Sandbox aparna

Jump to navigation Jump to search

Bacteria – Gram-Negative Bacilli

  • Acinetobacter baumannii[1]
  • Preferred regimen (1): Imipenem 0.5-1 g IV q6h
  • Preferred regimen (2): Ampicillin/sulbactam 3 g IV 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 single doses THEN 50 mg IV q12h
  • Preferred regimen (6): Amikacin 7.5 mg/kg IV q12h or 15 mg/kg IV q24h
  • Preferred regimen (7) (pan-resistant isolates): (Colistin 5 mg/kg/day IV q12h ± Imipenem)
  • Preferred regimen (8) (pan-resistant isolates): Ampicillin/sulbactam
  • 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 q6-8h or 2 DS PO bid


  • Aeromonas hydrophila [2]
  • 1. Diarrhea
  • Preferred regimen (if not self-limiting, or if severe): Ciprofloxacin 500 mg PO bid.
  • Alternate regimen: TMP-SMX 1DS PO bid
  • Note: High resistance to sulfa agents described in Taiwan and Spain
  • 2. Skin and soft tissue infection
  • 2.1 Mild infection
  • 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
  • Note(2): 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.


  • Bordetella pertussis[3]
  • 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 PO 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 q24h AND SMX 40 mg/kg/day PO 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
  • 2. Post exposure prophylaxis[4]
  • Preferred regimen: The antibiotic regimens for post exposure prophylaxis are similar to the regimens used for the treatment of pertussis
  • Note (1): Post exposure prophylaxis to an asymptomatic contacts within 21 days of onset of cough in the index patient can potentially prevent symptomatic infection
  • Note (2): Close contacts include persons who have direct contact with respiratory, oral or nasal secretions from a symptomatic patient (eg: cough, sneeze, sharing food, eating utensils, mouth to mouth resuscitation, or performing a medical examination of the mouth, nose, throat.
  • Note (3): Some close contacts are at high risk for acquiring severe disease following exposure to pertussis. These contacts include infants aged < 1 year , persons with some immunodeficiency conditions, or other underlying medical conditions such as chronic lung disease, respiratory insufficiency and cystic fibrosis.
  • Burkholderia cepacia complex[5]
  • Burkholderia pseudomallei
  • 1. Melioidosis[6]
  • 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 1 g q8h
  • Preferred regimen (3): Imipenem 25 mg/kg upto 1 g q6h
  • 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 fetus[7]
  • 1. Serious infections
  • 2. Endovascular infections
  • 3. CNS
  • Capnocytophaga canimorsus[8]
  • 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
  • Alternative regimen (3) (complicated infections or immunocompromise): 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
  • 2. Mild cellulitis/dog or cat bites
  • 3. Meningitis or brain abscess
  • 4. 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[9]
  • 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 IV q6h
  • 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
  • Note: Usually carbenicillin sensitive, cephalothin resistant
  • Citrobacter koseri[10]
  • 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
  • Enterobacter species[11]
  • 1. Severe infections
  • Preferred regimen (1): Piperacillin-tazobactam 3.375-4.5 g IV q6h AND (Aminoglycoside (gentamicin,tobramycin or amikacin) OR Fluoroquinolone,e.g.,ciprofloxacin 400 mg IV q8-12hrs
  • Preferred regimen (2) (for coverage of ESBLs): Imipenem 500 mg IV q6h
  • Preferred regimen (3) (for coverage of ESBLs): Meropenem 500-1000 mg IV q8h
  • Preferred regimen (4) (for coverage of ESBLs): Doripenem 500 mg IV q8h
  • Preferred regimen (5) : Cefepime 2 g IV q8h
  • 2. UTI without systemic symptoms
  • Preferred regimen: Ciprofloxacin 250 mg PO bid OR agent based upon susceptibility profile
  • Enterobacter cloacae[12]
  • Escherichia coli[13]
  • 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
  • 3.2 Acute pyelonephritis (Hospitalized)
  • 4. Traveler’s diarrhea
  • Preferred regimen (1): Ciprofloxacin 750 mg PO qd 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
  • 6. Bacteremia/pneumonia

  • Francisella tularensis[15]
  • 1. Tularemia
  • Preferred regimen (2): Gentamicin 5 mg/kg IV q24h for 10 days
  • Preferred regimen (3) (pregnancy): Gentamicin 5 mg/kg IV q24h for 10 days
  • Alternative regimen (1): Doxycycline 100 mg IV bid
  • Alternative regimen (3): Ciprofloxacin 400 mg IV bid until stable THEN PO for 14-21 days (total)
  • Helicobacter pylori[16]
  • 1. Peptic ulcer disease
  • 1.1 Regimens for Initial Treatment
  • 1.1.1 Triple therapy
  • 1.1.2 Quadruple therapy
  • 1.1.3 Sequential therapy
  • 1.2 Second-Line Therapies
  • 1.2.1 Triple therapy
  • 1.2.2 Quadruple therapy
  • 1.2.3 Levofloxacin triple therapy
  • 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 (formly known as Calymmatobacterium granulomatis)
  • 1. Granuloma inguinale (donovanosis)[17]
  • 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[18]
  • 1. Severe, nosocomial infections
  • 1.1 Non-ESBLs in pneumonia, sepsis, complicated UTI, or intra-abdominal infections
  • 1.2 ESBLs in pneumonia, sepsis, complicated UTI, or intra-abdominal infections
  • Preferred regimen (1): Imipenem 500 mg IV q6h
  • Preferred regimen (2): Meropenem 1 g IV q8h
  • Preferred regimen (3): Ertapenem 1 g IV q24h
  • Preferred regimen (4): Doripenem 500 mg IV q8h
  • Note: In ESBLs, inconsistent activity is seen with aminoglycosides, fluoroquinolones, and piperacillin-tazobactam. Avoid cephalosporins.

  • 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 course 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.[22]

  • Legionella pneumophila[23]
  • 1. Pneumonia
  • 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 AND any other agents listed
  • Alternative regimen (1): Erythromycin 1 g IV q6h and THEN 500 mg PO q6h for 7-10 days (total)
  • Alternative regimen (2): Ciprofloxacin 400 mg IV q12h THEN 750 mg PO bid 7-10 days (total)
  • 2. Pontiac fever
  • Preferred regimen: no antibiotic treatment, usually self limited, and usually only diagnosed by delayed serologic testing
  • 3. Endocarditis
  • Preferred regimen: (Fluoroquinolones, Levofloxacin 750 mg PO/IV qd for 7-10 days OR Moxifloxacin 400 mg PO/IV qd for 7-10 days) AND Rifampin 300 mg PO bid for 4-6 weeks
Moraxella catarrhalis[24]
  • Morganella morganii[25]
  • Preferred regimen (1): Imipenem 500 mg IV q6h
  • Preferred regimen (2): Meropenem 1.0 g IV q8h (adjust dose if necessary for renal function).
  • 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[26]
  • 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 (3): TMP-SMX DS PO bid for 3 days
  • Alternative regimen (4): Ceftriaxone 1-2 g IV qd in severe cases
  • 2. Immunocompromised hosts
  • Alternative regimen (3): TMP-SMX DS PO bid for 3 days if susceptible
  • Proteus mirabilis[27]
  • 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: Duration of treatment for uncomplicated UTI 3 days, pyelonephritis 7-14 days, complicated UTI 10-21 days and bacteremia is 7-14 days
  • Indole positive Proteus species[28]
  • 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 (2 weeks), shorter than chronic prostatitis (4-6 weeks)
  • Alternative regimen: TMP-SMX DS PO q12h for 10-14 days or TMP 5-10 mg/kg/day IV q6h.
  • Pseudomonas aeruginosa[30]
  • 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 750 mg 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 5-7 mg/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

  • 1. Salmonellosis in immunocompetent hosts[31]
  • 1.1 Gastroenteritis
  • Antimicrobial therapy is usually not recommended for uncomplicated diarrheal illness.
  • 1.1.1 Indications for antimicrobial therapy
  • severedisease,
  • Age > 50 yrs
  • Prosthesis
  • Presence of valvular heart disease
  • Severe atherosclerosis
  • Cancer
  • Uremia
  • Immunosuppression
  • 1.1.2 Treatment regimens
  • Preferred regimen (1): TMP-SMX DS PO bid for 5-7 days
  • Preferred regimen (2): Ciprofloxacin 500 mg PO bid for 5-7 days
  • Preferred regimen (3): Ceftriaxone 2 g IV q24h for 5-7 days
  • 1.2 Typhoid fever[32]
  • 1.2.1 Uncomplicated typhoid
  • Preferred regimen (1) (fully susceptible): Fluoroquinolone (e.g., Ofloxacin 15 mg/kg PO qd for 5–7 days)
  • Preferred regimen (2) (multi drug-resistant): Fluoroquinolone (Ofloxacin 15 mg/kg PO qd for 5–7 days)
  • Preferred regimen (3) (quinolone-resistant): Azithromycin 8–10 mg/kg PO qd for 7 days
  • Preferred regimen (4) (quinolone-resistant): Fluoroquinolone 20 mg/kg PO qd for 10-14 days
  • Alternative regimen (1) (fully susceptible): Chloramphenicol 50–75 mg/kg PO qd for 14-21 days
  • Alternative regimen (2) (fully susceptible): Amoxicillin 75–100 mg/kg PO qd for 14 days
  • Alternative regimen (3) (fully susceptible): Trimethoprim–Sulfamethoxazole, 8 mg/kg (trimethoprim)– 40 mg/kg (sulfamethoxazole) PO qd for 14 days
  • Alternative regimen (4) (multi drug-resistant): Azithromycin 8–10 mg/kg PO for 7 days
  • Alternative regimen (5) (multi drug-resistant): Third-generation cephalosporin, e.g., cefixime 20 mg/kg PO qd for 7-14 days
  • Alternative regimen (6) (quinolone-resistant): Third-generation cephalosporin, e.g., cefixime 20 mg/kg PO qd for 7-14 days
  • 1.2.2 Severe typhoid
  • Preferred regimen (1) (fully susceptible): Fluoroquinolone (e.g., Ofloxacin 15 mg/kg IV qd for 10-14 days)
  • Preferred regimen (2) (multi drug-resistant): Fluoroquinolone (Ofloxacin 15 mg/kg IV qd for 10-14 days)
  • Preferred regimen (3) (quinolone-resistant): Ceftriaxone 60 mg/kg IV qd for 10-14 days
  • Preferred regimen (4) (quinolone-resistant): Cefotaxime 80 mg/kg IV qd for 10-14 days
  • Alternative regimen (1) (fully susceptible): Chloramphenicol 100 mg/kg PO qd for 14-21 days
  • Alternative regimen (2) (fully susceptible): Ampicillin 100 mg/kg PO qd for 14-21 days
  • Alternative regimen (3) (fully susceptible): Trimethoprim–Sulfamethoxazole, 8 mg/kg (trimethoprim)– 40 mg/kg (sulfamethoxazole) IV qd for 10-14 days
  • Alternative regimen (4) (multi drug-resistant): Ceftriaxone 60 mg/kg IV qd for 10-14 days
  • Alternative regimen (5) (multi drug-resistant): Cefotaxime 80 mg/kg IV qd for 10-14 days
  • Alternative regimen (6) (quinolone-resistant): Fluoroquinolone 20 mg/kg IV qd for 10-14 days
  • 1.3 Non-typhoid (serious infection)
  • 1.4 Bacteremia
  • 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
  • 1.5 Vascular prosthesis infection
  • 1.6 Osteomyelitis
  • Preferred regimen (3): Ciprofloxacin 750 mg PO bid for ≥ 4 weeks
  • 1.7 Arthritis
  • Preferred regimen (2): Cefotaxime 2 g IV q6-8h for 6 weeks
  • 1.8 Endocarditis
  • Preferred regimen (2): Cefotaxime 2 g IV q6-8h for 6 weeks
  • 1.9 UTI
  • 1.10 Carrier state
  • Preferred regimen (1): Ciprofloxacin 500 mg PO bid for 4-6 weeks
  • Preferred regimen (2): TMP-SMX 1DS bid PO for 6 weeks
  • Preferred regimen (3): Amoxicillin 500 mg PO for 6 weeks
  • 2. Salmonellosis in immunocompromised hosts
  • 2.1 HIV and salmonellosis[33]
  • 2.1.1 Gastroenteritis
  • Preferred regimen: Ciprofloxacin 500-750 mg PO bid or 400 mg IV q12h, if susceptible
  • Alternative regimen (1): Levofloxacin 750 mg PO/IV q24h
  • Alternative regimen (2): Moxifloxacin 400 mg PO/IV q24h
  • Alternative regimen (3): TMP 160 mg AND SMX 800 mg PO/IV q12h
  • Alternative regimen (4): Ceftriaxone 1 g IV q24h
  • Alternative regimen (5): Cefotaxime 1 g IV q8h
  • Duration of treatment for gastroenteritis without bacteremia
  • If CD4 count ≥ 200 cells/μL: Duration of treatment is 7–14 days
  • If CD4 count < 200 cells/μL: Duration of treatment is 2–6 weeks
  • Duration of treatment for gastroenteritis with bacteremia
  • If CD4 count ≥ 200/μL: Duration of treatment is 14 days; longer duration if bacteremia persists or if the infection is complicated (e.g., if metastatic foci of infection are present)
  • If CD4 count < 200 cells/μL: Duration of treatment is 2–6 weeks
  • Note (1): Secondary prophylaxis should be considered for
  • Patients with recurrent Salmonella gastroenteritis with or without bacteremia
  • Patients with CD4 < 200 cells/μL with severe diarrhea


  • Serratia marcescens[34]
  • 1. Bacteremia, pneumonia or serious infections
  • 2. Endocarditis
  • Note: Choice dictated by sensitivities. 4 to 6 week duration of parenteral therapy.
  • 3. Osteomyelitis
  • Note (1): Choice dictated by sensitivity profile. Treat for 6-12 weeks depending upon response.
  • Note (2): Use IV treatment until stable/clinically improved (10-14 days Minimum) then may convert to PO therapy if appropriate
  • 4. UTI
  • Preferred regimen (1): Ciprofloxacin 250 mg PO bid or 400 mg IV q12h
  • Preferred regimen (2): Levofloxacin 250 mg PO qd or 500 mg 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.
  • 1.1 Pediatrics
  • Preferred regimen (1): Ciprofloxacin 15 mg/kg PO bid for 3 days
  • Alternative regimen (1): Pivmecillinam 20 mg/kg PO qid for 5 days
  • Alternative regimen (2): Ceftriaxone 50-100 mg/kg IM qd for 2 to 5 days
  • Alternative regimen (3): Azithromycin 6-20 mg/kg PO qd for 1 to 5 days
  • 1.2 Adults
  • Preferred regimen (1): Ciprofloxacin 500 mg PO bid for 3 days
  • Alternative regimen (1): Pivmecillinam 100 mg PO qid for 5 days
  • Alternative regimen (2): Azithromycin 1-1.5 g PO qd for 1 to 5 days
  • Stenotrophomonas maltophilia[36]
  • Preferred treatment: TMP-SMX 15-20 mg/kg/day (TMP component) IV/PO q8h
  • Alternative treatment (1): Ceftazidime 2 g IV q8h
  • Alternative treatment (3): Tigecycline 100 mg IV single dose THEN 50 mg IV q12h
  • Alternative treatment (4): Ciprofloxacin 500-750 mg PO/400 mg IV q12h
  • Alternative treatment (5): Moxifloxacin 400 mg PO/IV
  • Alternative treatment (6): Levofloxacin 750 mg PO/IV
  • Alternative treatment (7) (multiply-resistance): Colistin 2.5 mg/kg IV q12h
  • Note: Treatment duration uncertain, but usually ≥ 14 days

References

  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. "Recommended Antimicrobial Agents for the Treatment and Postexposure Prophylaxis of Pertussis 2005 CDC Guidelines".
  4. "Recommended Antimicrobial Agents for the Treatment and Post exposure Prophylaxis of Pertussis 2005 CDC Guidelines".
  5. Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
  6. Wiersinga WJ, Currie BJ, Peacock SJ (2012). "Melioidosis". N. Engl. J. Med. 367 (11): 1035–44. doi:10.1056/NEJMra1204699. PMID 22970946.
  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.
  13. Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
  14. Tunkel AR, Hartman BJ, Kaplan SL, Kaufman BA, Roos KL, Scheld WM et al. (2004) Practice guidelines for the management of bacterial meningitis. Clin Infect Dis 39 (9):1267-84. DOI:10.1086/425368 PMID: [1]
  15. Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
  16. Lua error: expandTemplate: template "citation error" does not exist.
  17. 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.
  18. Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
  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. 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.
  21. 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)
  22. 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)
  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.
  31. Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
  32. "TYPHOID FEVER".
  33. "Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents" (PDF).
  34. Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
  35. "Guidelines for the control of shigellosis, including epidemics due to Shigella dysenteriae type 1" (PDF).
  36. Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.