Sandbox aparna
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
-
- 1. UTI[9]
- Preferred regimen: Ciprofloxacin 250 mg PO bid
- Enterobacter cloacae
Return to Top
-
- 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
- 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
-
- 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[20]
Return to Top
- 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
- 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
- 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.