Sandbox Maliha
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Treatment
===Overview===Empiric antimicrobial therapy for Mycotic Aneurysm include intravenous Vancomycin and either Ceftriaxone, Piperacillin-Tazobactam or Ciprofloxacin for 6 weeks. Alternative regimens include [[Cefepime[[, Imipenem-Cilastatin, Meropenem, or Ertapenem for Gram-negative bacteria.
Antimicrobial Regimen
- Empiric antimicrobial therapy[1]
- Preferred regimen: Vancomycin 2 g/day IV divided q6-12h targeting trough concentration of 15-20 μg/mL for 6 weeks (for critically ill patient, start with a loading dose of 25 mg/kg followed by 15 mg/kg q12h) AND (Ceftriaxone 2 g IV q24h for 6 weeks OR Piperacillin-Tazobactam 3.375 g IV q6h for 6 weeks OR Ciprofloxacin 400 mg IV q12h for 6 weeks)
- Alternative regimen: Consider substituting Daptomycin for Vancomycin. Consider Cefepime, Imipenem-Cilastatin, Meropenem, or Ertapenem for Gram-negative bacteria.
The treatment for chronic fibrosing mediastinitis is somewhat controversial, and may include either steroids or surgical decompression of the affected vessels.
- ↑ Gilbert, David (2014). The Sanford guide to antimicrobial therapy 2014. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808782.