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:::* Preferred regimen (7): [[Pentamidine]] {{and}} [[Itraconazole]] {{and}} [[Flucytosine]] {{and}} [[Levofloxacin]] {{and}} [[Amphotericin B]] {{and}} [[Rifampin]]
:::* Preferred regimen (7): [[Pentamidine]] {{and}} [[Itraconazole]] {{and}} [[Flucytosine]] {{and}} [[Levofloxacin]] {{and}} [[Amphotericin B]] {{and}} [[Rifampin]]
:::* Preferred regimen (8): [[Pentamidine]] {{and}} [[Fluconazole]] {{and}} [[Miltefosine]]
:::* Preferred regimen (8): [[Pentamidine]] {{and}} [[Fluconazole]] {{and}} [[Miltefosine]]
:::* Note: The mainstay of successful treatment includes early diagnosis and combination therapy with pentamidine, azole, sulfonamide, and possibly miltefosine or flucytosine.
:::* Note: The mainstay of successful treatment includes early diagnosis and combination therapy with pentamidine, azole, sulfonamide, miltefosine, and possibly flucytosine.
::* 2. '''Cutaneous acanthamoebiasis'''<ref>{{Cite journal| issn = 0893-8512| volume = 16| issue = 2| pages = 273–307| last1 = Marciano-Cabral| first1 = Francine| last2 = Cabral| first2 = Guy| title = Acanthamoeba spp. as agents of disease in humans| journal = Clinical Microbiology Reviews| date = 2003-04| pmid = 12692099| pmc = PMC153146}}</ref><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><ref>{{Cite journal| doi = 10.1111/j.1574-695X.2007.00232.x| issn = 0928-8244| volume = 50| issue = 1| pages = 1–26| last1 = Visvesvara| first1 = Govinda S.| last2 = Moura| first2 = Hercules| last3 = Schuster| first3 = Frederick L.| title = Pathogenic and opportunistic free-living amoebae: Acanthamoeba spp., Balamuthia mandrillaris, Naegleria fowleri, and Sappinia diploidea| journal = FEMS immunology and medical microbiology| date = 2007-06| pmid = 17428307}}</ref>
::* 2. '''Cutaneous acanthamoebiasis'''<ref>{{Cite journal| issn = 0893-8512| volume = 16| issue = 2| pages = 273–307| last1 = Marciano-Cabral| first1 = Francine| last2 = Cabral| first2 = Guy| title = Acanthamoeba spp. as agents of disease in humans| journal = Clinical Microbiology Reviews| date = 2003-04| pmid = 12692099| pmc = PMC153146}}</ref><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><ref>{{Cite journal| doi = 10.1111/j.1574-695X.2007.00232.x| issn = 0928-8244| volume = 50| issue = 1| pages = 1–26| last1 = Visvesvara| first1 = Govinda S.| last2 = Moura| first2 = Hercules| last3 = Schuster| first3 = Frederick L.| title = Pathogenic and opportunistic free-living amoebae: Acanthamoeba spp., Balamuthia mandrillaris, Naegleria fowleri, and Sappinia diploidea| journal = FEMS immunology and medical microbiology| date = 2007-06| pmid = 17428307}}</ref>
:::* Preferred regimen: [[Pentamidine]] {{and}} [[Sulfadiazine]] {{and}} [[Flucytosine]] {{and}} ([[Itraconazole]] {{or}} [[Fluconazole]]) {{and}} [[Chlorhexidine]] topical {{and}} [[Ketoconazole]] topical
:::* Preferred regimen: [[Pentamidine]] {{and}} [[Sulfadiazine]] {{and}} [[Flucytosine]] {{and}} ([[Itraconazole]] {{or}} [[Fluconazole]]) {{and}} [[Chlorhexidine]] topical {{and}} [[Ketoconazole]] topical
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{{PBI|Balamuthia mandrillaris}}
{{PBI|Balamuthia mandrillaris}}
:* Balamuthia mandrillaris
:* Balamuthia mandrillaris
 
::* Preferred regimen: [[Pentamidine]] {{and}} [[Albendazole]] {{and}} ([[Itraconazole]] {{or}} [[Fluconazole]]) {{and}} [[Miltefosine]]
 
 


==References==
==References==
{{reflist}}
{{reflist}}

Revision as of 23:50, 22 July 2015

  • 1. Empiric antimicrobial therapy pending in vitro susceptibility
  • 1.1 Non–life-threatening infections or MDR-GNB prevalence < 20%
  • 1.2 Life-threatening infections or MDR-GNB prevalence > 20%
  • 2. In vitro susceptibility available
  • 2.1 Susceptible to all tested agents
  • 2.2 Extended spectrum beta-lactamase (ESBL)-producing Enterobacter spp.
  • Preferred regimen: Meropenem 0.5–1 g IV q8h
  • Alternative regimen (1): Imipenem 500 mg IV q6h
  • Alternative regimen (2): Doripenem 500 mg IV q8h
  • Alternative regimen (3): Ertapenem 1 g IV q24h
  • Alternative regimen (4): Cefepime 2 g IV q8h (if MIC ≤ 1 μg/mL)
  • 2.3 Resistant to all tested agents

  • Acanthamoeba species
  • 1. Granulomatous amoebic encephalitis, meningitis, and disseminated Acanthamoeba disease[6][7]
  • 3. Acanthamoeba keratitis[11]
  • Preferred regimen: (Polyhexamethylene biguanide topical OR Chlorhexidine topical) ± (Propamidine topical OR Hexamidine topical)
  • Note (1): Azole antifungal drugs (Ketoconazole, Itraconazole, Voriconazole) may be considered as oral or topical adjuncts.
  • Note (2): The duration of therapy for Acanthamoeba keratitis may last six months to a year.
  • Note (3): Pain control can be helped by topical cyclopegic solutions and oral nonsteroidal medications.
  • Note (4): The use of corticosteroids to control inflammation is controversial.
  • Note (5): Penetrating keratoplasty may help restore visual acuity.

  • Balamuthia mandrillaris

References

  1. Sanders, W. E.; Sanders, C. C. (1997-04). "Enterobacter spp.: pathogens poised to flourish at the turn of the century". Clinical Microbiology Reviews. 10 (2): 220–241. ISSN 0893-8512. PMC 172917. PMID 9105752. Check date values in: |date= (help)
  2. Jacoby, George A. (2009-01). "AmpC beta-lactamases". Clinical Microbiology Reviews. 22 (1): 161–182. doi:10.1128/CMR.00036-08. ISSN 1098-6618. PMC 2620637. PMID 19136439. Check date values in: |date= (help)
  3. Paterson, David L.; Bonomo, Robert A. (2005-10). "Extended-spectrum beta-lactamases: a clinical update". Clinical Microbiology Reviews. 18 (4): 657–686. doi:10.1128/CMR.18.4.657-686.2005. ISSN 0893-8512. PMC 1265908. PMID 16223952. Check date values in: |date= (help)
  4. Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
  5. Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
  6. Visvesvara, Govinda S.; Moura, Hercules; Schuster, Frederick L. (2007-06). "Pathogenic and opportunistic free-living amoebae: Acanthamoeba spp., Balamuthia mandrillaris, Naegleria fowleri, and Sappinia diploidea". FEMS immunology and medical microbiology. 50 (1): 1–26. doi:10.1111/j.1574-695X.2007.00232.x. ISSN 0928-8244. PMID 17428307. Check date values in: |date= (help)
  7. Bennett, John (2015). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Elsevier/Saunders. ISBN 978-1455748013.
  8. Marciano-Cabral, Francine; Cabral, Guy (2003-04). "Acanthamoeba spp. as agents of disease in humans". Clinical Microbiology Reviews. 16 (2): 273–307. ISSN 0893-8512. PMC 153146. PMID 12692099. Check date values in: |date= (help)
  9. Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
  10. Visvesvara, Govinda S.; Moura, Hercules; Schuster, Frederick L. (2007-06). "Pathogenic and opportunistic free-living amoebae: Acanthamoeba spp., Balamuthia mandrillaris, Naegleria fowleri, and Sappinia diploidea". FEMS immunology and medical microbiology. 50 (1): 1–26. doi:10.1111/j.1574-695X.2007.00232.x. ISSN 0928-8244. PMID 17428307. Check date values in: |date= (help)
  11. "Acanthamoeba Keratitis Fact Sheet (CDC)".