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Bacteria – Gram-Negative Bacilli

Achromobacter xylosoxidans Return to Top
Acinetobacter baumannii Return to Top

Preferred regimen (1): Imipenem 0.5-1 g IV q6h
Preferred regimen (2): Ampicillin/sulbactam 3 g 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 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 1-2 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 divided 3 OR 4 doses/day OR 2 DS PO bid

Aeromonas hydrophila Return to Top

Bartonella Return to Top

Bartonella^[1]

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 100 mg 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 6 weeks Template:With or without Doxycycline 100 mg PO bid for 6 weeks.

Bordetella pertussis Return to Top

Bordetella pertussis^[2]

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 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/day AND SMX 40 mg/kg/day 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

1.4 Post exposure prophylaxis

Burkholderia cepacia Return to Top

Burkholderia cepacia^[3]

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^[4]

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 1g q8h
Preferred regimen (3): 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 3 months)

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

Campylobacter Return to Top
Campylobacter fetus Return to Top

Campylobacter fetus^[5]

1. Serious infections

Preferred regimen (1): Gentamicin 5 mg/kg/day IV
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^[6]

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.

2. Complicated infections or immunocompromise

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 (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.

3. 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.

4. 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

5. 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^[7]

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 q6h IV
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.

Citrobacter koseri Return to Top

Citrobacter koseri^[8]

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 aerogenes

1. UTI^[9]

Preferred regimen: Ciprofloxacin 250 mg PO bid

Enterobacter cloacae Return to Top

Enterobacter cloacae

1.UTI^[10]

Preferred regimen: Ciprofloxacin 250 mg PO bid

Escherichia coli Return to Top

Escherichia coli^[11]

1. Meningitits

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 gm IV q4-6h for 14 days
Alternative regimen (1): Ticarcillin-Clavulanate 3.1 gm IV q6h

Alternative regimen (2): Ampicillin-Sulbactam 3 gm IV q6h

Alternative regimen (3): Piperacillin-Tazobactam 3.375 gm IV q4-6h

Alternative regimen (4): Ertapenem 1 gm IV q24h

Alternative regimen (5): Doripenem 500 mg q8h for 14 days

4. Traveler’s diarrhea

Preferred regimen (1): Ciprofloxacin 750 mg PO OD 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 OR other third or fourth generation cephalosporin

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(if sensitive) 2 g IV q6h

Preferred regimen (6): TMP-SMX(if sensitive) 5-10 mg/kg/day for q6-8hIV
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).
Alternative regimen (2): Ampicillin-sulbactam 3g IV q6h AND (Gentamicin 1.5 mg/kg/q8h OR 5-7 mg/kg/day IV OR Gentamicin 5mg/kg/day OR Tobramycin 5mg/kg/dayIV for 7-14days)
Note: Monotherapy generally not recommended for bacteremia/pneumonia

Francisella tularensis Return to Top

Francisella tularensis^[12]

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/day IV 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)
Alternative regimen (4) (pregnancy): Ciprofloxacin

Helicobacter pylori Return to Top

Helicobacter pylori^[13]

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 followed by PPI (standard dose twice daily) 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)^[14]

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^[15]

1. Severe, nosocomial infection

Preferred regimen (1): Cefepime 2g IV q8h

Preferred regimen (2): Ceftazidime 2g IV q8h

Preferred regimen (3): Imipenem 500mg IV q6h

Preferred regimen (4): Meropenem 1g IV q8h

Preferred regimen (5): Piperacillin-tazobactam 4.5 g IV q6h AND Aminoglycoside

Preferred regimen (6): Respiratory fluoroquinolone
Preferred regimen (7) (For coverage of ESBLs in pneumonia, sepsis, complicated UTI or intra-abdominal infections): Imipenem 500mg IV q6h

Preferred regimen (8) (For coverage of ESBLs in pneumonia, sepsis, complicated UTI or intra-abdominal infections): Meropenem 1g IV q8h

Preferred regimen (9) (For coverage of ESBLs in pneumonia, sepsis, complicated UTI or intra-abdominal infections): Ertapenem 1g IV q24h

Preferred regimen (10) (For coverage of ESBLs in pneumonia, sepsis, complicated UTI or intra-abdominal infections): Doripenem 500mg IV q8h
Note: In ESBLs,inconsistent activity seen with aminoglycosides, fluoroquinolones, and piperacillin-tazobactam. Avoid cephalosporins
Alternate regimen (1): Ceftriaxone 1 gm IV q24h AND Metronidazole 500 mg IV q6h OR 1 gm IV q12h

Alternate regimen (2): Moxifloxacin 400 mg IV/PO q24h

Klebsiella rhinoscleromatis Return to Top

Klebsiella rhinoscleromatis

1. Rhinoscleroma^[16]^[17]^[18]

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 cours 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.^[19]

Legionella pneumophila Return to Top
^[20]

Legionella pneumophila

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
Alternative regimen (1): Erythromycin 1 g IV q6h and THEN 500 mg PO q6h for 7-10 days

Alternative regimen (2): Ciprofloxacin 400 mg IV q12h THEN 750 mg PO bid 7-10 days

Moraxella catarrhalis Return to Top

Pneumonia

Preferred regimen (1): Amoxicillin-Clavulanate 875/125 mg PO bid OR XL 2000/125 PO bid

Preferred regimen (2): Oral cephalosporins such as Cefprozil 200-500 mg bid

Preferred regimen (3): Cefpodoxime 200-400 mg bid

Preferred regimen (4): Cefuroxime 250-500 mg bid

Preferred regimen (5): Cefdinir 300 mg bid

Preferred regimen (6): Parenteral cephalosporins such as Cefuroxime OR Cefotaxime OR Ceftriaxone

Preferred regimen (7): Macrolides such as Erythromycin 500 mg PO q6h

Preferred regimen (8): Clarithromycin 500 mg bid OR XL 1 g PO

Preferred regimen (9): Azithromycin 500 mg single dose {then}} 250 mg PO

Preferred regimen (10): Flouroquinolones such as Moxifloxacin 400 mg IV/PO qd

Preferred regimen (11): Levofloxacin 500 mg IV/PO qd

Preferred regimen (12): TMP-SMX DS PO bid

Morganella morganii Return to Top

Morganella morganii^[21]

Preferred regimen (1): Imipenem 500 mg IV q6h

Preferred regimen (2): Meropenem 1.0 g IV q8h (adjust dose if necessary for renalfunction).
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^[22]

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) (severe cases): Ceftriaxone 1-2 g IV qd

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

Proteus mirabilis Return to Top

Proteus mirabilis^[23]

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: Uncomplicated UTI 3 days, pyelonephritis 7-14 days, complicated UTI 10-21 days and bacteremia 7-14 days

Indole positive Proteus species Return to Top

Indole positive Proteus species^[24]

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^[25]

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 (2weeks), shorter than chronic prostatitis (4-6wks)
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^[26]

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 750mg 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 5-7mg/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 Return to Top

Salmonella^[27]

1.Gastroenteritis

1.1 Immunocompetent

Preferred treatment (1): TMP-SMX DS PO bid

Preferred treatment (2): Ciprofloxacin 500 mg PO bid

Preferred treatment (3): Ceftriaxone 2 g IV q24h for 5-7 days.

1.2 Immunosuppressed

Preferred treatment (1): TMP-SMX DS PO bid

Preferred treatment (2): Ciprofloxacin 500 mg PO bid

Preferred treatment (3): Ceftriaxone 2 g IV q24h for ≥ 14 days.

2. Typhoid fever

Preferred regimen: Ceftriaxone 1-2 g IV q24h THEN (Cefixime 400 mg PO for 10-14 days OR Ciprofloxacin 400 mg IV q12h OR 500 mg PO bid)

3. Non-typhoid (serious infection)

Preferred regimen (1): 3rd generation Cephalosporin (Ceftriaxone/Cefotaxime)

Preferred regimen (2): Fluoroquinolone(Ciprofloxacin, Levofloxacin)

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

5. Vascular prosthesis infection

Preferred regimen (1): Ceftriaxone

Preferred regimen (2): Cefotaxime

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

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

7. Arthritis

Preferred regimen (1): Ceftriaxone 2 g IV q24h

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

8.Endocarditis

Preferred regimen (1): Ceftriaxone 2 g IV q24h

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

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)

10. HIV and salmonellosis

Preferred regimen: (IV Cephalosporin OR IV Fluoroquinolone) THEN oral flouroquinolones (Ciprofloxacin 500-750 mg PO bid for 4weeks).
Note: If relapse occurs within 6weeks give life-long abx or until immune recovery post-ART
11.Carrier state : Ciprofloxacin 500mg PO bid for 4-6weeks OR TMP-SMX 1DS bid PO for 6weeksOR Amoxicillin 500mg PO for 6weeks.

Serratia marcescens Return to Top

Serratia marcescens^[28]

1.Bacteremia,Pneumonia or SeriousInfections

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

2.Endocarditis

Preferred regimen : Choice dictated by sensitivities. 4to6 week duration of parenteral therapy.

3.Osteomyelitis

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

4.UTI

Preferred regimen : Ciprofloxacin 250mg PO bid or 400mg IV q12h OR Levofloxacin 250mg PO everyday or 500mg 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

Shigella^[29]

Preferred regimen

If known sulfa sensitive : TMP(160mg)/SMX(800mg) PO q12h for 3-5days.
Pediatric dose : TMP5mg/SMX 25mg/kg PO bid.
If TMP/SMX resistant or unknown susceptibility : Ciprofloxacin 500mg OR Norfloxacin 400mg OR Ofloxacin 200mg PO bid for 3-5days.

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.
Note : In southeast Asia, growing resistance seen to fluoroquinolones, azithromycin maybe preferred.

Stenotrophomonas maltophilia Return to Top

Stenotrophomonas maltophilia^[30]

Preferred treatment : TMP-SMX 15-20(TMP component)mg/kg/day 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 (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.
Note : Treatment duration uncertain,but usually ≥14days

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

↑ 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.
↑ 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.
↑ 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.
↑ 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.

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

[pmid22970946-4] Wiersinga WJ, Currie BJ, Peacock SJ (2012). "Melioidosis". N. Engl. J. Med. 367 (11): 1035–44. doi:10.1056/NEJMra1204699. PMID 22970946.

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

[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] 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.

[pmid22491499-13] Lua error: expandTemplate: template "citation error" does not exist.

[14] 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.

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

[16] 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)

[17] 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.

[18] 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)

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

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

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

[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.

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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>
-::*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'''<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>
-::*2.1 '''Endocarditis in Adults'''
-:::*2.1.1 '''Strains Susceptible to Penicillin, Gentamicin, and Vancomycin'''
-::::* 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: [[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 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
-:* 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.
-:::* 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'''
-::::* 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
-::::* Alterbative regimen:  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.
 ====Bacteria – Gram-Negative Bacilli====
 {{PBI|Achromobacter xylosoxidans}}
@@ Line 211: / Line 48: @@
 :::::* Preferred regimen (2): [[Erythromycin]] 40-50 mg/kg/day qid for 14 days
 :::::* Preferred regimen (3): [[Clarithromycin]] 15 mg/kg PO bid for 7 days,
-:::::* Alternative regimen: 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/day {{and}} [[Sulfamethoxazole|SMX]] 40 mg/kg/day 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
@@ Line 220: / Line 57: @@
 {{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<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 (2): [[Imipenem]] 1 g IV q6h
-:::* Preferred regimen (3): [[Meropenem]] 1-2 g IV q8h
+::* Preferred regimen (3): [[Meropenem]] 1-2 g IV q8h
-:::* Preferred regimen (4): [[Minocycline]] 100 mg IV/PO bid.
+::* Preferred regimen (4): [[Minocycline]] 100 mg IV/PO bid.
 {{PBI|Burkholderia pseudomallei}}
@@ Line 241: / Line 78: @@
 ::* 1. '''Serious infections'''
 :::* Preferred regimen (1): [[Gentamicin]] 5 mg/kg/day IV
 :::* Preferred regimen (2): [[Imipenem]] 1 mg IV q6h
 :::* Preferred regimen (3): [[Ceftriaxone]] 2 g IV q12h.
 ::* 2. '''Endovascular infections'''
@@ Line 249: / Line 84: @@
 ::* 3. '''CNS'''
 :::* preferred regimen (1): [[Ceftriaxone]]
 :::* preferred regimen (2): [[Chloramphenicol]] for 2-3 weeks.
 {{PBI|Campylobacter jejuni}}
@@ Line 264: / Line 98: @@
 :::* 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 (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 (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.
 ::* 3. '''Mild cellulitis/dog or cat bites'''
 :::* Preferred regimen (1): [[Amoxicillin/clavulanate]] 500 mg PO q8h {{or}} 875 mg PO bid
@@ Line 275: / Line 110: @@
 ::* 4. '''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
+:::* Preferred regimen (2) (if beta-lactamase producing or polymicrobial brain abscess): [[Imipenem]]/[[Cilastin]] 1000 mg q6-8h {{and}} [[Clindamycin]] 600 mg IV q8h
 ::* 5. '''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 (1): [[Meropenem]] 1-2 g IV q8h
+::* 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 q6h IV
+::* 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.
-:::* Preferred regimen (2): [[Imipenem]] 1 g IV q6h
+{{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>
+::* 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 [[Cephalosporins|first generation cephalosporins]]
+{{PBI|Elizabethkingia meningoseptica}}
+{{PBI|Enterobacter aerogenes}}
+:* [[Enterobacter aerogenes]]
+::* 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|Enterobacter cloacae}}
+:* [[Enterobacter cloacae]]
+::* 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
-:::* Preferred regimen (3): [[Doripenem]] 500 mg IV q8h
+{{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>
+::* 1. '''Meningitits'''
+:::* Preferred regimen (1): [[Ceftriaxone]] 4 g IV q12–24h
-:::* Preferred regimen (4): [[Cefepime]] 1-2 g IV q8h
+:::* Preferred regimen (2): [[Cefotaxime]] 8–12 g/day IV q4–6h
+:::* Alternative regimen (1): [[Aztreonam]] 6–8 g/day IV q6–8h
-:::* Preferred regimen (5): [[Ciprofloxacin]] 400 mg IV q12h {{or}} 500 mg PO bid for UTI
+:::* Alternative regimen (2): [[Gatifloxacin]] 400 mg/day IV q24h
-:::* Preferred regimen (6): [[Gentamicin]] 5 mg/kg/day.
+:::* Alternative regimen (3): [[Moxifloxacin]] 400 mg/day IV q24h
-:::* Alternate regimen (1): [[Piperacillin]]/[[tazobactam]] 3.375 mg q6h IV
-:::* 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.
+:::* Alternative regimen (4): [[Meropenem]] 6 g/day IV q8h
-{{PBI|Citrobacter koseri}}
+:::* Alternative regimen (5): [[Trimethoprim-Sulfamethoxazole]] 10–20 mg/kg/day IV q6–12h
-::* 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 (1): [[Ceftriaxone]] 1-2 g IV q12-24h
+:::* 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 gm IV q4-6h for 14 days
+::::* Alternative regimen (1): [[Ticarcillin-Clavulanate]] 3.1 gm IV q6h
+::::* Alternative regimen (2): [[Ampicillin]]-[[Sulbactam]] 3 gm IV q6h
+::::* Alternative regimen (3): [[Piperacillin-Tazobactam]] 3.375 gm IV q4-6h
+::::* Alternative regimen (4): [[Ertapenem]] 1 gm IV q24h
+::::* Alternative regimen (5): [[Doripenem]] 500 mg q8h for 14 days
+::*4. '''Traveler’s diarrhea'''
+:::* Preferred regimen (1): [[Ciprofloxacin]] 750 mg PO OD 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.
-:::* Preferred regimen (2): [[Cefotaxime]] 1-2 g IV q6h
+:::* Note: Avoid fluoroquinolones in pediatrics and pregnancy.
+::*5. '''Malacoplakia'''
+:::* Preferred regimen (1): [[Bethanechol chloride]] {{and}} ([[Ciprofloxacin]] 400 mg IV q12h
-:::* Preferred regimen (3): [[Cefepime]] 1-2 IV q8h.
+:::* Preferred regimen (2): [[TMP-SMX]] 2 mg/kg (TMP component IV q6h)
-:::* Alternate regimen (1): [[Ciprofloxacin]] 400 mg IV q12h {{or}} 500 mg PO q12h for UTI
+::*6. '''Bacteremia/pneumonia'''
+:::* Preferred regimen (1): [[Ceftriaxone]] 1-2 g IV q24h {{or}} other third or fourth generation cephalosporin
-:::* Alternate regimen (2): [[Imipenem]] 1 g IV q6h
+:::* Preferred regimen (2): [[Ciprofloxacin]] 400 mg IV q12h {{or}} 500 mg PO q12h
-:::* Alternate regimen (3): [[Doripenem]] 500 mg IV q8h
+:::* Preferred regimen (3): [[Levofloxacin]] 500 mg PO/IV q24h
-:::* Alternate regimen (4): [[Meropenem]] 1-2 g IV q8h
+:::* Preferred regimen (4): [[Moxifloxacin]] 400 mg IV/PO q24h
-:::* Alternate regimen (5): [[Aztreonam]] 1-2 g IV q6h
+:::* Preferred regimen (5): [[Ampicillin]](if sensitive) 2 g IV q6h
-:::* Alternate regimen (6): [[TMP-SMX]] 5 mg/kg IV q6h  {{or}} DS PO bid for UTI.
+:::* Preferred regimen (6): [[TMP-SMX]](if sensitive) 5-10 mg/kg/day for q6-8hIV
-:::* Note: Usually [[Ampicillin]] resistant, but may be sensitive to [[Cephalosporins|first generation cephalosporins]]
+:::* 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).
-{{PBI|Elizabethkingia meningoseptica}}
+:::* Alternative regimen (2): [[Ampicillin-sulbactam]] 3g IV q6h {{and}} ([[Gentamicin]] 1.5 mg/kg/q8h {{or}} 5-7 mg/kg/day IV {{or}} [[Gentamicin]] 5mg/kg/day {{or}} [[Tobramycin]] 5mg/kg/dayIV for 7-14days)
-{{PBI|Enterobacter aerogenes}}
+:::* Note: Monotherapy generally not recommended for bacteremia/pneumonia
-:* [[Enterobacter aerogenes]]
-::*'''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|Enterobacter cloacae}}
-:* [[Enterobacter cloacae]]
-::*'''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}}
-::* 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'''
-::::*1.1.Preferred regimen: [[Ceftriaxone]] 4 g IV q12–24h {{or}} [[Cefotaxime]] 8–12 g/day q4–6h
-::::*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
-:::*'''2.Uncomplicated urinary tract infection'''
-::::*2.1.Preferred agents (IDSA/AUA Guidelines): [[TMP-SMX]] DS PO bid for 3-day
-::::*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.
-::::*2.3.Alternative regimen(2): [[Nitrofurantoin]] 100 mg PO q6h {{or}} [[Nitrofurantoin]] macrocrystals (Macrobid) 100 mg PO bid for 7 days.
-::::*2.4.Alternative regimen(3): [[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: [[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: [[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
-::::*3.1.'''Acute pyelonephritis (Hospitalized)'''
-:::::*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: [[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.
-:::*4.'''Traveler’s diarrhea'''
-::::*Preferred regimen : [[Ciprofloxacin]] 750 mg PO OD for 1-3 days or other Fluoroquinolones
-::::*Pediatrics & pregnancy: [[Azithromycin]] 10 mg/kg/day single dose {{or}} [[Ceftriaxone]] 50 mg/kg/day IV OD for 3 days.
-::::Avoid Fluoroquinolones in Pediatrics and pregnancy.
-:::*5.'''Malacoplakia'''
-::::*[[Bethanechol chloride]] {{and}} ([[Ciprofloxacin]] 400 mg IV q12h {{or}} [[TMP-SMX]] 2 mg/kg (TMP component) IV q6h)
-:::*'''6.Bacteremia/Pneumonia'''
-::::*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
-::::*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).
-::::*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
-::::*Note: Monotherapy generally not recommended for bacteremia/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/day IV 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)
+:::* Alternative regimen (4) (pregnancy): [[Ciprofloxacin]]
 {{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 followed by PPI (standard dose twice daily) {{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
 ----
@@ Line 379: / Line 284: @@
 :* '''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
 ----
@@ Line 389: / Line 294: @@
 {{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>
-:::*'''1.Severe,nosocomial infection'''
+:::* 1. '''Severe, nosocomial infection'''
-::::*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
+::::* Preferred regimen (1): [[Cefepime]] 2g IV q8h
-::::*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
-::::*In ESBLs,inconsistent activity seen with aminoglycosides, fluoroquinolones, and piperacillin-tazobactam. Avoid cephalosporins
+::::* Preferred regimen (2): [[Ceftazidime]] 2g 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]] 500mg IV q6h
+::::* Preferred regimen (4): [[Meropenem]] 1g IV q8h
+::::* Preferred regimen (5): [[Piperacillin]]-[[tazobactam]] 4.5 g IV q6h {{and}} [[Aminoglycoside]]
+::::* Preferred regimen (6): Respiratory fluoroquinolone
+::::* Preferred regimen (7) (For coverage of ESBLs in pneumonia, sepsis, complicated UTI or intra-abdominal infections): [[Imipenem]] 500mg IV q6h
+::::* Preferred regimen (8) (For coverage of ESBLs in pneumonia, sepsis, complicated UTI or intra-abdominal infections): [[Meropenem]] 1g IV q8h
+::::* Preferred regimen (9) (For coverage of ESBLs in pneumonia, sepsis, complicated UTI or intra-abdominal infections): [[Ertapenem]] 1g IV q24h
+::::* Preferred regimen (10) (For coverage of ESBLs in pneumonia, sepsis, complicated UTI or intra-abdominal infections): [[Doripenem]] 500mg IV q8h
+::::* Note: In ESBLs,inconsistent activity seen with aminoglycosides, fluoroquinolones, and piperacillin-tazobactam. Avoid cephalosporins
+::::* Alternate regimen (1): [[Ceftriaxone]] 1 gm IV q24h {{and}} [[Metronidazole]] 500 mg IV q6h {{or}} 1 gm IV q12h
+::::* Alternate regimen (2): [[Moxifloxacin]] 400 mg IV/PO q24h
 ----
 {{PBI|Klebsiella rhinoscleromatis}}
+:*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>
-:::* 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
-:::* Alternative regimen: [[Tetracycline]] {{or}} [[Streptomycin]] {{or}} [[Doxycycline]]  {{or}} [[Ceftriaxone]] {{or}} [[Ofloxacin]]
+:::* 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 cours 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}}<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>
+:*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.
+::* Preferred regimen (1): [[Levofloxacin]] 750 mg PO/IV qd for 7-10 days
-:::* 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
+::* 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
+::* Alternative regimen (1): [[Erythromycin]] 1 g IV q6h and {{then}} 500 mg PO q6h for 7-10 days
+::* Alternative regimen (2): [[Ciprofloxacin]] 400 mg IV q12h {{then}} 750 mg PO bid 7-10 days
 {{PBI|Moraxella catarrhalis}}
-:::* Pneumonia
+:* 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
+::* Preferred regimen (1): [[Amoxicillin-Clavulanate]] 875/125 mg PO bid {{or}} XL 2000/125 PO bid
+::* Preferred regimen (2): Oral cephalosporins such as [[Cefprozil]] 200-500 mg bid
+::* Preferred regimen (3): [[Cefpodoxime]] 200-400 mg bid
+::* Preferred regimen (4): [[Cefuroxime]] 250-500 mg bid
+::* Preferred regimen (5): [[Cefdinir]] 300 mg bid
+::* Preferred regimen (6): Parenteral cephalosporins such as [[Cefuroxime]] {{or}} [[Cefotaxime]] {{or}} [[Ceftriaxone]]
+::* Preferred regimen (7): Macrolides such as [[Erythromycin]] 500 mg PO q6h
+::* Preferred regimen (8): [[Clarithromycin]] 500 mg bid {{or}} XL 1 g PO
+::* Preferred regimen (9): [[Azithromycin]] 500 mg single dose {then}} 250 mg PO
+::* Preferred regimen (10): Flouroquinolones such as [[Moxifloxacin]] 400 mg IV/PO qd
+::* Preferred regimen (11): [[Levofloxacin]] 500 mg IV/PO qd
+::* Preferred regimen (12): [[TMP-SMX]] DS 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.
-:::*Note (2): Duration of treatment for UTI(generallycomplicated) is 7days and Duration of treatment for bacteremia is 14days.
+::* Preferred regimen (2): [[Meropenem]] 1.0 g IV q8h (adjust dose if necessary for renalfunction).
-:::*Note (3): [[Tigecycline]] is not reliably effective
+::* Note (1): [[Carbapenems]] are considered first line therapy due to inducible cephalosporinases, and presence of extended-spectrum beta-lactamases in some isolates.
-:::*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 (2): Duration of treatment for UTI (generally complicated) is 7 days and Duration of treatment for bacteremia is 14 days.
-:::*Alternative Regimen (2) : [[Aminoglycosides]] can be used alone for treatment of UTI,[[Gentamicin]] {{or}} [[Tobramycin]] 1mg/kg/day IV {{or}} [[Amikacin]] 3mg/kg/day
+::* 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
 {{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) (severe cases): [[Ceftriaxone]] 1-2 g IV qd
+::* 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) (if susceptible): [[TMP-SMX]] DS PO bid for 3 days
 {{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: Uncomplicated UTI 3 days, pyelonephritis 7-14 days, complicated UTI 10-21 days and bacteremia 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).
-::::*Note (2) : Duration of treatment for (bacteremia)is 10-14days or 3-5days after defervescence or control/elimination of complicatingfactors.
+:::* Preferred regimen (2): [[Levofloxacin]] 500 mg IV/PO q24h
-::::*Note (3) : Duration for acute prostatitis(2weeks), shorter than chronic prostatitis(4-6wks)
-::::*Alternative regimen : [[TMP-SMX]](Bactrim)DS1 PO q12h for 10-14days {{or}} TMP 5-10 mg/kg/day IV q6h.
+:::* 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 (2weeks), shorter than chronic prostatitis (4-6wks)
+:::* 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).
-::::* Note : [[Amikacin]] > [[Tobramycin]] > [[Gentamicin]] with respect to P.aeruginosa susceptibility percentages at most institutions.
+::*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}} 750mg 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}} 5-7mg/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.
 {{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>
+:* 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.Gastroenteritis'''
+::* 1.'''Gastroenteritis'''
-::::*Preferred treatment
+:::* 1.1 '''Immunocompetent'''
-:::::*Immunocompetent : [[TMP-SMX]] DS PO bid {{or}} [[Ciprofloxacin]] 500mg PO bid {{or}} [[Ceftriaxone]] 2gIV/day for 5-7days.
-:::::*Immunosuppressed : [[TMP-SMX]] DS PO bid {{or}} [[Ciprofloxacin]] 500mg PO bid {{or}} [[Ceftriaxone]] 2gIV/day for ≥14days.
+::::* Preferred treatment (1): [[TMP-SMX]] DS PO bid
-:::*'''2.Typhoidfever'''
-::::*Preferred regimen : [[Ceftriaxone]] 1-2g IV q24h then [[Cefixime]] 400mg PO for 10-14days {{or}} [[Ciprofloxacin]] 400mg IV q12h or 500mg PO bid.
+::::* Preferred treatment (2): [[Ciprofloxacin]] 500 mg PO bid
-:::*'''3.Non-typhoid(seriousinfection)'''
-::::*Preferred regimen : [[Cephalosporin|3rd generation Cephalosporin]] (Ceftriaxone/Cefotaxime){{or}} [[Fluoroquinolone]]([[Ciprofloxacin]], [[Levofloxacin]])
+::::* Preferred treatment (3): [[Ceftriaxone]] 2 g IV q24h for 5-7 days.
-:::*'''4.Bacteremia'''
-::::*Preferred regimen : [[Ceftriaxone]] 2g IV q24h {{or}} [[Cefotaxime]] 2g IV q6-8h for 7-14days {{or}} [[Ciprofloxacin]] 400mg IV q12h for 7-14days
+:::* 1.2 '''Immunosuppressed'''
-:::*'''5.Vascular prosthesis infection'''
-::::*Preferred regimen : [[Ceftriaxone]], [[Cefotaxime]] {{or}} [[Ciprofloxacin]] 400mg IV q12h for 6wks
+::::* Preferred treatment (1): [[TMP-SMX]] DS PO bid
-:::*'''6.Osteomyelitis'''
-::::*Preferred regimen : [[Ceftriaxone]] 2g IV q24h {{or}} [[Cefotaxime]] 2g IV q6-8h {{or}} [[Ciprofloxacin]] 750mg PO bid for ≥4wks
+::::* Preferred treatment (2): [[Ciprofloxacin]] 500 mg PO bid
-:::*'''7.Arthritis'''
-::::*Preferred regimen : [[Ceftriaxone]] 2g IV q24h {{or}} [[Cefotaxime]] 2g IVq 6-8h for 6weeks.
+::::* Preferred treatment (3): [[Ceftriaxone]] 2 g IV q24h for ≥ 14 days.
-:::*'''8.Endocarditis'''
+::* 2. '''Typhoid fever'''
-::::*Preferred regimen : [[Ceftriaxone]] 2g IV q24h {{or}} [[Cefotaxime]] 2g IV q6-8h for 6weeks.
+:::* Preferred regimen: [[Ceftriaxone]] 1-2 g IV q24h {{then}} ([[Cefixime]] 400 mg PO for 10-14 days {{or}} [[Ciprofloxacin]] 400 mg IV q12h {{or}} 500 mg PO bid)
-:::*'''9.UTI'''
+::* 3. '''Non-typhoid (serious infection)'''
-::::*Preferred regimen : [[Ceftriaxone]], [[Cefotaxime]] {{or}} [[Ciprofloxacin]] IV for 1-2weeks, then [[Ciprofloxacin|oral Ciprofloxacin]] {{or}} [[TMP-SMX]] for 6weeks
+:::* Preferred regimen (1): [[Cephalosporin|3rd generation Cephalosporin]] (Ceftriaxone/Cefotaxime)
-:::*'''10.HIV and salmonellosis'''
-::::*Preferred regimen : IV [[Cephalosporin]] {{or}} IV [[Fluoroquinolone]], then oral Flouroquinolones([[Ciprofloxacin]] 500-750mg PO bid for 4weeks).
+:::* Preferred regimen (2): [[Fluoroquinolone]]([[Ciprofloxacin]], [[Levofloxacin]])
-::::*Note : If relapse occurs within 6weeks give life-long abx or until immune recovery post-ART
+::* 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
+::* 5. '''Vascular prosthesis infection'''
+:::* Preferred regimen (1): [[Ceftriaxone]]
+:::* Preferred regimen (2): [[Cefotaxime]]
+:::* Preferred regimen (3): [[Ciprofloxacin]] 400 mg IV q12h for 6 weeks
+::* 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
+::* 7. '''Arthritis'''
+:::* Preferred regimen (1): [[Ceftriaxone]] 2 g IV q24h
+:::* Preferred regimen (2): [[Cefotaxime]] 2 g IV q6-8h for 6 weeks.
+::* 8.'''Endocarditis'''
+:::* Preferred regimen (1): [[Ceftriaxone]] 2 g IV q24h
+:::* Preferred regimen (2): [[Cefotaxime]] 2 g IV q6-8h for 6 weeks.
+::* 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)
+::* 10. '''HIV and salmonellosis'''
+:::*Preferred regimen: (IV [[Cephalosporin]] {{or}} IV [[Fluoroquinolone]]) {{then}} oral flouroquinolones ([[Ciprofloxacin]] 500-750 mg PO bid for 4weeks).
+:::*Note: If relapse occurs within 6weeks give life-long abx or until immune recovery post-ART
 :::*'''11.Carrier state''' : [[Ciprofloxacin]] 500mg PO bid for 4-6weeks {{or}} [[TMP-SMX]] 1DS bid PO for 6weeks{{or}} [[Amoxicillin]] 500mg PO for 6weeks.
 {{PBI|Serratia marcescens}}

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Revision as of 05:36, 20 July 2015

Bacteria – Gram-Negative Bacilli

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