Sandbox/v43

Pathogen-Based Therapy Adapted from Lancet. 2012;380(9854):1693-702. and Clin Infect Dis. 2004;39(9):1267-84.

Bacteria   ▸  Acinetobacter baumannii   ▸  Enterobacteriaceae   ▸  Haemophilus influenzae   ▸  Listeria monocytogenes   ▸  Neisseria meningitidis   ▸  Pseudomonas aeruginosa   ▸  Staphylococcus aureus   ▸  Staphylococcus epidermidis   ▸  Streptococcus agalactiae   ▸  Streptococcus pneumoniae

Acinetobacter baumannii Preferred Regimen ▸ Meropenem 2 g IV q8h Alternative Regimen ▸ Colistin 1.25 mg/kg IV q6—12h OR ▸ Polymyxin B 0.75—1.25 mg/kg IV q12h Enterobacteriaceae Preferred Regimen ▸ Cefotaxime 2 g IV q4—6h OR ▸ Ceftriaxone 2 g IV q12h Alternative Regimen ▸ Aztreonam 2 g IV q6—8h OR ▸ Moxifloxacin 400 mg IV q24h OR ▸ TMP/SMZ 5 mg/kg IV q6—12h (TMP component) OR ▸ Meropenem 2 g IV q8h OR ▸ Ampicillin 2 g IV q4h H. influenzae, β-lactamase Negative Preferred Regimen ▸ Ampicillin 2 g IV q4h Alternative Regimen ▸ Cefotaxime 2 g IV q4—6h OR ▸ Ceftriaxone 2 g IV q12h OR ▸ Cefepime 2 g IV q8h OR ▸ Chloramphenicol 1—1.5 g IV q6h OR ▸ Aztreonam 2 g IV q6—8h OR ▸ Moxifloxacin 400 mg IV q24h H. influenzae, β-lactamase Positive Preferred Regimen ▸ Cefotaxime 2 g IV q4—6h OR ▸ Ceftriaxone 2 g IV q12h Alternative Regimen ▸ Cefepime 2 g IV q8h OR ▸ Chloramphenicol 1—1.5 g IV q6h OR ▸ Aztreonam 2 g IV q6—8h OR ▸ Moxifloxacin 400 mg IV q24h H. influenzae, β-lactamase Negative, Ampicillin Resistant Preferred Regimen ▸ Meropenem 2 g IV q8h Alternative Regimen ▸ Moxifloxacin 400 mg IV q24h Listeria monocytogenes Preferred Regimen ▸ Ampicillin 2 g IV q4h OR ▸ Penicillin G 4 MU IV q4h PLUS ▸ Gentamicin 1.7 mg/kg IV q8h Alternative Regimen ▸ TMP/SMZ 5 mg/kg IV q6—12h (TMP component) N. meningitidis, Penicillin MIC <0.1 μg/mL Preferred Regimen ▸ Penicillin G 4 MU IV q4h OR ▸ Ampicillin 2 g IV q4h Alternative Regimen ▸ Cefotaxime 2 g IV q4—6h OR ▸ Ceftriaxone 2 g IV q12h OR ▸ Chloramphenicol 1—1.5 g IV q6h N. meningitidis, Penicillin MIC ≥0.1 μg/mL Preferred Regimen ▸ Cefotaxime 2 g IV q4—6h OR ▸ Ceftriaxone 2 g IV q12h Alternative Regimen ▸ Cefepime 2 g IV q8h OR ▸ Chloramphenicol 1—1.5 g IV q6h OR ▸ Moxifloxacin 400 mg IV q24h OR ▸ Meropenem 2 g IV q8h Pseudomonas aeruginosa Preferred Regimen ▸ Ceftazidime 2 g IV q8h OR ▸ Cefepime 2 g IV q8h PLUS ▸ Gentamicin 1.7 mg/kg IV q8h Alternative Regimen ▸ Aztreonam 2 g IV q6—8h OR ▸ Meropenem 2 g IV q8h OR ▸ Ciprofloxacin 400 mg IV q8—12h PLUS ▸ Gentamicin 1.7 mg/kg IV q8h Staphylococcus aureus, Methicillin sensitive Preferred Regimen ▸ Nafcillin 1.5—2 g IV q4h OR ▸ Oxacillin 1.5—2 g IV q4h Alternative Regimen ▸ Vancomycin 15 mg/kg IV q6h (trough 15—20 μg/mL) OR ▸ Linezolid 600 mg IV q12h OR ▸ Daptomycin 6 mg/kg IV q24h Staphylococcus aureus, Methicillin resistant Preferred Regimen ▸ Vancomycin 15 mg/kg IV q6h (trough 15—20 μg/mL) PLUS ▸ Rifampin 600 mg IV q24h Alternative Regimen ▸ TMP/SMZ 5 mg/kg IV q6—12h (TMP component) OR ▸ Linezolid 600 mg IV q12h OR ▸ Daptomycin 6 mg/kg IV q24h PLUS ▸ Rifampin 600 mg IV q24h Staphylococcus epidermidis Preferred Regimen ▸ Vancomycin 15 mg/kg IV q6h (trough 15—20 μg/mL) PLUS ▸ Rifampin 600 mg IV q24h Alternative Regimen ▸ Linezolid 600 mg IV q12h PLUS ▸ Rifampin 600 mg IV q24h Streptococcus agalactiae Preferred Regimen ▸ Ampicillin 2 g IV q4h OR ▸ Penicillin G 4 MU IV q4h PLUS ▸ Gentamicin 1.7 mg/kg IV q8h Alternative Regimen ▸ Cefotaxime 2 g IV q4—6h OR ▸ Ceftriaxone 2 g IV q12h OR ▸ Vancomycin 15 mg/kg IV q6h (trough 15—20 μg/mL) S. pneumoniae, Penicillin MIC ≤0.06 μg/mL Preferred Regimen ▸ Penicillin G 4 MU IV q4h OR ▸ Ampicillin 2 g IV q4h Alternative Regimen ▸ Cefotaxime 2 g IV q4—6h OR ▸ Ceftriaxone 2 g IV q12h OR ▸ Chloramphenicol 1—1.5 g IV q6h S. pneumoniae, Penicillin MIC ≥0.12 μg/mL, Cefotaxime/Ceftriaxone MIC <1.0 μg/mL Preferred Regimen ▸ Cefotaxime 2 g IV q4—6h OR ▸ Ceftriaxone 2 g IV q12h Alternative Regimen ▸ Cefepime 2 g IV q8h OR ▸ Meropenem 2 g IV q8h S. pneumoniae, Penicillin MIC ≥0.12 μg/mL, Cefotaxime/Ceftriaxone MIC ≥1.0 μg/mL Preferred Regimen ▸ Vancomycin 15 mg/kg IV q6h (trough 15—20 μg/mL) PLUS ▸ Cefotaxime 2 g IV q4—6h OR ▸ Ceftriaxone 2 g IV q12h PLUS ▸ Rifampin 600 mg IV q24h Alternative Regimen ▸ Vancomycin 15 mg/kg IV q6h (trough 15—20 μg/mL) PLUS ▸ Moxifloxacin 400 mg IV q24h