocarditis in Adults'''  
:::*2.1.1 '''Strains Susceptible to Penicillin, Gentamicin, and Vancomycin'''
:::*2.1.1 '''Strains Susceptible to Penicillin, Gentamicin, and Vancomycin'''
::::*Preferred regimen: ([[Ampicillin|Ampicillin]] 12 g/day IV for 4–6weeks {{or}} [[Penicillin G|Aqueous crystalline penicillin G sodium]] 18–30 MU/day IV for 4–6weeks) {{and}} [[Gentamicin|Gentamicin sulfate]] 3 mg/kg/day IV/IM for 4–6 weeks
::::*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/day IV/IM for 4–6 weeks
::::*'''Note : In case of native valve endocarditis, 4-week therapy recommended for patients with symptoms of illness ≤3 months and 6-week therapy recommended for patients with symptoms >3 months and prosthetic valve or other prosthetic cardiac material a minimum of 6 week of therapy recommended '''
::::*'''Note : In case of native valve endocarditis, 4-week therapy recommended for patients with symptoms of illness ≤3 months and 6-week therapy recommended for patients with symptoms >3 months and prosthetic valve or other prosthetic cardiac material a minimum of 6 week of therapy recommended '''
::::* Alternate regimen: [[Vancomycin|Vancomycin hydrochloride]] 30 mg/kg/day IV for 6 weeks {{and}} [[Gentamicin|Gentamicin sulfate]] 3 mg/kg/day IV/IM for 6weeks
::::* Alternate regimen: [[Vancomycin|Vancomycin hydrochloride]] 30 mg/kg/day IV for 6 weeks {{and}} [[Gentamicin|Gentamicin sulfate]] 3 mg/kg/day IV/IM for 6 weeks
:::*2.1.2 '''Strains Susceptible to Penicillin, Streptomycin, and Vancomycin and Resistant to Gentamicin'''
:::*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 for 4–6weeks){{and}}[[Streptomycin|Streptomycin sulfate]] 15 mg/kg/day IV/IM for 4–6weeks
::::* Preferred regimen: ([[Ampicillin]] 12 g/day IV for 4–6 weeks {{or}}[[Penicillin G|Aqueous crystalline penicillin G sodium]] 24 MU/day IV for 4–6 weeks){{and}}[[Streptomycin|Streptomycin sulfate]] 15 mg/kg/day IV/IM for 4–6 weeks
::::* Alternate regimen: [[Vancomycin|Vancomycin hydrochloride]] 30 mg/kg/day IV 6weeks {{and}} [[Streptomycin|Streptomycin sulfate]] 15 mg/kg per 24 h IV/IM for 6weeks
::::* Alternate regimen: [[Vancomycin|Vancomycin hydrochloride]] 30 mg/kg/day IV 6 weeks {{and}} [[Streptomycin|Streptomycin sulfate]] 15 mg/kg per 24 h IV/IM for 6 weeks
:::*2.1.3 '''Strains Resistant to Penicillin and Susceptible to Aminoglycoside and Vancomycin'''
:::*2.1.3 '''Strains Resistant to Penicillin and Susceptible to Aminoglycoside and Vancomycin'''
::::*2.1.3.1 '''β Lactamase–producing strain'''  
::::*2.1.3.1 '''β Lactamase–producing strain'''  
:::::* Preferred regimen: [[Ampicillin-sulbactam]] 12 g/day IV for 6weeks {{and}} [[Gentamicin|Gentamicin sulfate]] 3 mg/kg/day IV/IM 6weeks
:::::* Preferred regimen: [[Ampicillin-sulbactam]] 12 g/day IV for 6 weeks {{and}} [[Gentamicin|Gentamicin sulfate]] 3 mg/kg/day IV/IM 6 weeks
:::::* Alternate regimen: [[Vancomycin|Vancomycin hydrochloride]] 30 mg/kg/day IV for 6weeks {{and}} [[Gentamicin|Gentamicin sulfate]] 3 mg/kg/day IV/IM for 6weeks
:::::* Alternate regimen: [[Vancomycin|Vancomycin hydrochloride]] 30 mg/kg/day IV for 6 weeks {{and}} [[Gentamicin|Gentamicin sulfate]] 3 mg/kg/day IV/IM for 6 weeks
::::*2.1.3.2 '''Intrinsic penicillin resistance'''  
::::*2.1.3.2 '''Intrinsic penicillin resistance'''  
:::::* Preferred regimen: [[Vancomycin|Vancomycin hydrochloride]] 30 mg/kg/day IV for 6weeks {{and}} [[Gentamicin|Gentamicin sulfate]] 3 mg/kg/day IV/IM for 6weeks
:::::* Preferred regimen: [[Vancomycin|Vancomycin hydrochloride]] 30 mg/kg/day IV for 6 weeks {{and}} [[Gentamicin|Gentamicin sulfate]] 3 mg/kg/day IV/IM for 6 weeks
:::*2.1.4 '''Strains Resistant to Penicillin, Aminoglycoside, and Vancomycin'''   
:::*2.1.4 '''Strains Resistant to Penicillin, Aminoglycoside, and Vancomycin'''   
::::*Preferred regimen(1): [[Linezolid]] 1200 mg/day IV/PO ≥8weeks  
::::*Preferred regimen(1): [[Linezolid]] 1200 mg/day IV/PO ≥8weeks  

Revision as of 16:26, 16 July 2015

  • 1. Bacteremia[1]
  • 1.1 Ampicillin or Penicillin susceptible
  • 1.2 Ampicillin resistant and vancomycin susceptible or Penicillin allergy
  • 1.3 Ampicillin and Vancomycin resistant
  • 2.1 Endocarditis in Adults
  • 2.1.1 Strains Susceptible to Penicillin, Gentamicin, and Vancomycin
  • Preferred regimen: (Ampicillin 12 g IV q24h for 4–6 weeks OR Aqueous crystalline penicillin G sodium 18–30 MU IV q24h for 4–6 weeks) AND Gentamicin sulfate 3 mg/kg IV/IM q24h for 4–6 weeks
  • Alternative regimen: Vancomycin hydrochloride 30 mg/kg IV q24h for 6 weeks AND 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
  • 2.1.3 Strains Resistant to Penicillin and Susceptible to Aminoglycoside and Vancomycin
  • 2.1.3.1 β Lactamase–producing strain
  • 2.1.3.2 Intrinsic penicillin resistance
  • 2.1.4 Strains Resistant to Penicillin, Aminoglycoside, and Vancomycin
  • 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
  • 2.2.3 Strains Resistant to Penicillin and Susceptible to Aminoglycoside and Vancomycin
  • 2.2.3.1 β Lactamase–producing strain
  • 2.2.3.2 Intrinsic penicillin resistance
  • 2.2.4 Strains Resistant to Penicillin, Aminoglycoside, and Vancomycin
  • 3. Meningitis[4]
  • 3.1 Ampicillin susceptible
  • 3.2 Ampicillin resistant
  • 3.3 Ampicillin and vancomycin resistant
  • 4. Urinary tract infections [5]
  • 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 [6]
  • 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
  • 1. Bacteremia[7]
  • 1.1 Ampicillin or Penicillin susceptible
  • 1.2 Ampicillin resistant and vancomycin susceptible or Penicillin allergy
  • 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 12 g/day IV for 4–6 weeks OR Aqueous crystalline penicillin G sodium 18–30 MU/day IV for 4–6 weeks) AND Gentamicin sulfate 3 mg/kg/day IV/IM for 4–6 weeks
  • Note : In case of native valve endocarditis, 4-week therapy recommended for patients with symptoms of illness ≤3 months and 6-week therapy recommended for patients with symptoms >3 months and prosthetic valve or other prosthetic cardiac material a minimum of 6 week of therapy recommended
  • Alternate regimen: Vancomycin hydrochloride 30 mg/kg/day IV for 6 weeks AND Gentamicin sulfate 3 mg/kg/day IV/IM for 6 weeks
  • 2.1.2 Strains Susceptible to Penicillin, Streptomycin, and Vancomycin and Resistant to Gentamicin
  • 2.1.3 Strains Resistant to Penicillin and Susceptible to Aminoglycoside and Vancomycin
  • 2.1.3.1 β Lactamase–producing strain
  • 2.1.3.2 Intrinsic penicillin resistance
  • 2.1.4 Strains Resistant to Penicillin, Aminoglycoside, and Vancomycin
  • 2.2 Endocarditis in Pediatrics
  • 2.2.1 Strains Susceptible to Penicillin, Gentamicin, and Vancomycin
  • Preferred regimen: (Ampicillin 300 mg/kg/day IV for 4–6weeks OR Penicillin 300,000 U/kg/day IV for 4–6 weeks) ANDGentamicin 3 mg/kg q24h IV/IM 4–6weeks
  • Note : In case of native valve endocarditis, 4-week therapy recommended for patients with symptoms of illness ≤3 months and 6-week therapy recommended for patients with symptoms >3 months and prosthetic valve or other prosthetic cardiac material a minimum of 6 week of therapy recommended
  • Alternate regimen : Vancomycin 40 mg/kg/day IV for 6weeks AND Gentamicin 3 mg/kg/day IV/IM for 6weeks
  • 2.2.2 Strains Susceptible to Penicillin, Streptomycin, and Vancomycin and Resistant to Gentamicin
  • 2.2.3 Strains Resistant to Penicillin and Susceptible to Aminoglycoside and Vancomycin
  • 2.2.3.1 β Lactamase–producing strain
  • 2.2.3.2 Intrinsic penicillin resistance
  • Preferred regimen: Vancomycin 40 mg/kg/day IV AND Gentamicin 3 mg/kg/day IV/IM for 6weeks
  • 2.2.4 Strains Resistant to Penicillin, Aminoglycoside, and Vancomycin
  • 3. Meningitis[4]
  • 3.1 Ampicillin susceptible
  • 3.2 Ampicillin resistant
  • 3.3 Ampicillin and vancomycin resistant
  • 4. Urinary tract infections[8]
  • 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 [9]
  • 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


  • Aeromonas hydrophila [10]
  • 1. Diarrhea
  • Preferred regimen(if not self-limiting, or if severe): Ciprofloxacin 500 mg PO bid.
  • Alternate regimen: TMP-SMX single dose PO bid
  • Note: High resistance to sulfa agents described in Taiwan and Spain
  • 2. Skin and soft tissue infection
  • 2.1 Mild infection
  • 2.2 Severe infection or sepsis
  • 3. Prevention
  • Preferred regimen: Frequent recommendations include using a Cephalosporin (e.g.,cefuroxime,ceftriaxoneorcefixime) OR a Fluoroquinolone (e.g.,ciprofloxacin or levofloxacin) during treatment with medicinal leeches.
  • Note: Aeromonas isolates from leeches have been described as uniformly susceptible to fluoroquinolones. Duration of antibiotic use is 3-5days, some recommend continuing until wound or eschar resolves
  1. ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
  2. ↑ Baddour, LM.; Wilson, WR.; Bayer, AS.; Fowler, VG.; Bolger, AF.; Levison, ME.; Ferrieri, P.; Gerber, MA.; Tani, LY. (2005). "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". Circulation. 111 (23): e394–434. doi:10.1161/CIRCULATIONAHA.105.165564. PMID 15956145. Unknown parameter |month= ignored (help)
  3. ↑ "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".
  4. ↑ 4.0 4.1 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 15494903.
  5. ↑ Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
  6. ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
  7. ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
  8. ↑ Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
  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.
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