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Pathogens of Clinical Relevance

Bacteria – Gram-Positive Cocci

  • Staphylococcus aureus
  • (1) Intravascular catheter-related infections[1]
  • Methicillin susceptible Staphylococcus aureus (MSSA)
  • Neonates
  • 0–4 weeks of age and 1200 g- 50 mg/kg/day in divided doses every 12 h.
  • <=7 days and 1200–2000 g- 50 mg/kg/day in divided doses every 12 h.
  • >7 days of age and <2000g- 75 mg/kg/day in divided doses every 8 h.
  • >7 days of age and >1200 g - 100 mg/kg/day in divided doses every 6 h.
  • Neonates
  • 0–4 weeks of age and 1200 g - 50 mg/kg/day in divided doses every 12 h.
  • Postnatal age < 7 days and 1200–2000 g- 50–100 mg/kg/day in divided doses every 12 h.
  • Postnatal age < 7 days and >2000 g, 75–150 mg/kg/day in divided doses every 8 h.
  • Postnatal age >=7 days and 1200–2000 g- 75–150 mg/kg/day in divided doses every 8 h.
  • Postnatal age >=7 days and >2000 g, 100–200 mg/kg/day in divided doses every 6 h.
  • Infants and children Nafcillin 100–200 mg/kg/day in divided doses every 4–6 h.
  • Neonates
  • Postnatal age <=7 days: 40 mg/kg/day divided every 12 h.
  • Postnatal age >7 days and 2000 g: 40 mg/kg/day divided every 12 h.
  • Postnatal age >7 days and 12000 g: 60 mg/kg/day divided every 8 h.
  • Infants and children: 50 mg/kg/day divided every 8 h.
  • Neonates
  • Postnatal age <=7 days and <1200 g, 15 mg/kg/day given every 24 h.
  • Postnatal age <=7 days and 1200–2000 g, 10–15 mg/kg given every 12–18 h.
  • Postnatal age <=7 days and >2000 g, 10–15 mg/kg given every 8–12 h.
  • Postnatal age >7 days and <1200 g, 15 mg/kg/day given every 24 h.
  • Postnatal age >7 days and 1200–2000 g, 10–15 mg/kg given every 8–12 h.
  • Postnatal age >7 days and >2000 g, 15–20 mg/kg given every 8 h.
  • Infants and children: 40 mg/kg/day in divided doses every 6–8 h.
  • Methicillin resistant Staphylococcus aureus (MRSA)
  • Neonates
  • 0–4 weeks of age and birthweight <1200 g: 10 mg/kg every 8–12 h (note: use every 12 h in patients <34 weeks gestation and <1 week of age).
  • <7 days of age and birthweight >1200 g, 10 mg/kg every 8–12 h (note: use every 12 h in patients <34 weeks gestation and <1 week of age).
  • 7 days and birthweight >1200 g, 10 mg/kg every 8 h.
  • Infants and children <12 years of age: 10 mg/kg every 8 h Children 12 years of age and adolescents: 10 mg/kg every 12 h.
  • Neonates
  • Premature neonates and <1000 g, 3.5 mg/kg every 24 h; 0–4 weeks and <1200 g, 2.5 mg/kg every 18–24 h.
  • Postnatal age 7 days: 2.5 mg/kg every 12 h.
  • Postnatal age 17 days and 1200–2000 g, 2.5 mg/kg every 8–12 h.
  • Postnatal age 17 days and 12000 g, 2.5 mg/kg every 8 h.
  • Once daily dosing for premature neonates with normal renal function, 3.5–4 mg/kg every 24 h.
  • Once daily dosing for term neonates with normal renal function, 3.5–5 mg/kg every 24 h.
  • Infants and children <5 years of age: 2.5 mg/kg every 8 h; once daily dosing in patients with normal renal function, 5–7.5 mg/kg every 24 h.
  • Children >5 years of age: 2–2.5 mg/kg every 8 h; once daily dosing in patients with normal renal function, 5–7.5 mg/kg every 24 h.
  • Infants 12 months of age and children: mild-to-moderate infections, 6–12 mg TMP/kg/day in divided doses every 12 h; serious infection, 15–20 mg TMP/kg/day in divided doses every 6–8 h.
  • Methicillin-resistant Staphylococcus aureus (MRSA)
  • In adults
  • In childern
Note: Consider the addition of Rifampin 600 mg qd OR 300–450 mg bid to Vancomycin.
  • Methicillin-susceptible Staphylococcus aureus (MSSA)
  • (3) Cerebrospinal fluid shunt infection [5][6]
  • Methicillin-resistant Staphylococcus aureus (MRSA)
  • Preferred regimen: Vancomycin 30–45 mg/kg/day IV q8–12h AND/OR Rifampin 600 mg IV/PO q24h
Note: Shunt removal is recommended, and it should not be replaced until cerebrospinal fluid cultures are repeatedly negative.
  • Methicillin-susceptible Staphylococcus aureus (MSSA)
  • Penicillin-susceptible Staphylococcus aureus or Streptococcus
  • Preferred regimen: Penicillin G 4 MU IV q4h for 2–4 weeks, then PO to complete 6–8 weeks
  • Methicillin-susceptible Staphylococcus aureus or Streptococcus
  • Preferred regimen: Cefazolin 2 g IV q8h for 2–4 weeks, then PO to complete 6–8 weeks OR Nafcillin 2 g IV q4h for 2–4 weeks, then PO to complete 6–8 weeks OR Oxacillin 2 g IV q4h for 2–4 weeks, then PO to complete 6–8 weeks
  • Alternative regimen: Clindamycin 600 mg IV q6h for 2–4 weeks, then PO to complete 6–8 weeks
  • Methicillin-resistant Staphylococcus aureus (MRSA)
  • Preferred regimen: Vancomycin loading dose 25–30 mg/kg IV followed by 15–20 mg/kg IV q8–12h for 2–4 weeks, then PO to complete 6–8 weeks
  • Alternative regimen: Linezolid 600 mg PO/IV q12h for 4–6 weeks OR TMP-SMX 5 mg/kg/dose PO/IV q8–12h for 4–6 weeks
  • Pediatric dose: Vancomycin 15 mg/kg/dose IV q6h OR Linezolid 10 mg/kg/dose PO/IV q8h
Note: Consider the addition of Rifampin 600 mg qd or 300–450 mg bid to Vancomycin in adult patients.
  • (5) Bacterial meningitis
  • Methicillin susceptible Staphylococcus aureus (MSSA)
  • Methicillin resistant Staphylococcus aureus (MRSA)
Note: Consider the addition of Rifampin 600 mg qd or 300–450 mg bid to Vancomycin in adult patients.
  • (6) Septic thrombosis of cavernous or dural venous sinus[11]
  • Methicillin-resistant Staphylococcus aureus (MRSA)
  • Preferred regimen: Vancomycin 15–20 mg/kg/dose IV q8–12h for 4–6 weeks
  • Alternative regimen: Linezolid 600 mg PO/IV q12h for 4–6 weeks OR TMP-SMX 5 mg/kg/dose PO/IV q8–12h for 4–6 weeks
  • Pediatric dose: Vancomycin 15 mg/kg/dose IV q6h OR Linezolid 10 mg/kg/dose PO/IV q8h
Note (1): Surgical evaluation for incision and drainage of contiguous sites of infection or abscess is recommended whenever possible.
Note (2): Consider the addition of Rifampin 600 mg qd or 300–450 mg bid to vancomycin.
  • (7) Subdural empyema
  • Methicillin-resistant Staphylococcus aureus (MRSA)[12]
  • In adults
  • Preferred regimen: Vancomycin 30–45 mg/kg/day IV q8–12h for 4–6 weeks
  • Alternative regimen: Linezolid 600 mg PO/IV q12h for 4–6 weeks OR TMP-SMX 5 mg/kg/dose PO/IV q8–12h for 4–6 weeks
  • In childern
Note: Consider the addition of Rifampin 600 mg qd or 300–450 mg bid to vancomycin.
  • (8) Acute conjunctivitis [13]
  • Methicillin-resistant Staphylococcus aureus (MRSA)
  • (9) Appendicitis
Health Care–Associated Complicated Intra-abdominal Infection [14]
Methicillin-resistant Staphylococcus aureus (MRSA):
Preferred regimen: Vancomycin 15–20 mg/kg every 8–12 h
  • (10) Diverticulitis
Health Care–Associated Complicated Intra-abdominal Infection [14]
Methicillin-resistant Staphylococcus aureus (MRSA)
  • Preferred regimen: Vancomycin 15–20 mg/kg every 8–12 h
  • (11) Peritonitis secondary to bowel perforation, peritonitis secondary to ruptured appendix, peritonitis secondary to ruptured appendix, typhlitis
Health Care–Associated Complicated Intra-abdominal Infection [14]
  • Methicillin-resistant Staphylococcus aureus (MRSA)
  • Preferred regimen: Vancomycin 15–20 mg/kg every 8–12 h
  • (12) Cystic fibrosis [15]
  • Preferred Regimen (Adult)
  • If methicillin sensitive staphylococcus aureus: Nafcillin 2 gm IV q4hs OR Oxacillin 2 gm IV q4hs
  • If methicillin resistant staphylococcus aureus: Vancomycin 15-20 mg/kg IV q8-12h OR Linezolid 600 mg po/IV q12h
  • Preferred regimen (Pediatric)
  • If methicillin sensitive staphylococcus aureus: Nafcillin 5 mg/kg q6h (Age >28 days) OR Oxacillin 75 mg/kg q6h (Age >28 days)]]
  • If methicillin resistant staphylococcus aureus: Vancomycin 40 mg/kg divided q6-8h (Age >28 days) OR Linezolid 10 mg/kg po/IV q8h (up to age 12)
  • (13) Bronchiectasis [16]
  • (a) Preferred Regimen in adults
  • Recommended first-line treatment and length of treatment
Methicillin-susceptible Staphylococcus aureus (MSSA): Flucloxacillin 500 mg oral qds for 14 days
Methicillin-resistant Staphylococcus aureus (MRSA): Patient's body weight is <50 kg: Rifampicin 450 mg oral od AND Trimethoprim 200 mg oral bd for 14 days ; Patient's body weight is >50 kg: Rifampicin 600 mg oral od AND Trimethoprim 200 mg oral bd for 14 days
Methicillin-resistant Staphylococcus aureus (MRSA): Vancomycin 1 g IV bd (monitor serum levels and adjust dose accordingly) OR Teicoplanin 400 mg od for 14 days
  • Recommended second-line treatment and length of treatment
Methicillin-susceptible Staphylococcus aureus (MSSA): Clarithromycin 500 mg oral bd 14 days
Methicillin-resistant Staphylococcus aureus (MRSA): Patient's body weight is <50 kg: Rifampicin 450 mg oral od AND Doxycycline 200 mg oral od 14 days, Patient's body weight is >50 kg: Rifampicin 600 mg oral AND Doxycycline 200 mg oral od 14 days. Third-line: Linezolid 600 mg bd 14 days
Methicillin-resistant Staphylococcus aureus (MRSA): Linezolid 600 mg IV bd 14 days
  • (b) Preferred Regimen in children
  • Recommended first-line treatment and length of treatment
Methicillin-susceptible Staphylococcus aureus (MSSA): Flucloxacillin
Methicillin-resistant Staphylococcus aureus (MRSA): Children (< 12 yr): Trimethoprim 4-6 mg/kg/24 hr divided q 12 hr PO Children (> 12 yr) : Trimethoprim 100-200 mg q 12 hr PO. Rifampicin 450 mg oral od  : Rifampicin 600 mg oral od AND
Methicillin-resistant Staphylococcus aureus (MRSA): Vancomycin 45-60 mg/kg/24 hr divided q 8-12 hr IV OR Teicoplanin
  • Recommended second-line treatment and length of treatment
Methicillin-susceptible Staphylococcus aureus (MSSA): Clarithromycin 15 mg/kg/24 hr divided q 12 hr PO
Methicillin-resistant Staphylococcus aureus (MRSA): Rifampicin AND Doxycycline 2-5 mg/kg/24 hr divided q 12-24 hr PO or IV (max dose: 200 mg/24 hr) ; Rifampicin AND Doxycycline 2-5 mg/kg/24 hr divided q 12-24 hr PO or IV (max dose: 200 mg/24 hr) . Third-line: Linezolid 10 mg/kg q 12 hr IV or PO
Methicillin-resistant Staphylococcus aureus (MRSA): Linezolid 10 mg/kg q 12 hr IV or PO
  • (B)Long-term oral antibiotic treatment
  • (a) Preferred Regimen in adults
  • Recommended first-line treatment and length of treatment
Methicillin-susceptible Staphylococcus aureus (MSSA): Flucloxacillin 500 mg oral bd
  • Recommended second-line treatment and length of treatment
Methicillin-susceptible Staphylococcus aureus (MSSA): Clarithromycin 250 mg oral bd
  • (14) Empyema
  • (15) Community-acquired pneumonia
  • Methicillin-susceptible Staphylococcus aureus (MSSA)
  • Methicillin-resistant Staphylococcus aureus (MRSA)
  • Preferred Regimen : Vancomycin 45-60 mg/kg/day divided q8-12h (max: 2000 mg/dose) for 7-21 days OR Linezolid 600 mg PO/IV q12h for 10-14 days
  • Alternative Regimen: Trimethoprim-Sulfamethoxazole 1-2 double-strength tablets (800/160 mg) q12-24h
  • (16) Olecranon bursitis or prepatellar bursitis
  • Methicillin-susceptible Staphylococcus aureus (MSSA)
  • Methicillin-resistant Staphylococcus aureus (MRSA)
Note: Initially aspirate q24h and treat for a minimum of 2–3 weeks.
  • (17) Septic arthritis
  • In adults
  • Methicillin-resistant Staphylococcus aureus (MRSA)
  • Preferred regime: Vancomycin 15–20 mg/kg IV q8–12h
  • Alternative regimen (1): Daptomycin 6 mg/kg IV q24h in adults
  • Alternative regimen (2): Linezolid 600 mg PO/IV q12h
  • Alternative regimen (3): Clindamycin 600 mg PO/IV q8h
  • Alternative regimen (4): TMP-SMX 3.5–4.0 mg/kg PO/IV q8–12h
  • In childern
  • Methicillin-susceptible Staphylococcus aureus (MSSA)
  • (18) Septic arthritis, prosthetic joint infection (device-related osteoarticular infections)
  • Methicillin-susceptible Staphylococcus aureus (MSSA)
  • Methicillin-resistant Staphylococcus aureus (MRSA)
  • Early-onset (< 2 months after surgery) or acute hematogenous prosthetic joint infections involving a stable implant with short duration (< 3 weeks) of symptoms and debridement (but device retention)
  • Preferred regimen: Vancomycin AND Rifampin 600 mg PO qd or 300–450 mg PO bid for 2 weeks
  • Alternative regimen: (Daptomycin 6 mg/kg IV q24h OR Linezolid 600 IV q8h) AND Rifampin 600 mg PO qd or 300–450 mg PO bid for 2 weeks
Note: The above regimen should be followed by Rifampin plus a fluoroquinolone, TMP/SMX, a tetracycline or Clindamycin for 3 or 6 months for hips and knees, respectively.
  • (19) Hematogenous osteomyelitis
  • Adult (>21 yrs)
  • Methicillin-resistant Staphylococcus aureus (MRSA) possible
  • Preferred regimen: Vancomycin 1 gm IV q12h (if over 100 kg, 1.5 gm IV q12h)
  • Methicillin-resistant Staphylococcus aureus (MRSA) unlikely
  • Children (>4 mos.)-Adult
  • Methicillin-resistant Staphylococcus aureus (MRSA) possible
  • Methicillin-resistant Staphylococcus aureus (MRSA) unlikely
Note: Add Ceftazidime 50 q8h or Cefepime 150 div q8h if Gm-neg. bacilli on Gram stain
  • Newborn (<4 mos.)
  • Methicillin-resistant Staphylococcus aureus (MRSA) possible
  • Methicillin-resistant Staphylococcus aureus (MRSA) unlikely
  • Specific therapy
  • Methicillin-susceptible Staphylococcus aureus (MSSA)
  • Methicillin-resistant Staphylococcus aureus (MRSA)
  • (20) Diabetic foot osteomyelitis
  • High Risk for MRSA
  • (21) Necrotizing fasciitis[17]
  • In adult
  • In childern
  • (22) Staphylococcal toxic shock syndrome [18]
  • Methicillin sensitive Staphylococcus aureus
  • Preferred regimen: Cloxacillin 250-500 mg q6h PO (max dose: 4 g/24 hr) OR Nafcillin 4-12 g/24 hr divided q4-6hr IV (max dose: 12 g/24 hr) OR Cefazolin 0.5-2g q8h IV or IM (max dose: 12 g/24 hr), AND Clindamycin 150-600 mg q6-8h IV, IM, or PO (max dose: 5 g/24 hr IV or IM or 2 g/24 hr PO)
  • Alternative regimen (1):Clarithromycin 250-500 mg q12h PO (max dose: 1 g/24 hr) AND Clindamycin 150-600 mg q6-8h IV, IM, or PO (max dose: 5 g/24 hr IV or IM or 2 g/24 hr PO)
  • Alternative regimen (1):Rifampicin, AND Linezolid 600 mg q 12 hr IV or PO OR Daptomycin OR Tigecycline 100 mg loading dose followed by 50 mg q12h IV
  • Methicillin resistant Staphylococcus aureus
  • Glycopeptide resistant or intermediate Staphylococcus aureus
  • Preferred regimen: Linezolid 600 mg q12h IV or PO AND Clindamycin 150-600 mg q6-8h IV, IM, or PO (max dose: 5 g/24 hr IV or IM or 2 g/24 hr PO) (if sensitive)
  • Alternative regimen (1):Daptomycin OR Tigecycline 100 mg loading dose followed by 50 mg q12 IV
Note: Incidence increasing. Geographical patterns highly variable.

Prophylaxis

Antimicrobial Regimen

  • Staphylococcus aureus
  • Coronary artery bypass graft-associated acute mediastinitis[19]
  • Methicillin susceptible staphylococcus aureus (MSSA)
  • Preferred regimen: A first- or second-generation Cephalosporin is recommended for prophylaxis in patients without methicillin-resistant Staphylococcus aureus colonization.
  • Methicillin resistant staphylococcus aureus (MRSA)
  • Preferred regimen: Vancomycin alone or in combination with other antibiotics to achieve broader coverage is recommended for prophylaxis in patients with proven or suspected methicillin-resistant S. aureus colonization
Note (1): Preoperative antibiotics should be administered to all patients to reduce the risk of mediastinitis in cardiac surgery.
Note (2): The use of intranasal Mupirocin is reasonable in nasal carriers of Staphylococcus aureus.


Bacteria – Gram-Positive Bacilli

  • Erysipeloid of Rosenbach (localized cutaneous infection)[20]
  • Diffuse cutaneous infection
  • Preferred regimen: As for localized infection
Note: Assess for endocarditis
  • Bacteremia or endocarditis
  • Preferred regimen: Penicillin G benzathine 2-4 MU IV q4h for 4-6 weeks
  • Alternative regimen (1): Ceftriaxone 2 g IV q24h for 4-6 weeks
  • Alternative regimen (2): Imipenem 500 mg IV q6h for 4-6 weeks
  • Alternative regimen (3): Ciprofloxacin 400 mg IV q12h for 4-6 weeks
  • Alternative regimen (4): Daptomycin 6 mg/kg IV q24h for 4-6 weeks
Note: Recommended duration of therapy for endocarditis is 4 to 6 weeks, although shorter courses consisting of 2 weeks of intravenous therapy followed by 2 to 4 weeks of oral therapy have been successful.
  • Systemic infection[21]
  • Shoulder prosthesis infection
  • Acne vulgaris
  • Rhodococcus equi [22]
  • Preferred regimen:
  • First line: vancomycin 1 g IV q12h (15 mg/kg q12 for >70 kg) OR Imipenem 500 mg IV q6h AND Rifampin 600 mg PO once daily OR Ciprofloxacin 750 mg PO twice daily OR Erythromycin 500 mg PO four times a day for at least 4 weeks or until infiltrate disappears (at least 8 weeks in immunocompromised patients)
  • Oral/maintenance therapy (after infiltrate clears): Ciprofloxacin 750 mg PO twice daily OR Erythromycin 500 mg PO four times a day
  • Alternative regimen: Azithromycin OR TMP-SMX OR Chloramphenicol OR Clindamycin
  • NOTE: Avoid Penicillins/Cephalosporins due to development of resistance; Linezolid effective in vitro, but no clinical reports of use


Bacteria – Gram-Negative Cocci and Coccobacilli

Bacteria – Spirochetes

Bacteria – Gram-Negative Bacilli

  • Enteric flora
  • Non-fermenters

Bacteria – Atypical Organisms

  • Adult
  • Preferred regimen (1): Doxycycline 100 mg PO bid for 14-21 days
  • Preferred regimen (2): Tetracycline 250 mg PO qid for 14-21 days
  • Preferred regimen (3): Azithromycin 500 mg PO for once a day followed by 250 mg/day for 4 days
  • Preferred regimen (4): Clarithromycin 500 mg PO bid for 10 days
  • Preferred regimen (5): Levofloxacin 500 mg IV or PO qd for 7 to 14 days
  • Preferred regimen (6): Moxifloxacin 400 mg PO qd for 10 days.
  • Pediatric
  • Preferred regimen (1):Erythromycin suspension,PO 50 mg/kg per day for 10 to 14 days
  • Preferred regimen (2):Clarithromycin suspension, 15 mg/kg per day for10 days
  • Preferred regimen (3): Azithromycin suspension, PO 10 mg/kg once on the first day, followed by 5 mg/kg qd daily for 4 days
  • Upper respiratory tract infection[24]
  • Bronchitis
  • Antibiotic therapy for C. pneumoniae is not required.
  • Pharyngitis
  • Antibiotic therapy for C. pneumoniae is not required.
  • Sinusitis
  • Antibiotic therapy is advisable if symptoms remain beyond 7-10 days.
  • Adult
  • Pediatric
  • Preferred regimen: Azithromycin
  • Alternative regimen: fluoroquinolones
  • Pregnant Patients
  • Preferred regimen : Azithromycin
  • Alternative regimen: fluoroquinolones
  • Endocarditis in valve replacement patients
  • Preferred regimen : Doxycycline
  • Alternative regimen : fluoroquinolones.

Bacteria – Miscellaneous

Bacteria – Anaerobic Gram-Negative Bacilli

Fungi

  • Mild to moderate pulmonary blastomycosis
  • Preferred regimen: Itraconazole 200 mg PO once or twice per day for 6–12 months
  • Note: Oral Itraconazole, 200 mg 3 times per day for 3 days and then once or twice per day for 6–12 months, is recommended
  • Moderately severe to severe pulmonary blastomycosis
  • Preferred regimen(1): Lipid amphotericin B (Lipid AmB) 3–5 mg/kg per day for 1–2 weeks AND Itraconazole 200 mg PO bid for 6–12 months
  • Preferred regimen(2): Amphotericin B deoxycholate 0.7–1 mg/kg per day for 1–2 weeks AND Itraconazole 200 mg PO bid for 6–12 months
  • Note: Oral Itraconazole, 200 mg 3 times per day for 3 days and then 200 mg twice per day, for a total of 6–12 months, is recommended
  • Mild to moderate disseminated blastomycosis
  • Preferred regimen: Itraconazole 200 mg PO once or twice per day for 6–12 months
  • Note(1): Treat osteoarticular disease for 12 months
  • Note(2): Oral Itraconazole, 200 mg 3 times per day for 3 days and then 200 mg twice per day, for a total of 6–12 months, is recommended
  • Moderately severe to severe disseminated blastomycosis
  • Preferred regimen(1): Lipid amphotericin B(Lipid AmB) 3–5 mg/kg per day, for 1–2 weeks AND Itraconazole 200 mg PO bid for 6–12 months
  • Preferred regimen(2): Amphotericin B deoxycholate 0.7–1 mg/kg per day, for 1–2 weeks AND Itraconazole 200 mg PO bid for 6–12 months
  • Note: oral Itraconazole, 200 mg 3 times per day for 3 days and then 200 mg twice per day, for a total of 6–12 months, is recommended
  • CNS disease
  • Preferred regimen: Lipid amphotericin B (Lipid AmB) 5 mg/kg per day for 4–6 weeks AND an oral azole for at least 1 year
  • Note(1): Step-down therapy can be with Fluconazole, 800 mg per day OR Itraconazole, 200 mg 2–3 times per day OR voriconazole, 200–400 mg twice per day.
  • Note(2): Longer treatment may be required for immunosuppressed patients.
  • Immunosuppressed patients
  • Preferred regimen(1): Lipid amphotericin B (Lipid AmB), 3–5 mg/kg per day, for 1–2 weeks, AND Itraconazole, 200 mg PO bid for 12 months
  • Preferred regimen(2): Amphotericin B deoxycholate, 0.7–1 mg/kg per day, for 1–2 weeks, AND Itraconazole, 200 mg PO bid for 12 months
  • Note(1): Oral Itraconazole, 200 mg 3 times per day for 3 days and then 200 mg twice per day, for a total of 12 months, is recommended
  • Note(2): Life-long suppressive treatment may be required if immunosuppression cannot be reversed.
  • Pregnant women
  • Preferred regimen: Lipid amphotericin B (Lipid AmB) 3–5 mg/kg per day
  • Note(1): Azoles should be avoided because of possible teratogenicity
  • Note(2): If the newborn shows evidence of infection, treatment is recommended with Amphotericin B deoxycholate, 1.0 mg/kg per day
  • Children with mild to moderate disease
  • Preferred regimen: Itraconazole 10 mg/kg PO per day for 6–12 months
  • Note: Maximum dose 400 mg per day
  • Children with moderately severe to severe disease
  • Preferred regimen(1): Amphotericin B deoxycholate 0.7–1 mg/kg per day for 1–2 weeks AND Itraconazole 10 mg/kg PO per day to a maximum of 400 mg per day for 6–12 months
  • Preferred regimen(2): Lipid amphotericin B (Lipid AmB) 3–5 mg/kg per day for 1–2 weeks AND Itraconazole 10 mg/kg PO per day to a maximum of 400 mg per day for 6–12 months
  • Note: Children tolerate Amphotericin B deoxycholate better than adults do.


  • Preferred regimen(1): Griseofulvin 10-20 mg/kg/day for minimum 6 weeks
  • Preferred regimen(2): Itraconazole 4-6 mg/kg pulsed dose weekly
  • Preferred regimen(3): Terbinafine if <20 kg: 62.5 mg/day, if 20-40 kg: 125 mg/day, if >40 kg: 250 mg/day
  • Small, well-defined lesions
  • Larger lesionss
  • Athlete's foot
  • Interdigital
  • “Dry type”
  • Preferred regimen: Terbinafine 250 mg/day PO for 2-4 weeks OR Itraconazole 400 mg/day PO for 1 week per month (repeated if necessary) OR Fluconazole 200 mg PO weekly for 4-8 weeks

Mycobacteria

Parasites – Intestinal Protozoa

Parasites – Extraintestinal Protozoa

Parasites – Intestinal Nematodes (Roundworms)

Parasites – Extraintestinal Nematodes (Roundworms)

Parasites – Trematodes (Flukes)

Parasites – Cestodes (Tapeworms)

Parasites – Ectoparasites

Viruses

References

  1. ↑ Mermel LA, Allon M, Bouza E, Craven DE, Flynn P, O'Grady NP; et al. (2009). "Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 Update by the Infectious Diseases Society of America". Clin Infect Dis. 49 (1): 1–45. doi:10.1086/599376. PMC 4039170. PMID 19489710.
  2. ↑ Bennett, John (2015). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Elsevier/Saunders. ISBN 978-1455748013.
  3. ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
  4. ↑ Liu, Catherine; Bayer, Arnold; Cosgrove, Sara E.; Daum, Robert S.; Fridkin, Scott K.; Gorwitz, Rachel J.; Kaplan, Sheldon L.; Karchmer, Adolf W.; Levine, Donald P.; Murray, Barbara E.; J Rybak, Michael; Talan, David A.; Chambers, Henry F.; Infectious Diseases Society of America (2011-02-01). "Clinical practice guidelines by the infectious diseases society of america for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children". Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. 52 (3): –18-55. doi:10.1093/cid/ciq146. ISSN 1537-6591. PMID 21208910.
  5. ↑ Tunkel, Allan R.; Hartman, Barry J.; Kaplan, Sheldon L.; Kaufman, Bruce A.; Roos, Karen L.; Scheld, W. Michael; Whitley, Richard J. (2004-11-01). "Practice guidelines for the management of bacterial meningitis". Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. 39 (9): 1267–1284. doi:10.1086/425368. ISSN 1537-6591. PMID 15494903.
  6. ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
  7. ↑ Kasper, Dennis (2015). Harrison's principles of internal medicine. New York: McGraw Hill Education. ISBN 978-0071802154.
  8. ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
  9. ↑ Darouiche, Rabih O. (2006-11-09). "Spinal epidural abscess". The New England Journal of Medicine. 355 (19): 2012–2020. doi:10.1056/NEJMra055111. ISSN 1533-4406. PMID 17093252.
  10. ↑ Liu, Catherine; Bayer, Arnold; Cosgrove, Sara E.; Daum, Robert S.; Fridkin, Scott K.; Gorwitz, Rachel J.; Kaplan, Sheldon L.; Karchmer, Adolf W.; Levine, Donald P.; Murray, Barbara E.; J Rybak, Michael; Talan, David A.; Chambers, Henry F.; Infectious Diseases Society of America (2011-02-01). "Clinical practice guidelines by the infectious diseases society of america for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children". Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. 52 (3): –18-55. doi:10.1093/cid/ciq146. ISSN 1537-6591. PMID 21208910.
  11. ↑ Liu, Catherine; Bayer, Arnold; Cosgrove, Sara E.; Daum, Robert S.; Fridkin, Scott K.; Gorwitz, Rachel J.; Kaplan, Sheldon L.; Karchmer, Adolf W.; Levine, Donald P.; Murray, Barbara E.; J Rybak, Michael; Talan, David A.; Chambers, Henry F.; Infectious Diseases Society of America (2011-02-01). "Clinical practice guidelines by the infectious diseases society of america for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children". Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. 52 (3): –18-55. doi:10.1093/cid/ciq146. ISSN 1537-6591. PMID 21208910.
  12. ↑ Liu, Catherine; Bayer, Arnold; Cosgrove, Sara E.; Daum, Robert S.; Fridkin, Scott K.; Gorwitz, Rachel J.; Kaplan, Sheldon L.; Karchmer, Adolf W.; Levine, Donald P.; Murray, Barbara E.; J Rybak, Michael; Talan, David A.; Chambers, Henry F.; Infectious Diseases Society of America (2011-02-01). "Clinical practice guidelines by the infectious diseases society of america for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children". Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. 52 (3): –18-55. doi:10.1093/cid/ciq146. ISSN 1537-6591. PMID 21208910.
  13. ↑ Azari, Amir A.; Barney, Neal P. (2013-10-23). "Conjunctivitis: a systematic review of diagnosis and treatment". JAMA. 310 (16): 1721–1729. doi:10.1001/jama.2013.280318. ISSN 1538-3598. PMC 4049531. PMID 24150468.
  14. ↑ 14.0 14.1 14.2 Solomkin JS, Mazuski JE, Bradley JS, Rodvold KA, Goldstein EJ, Baron EJ; et al. (2010). "Diagnosis and management of complicated intra-abdominal infection in adults and children: guidelines by the Surgical Infection Society and the Infectious Diseases Society of America". Clin Infect Dis. 50 (2): 133–64. doi:10.1086/649554. PMID 20034345.
  15. ↑ Mogayzel PJ, Naureckas ET, Robinson KA, Mueller G, Hadjiliadis D, Hoag JB; et al. (2013). "Cystic fibrosis pulmonary guidelines. Chronic medications for maintenance of lung health". Am J Respir Crit Care Med. 187 (7): 680–9. PMID 23540878.
  16. ↑ Pasteur MC, Bilton D, Hill AT, British Thoracic Society Bronchiectasis non-CF Guideline Group (2010). "British Thoracic Society guideline for non-CF bronchiectasis". Thorax. 65 Suppl 1: i1–58. doi:10.1136/thx.2010.136119. PMID 20627931.
  17. ↑ Stevens DL, Bisno AL, Chambers HF, Dellinger EP, Goldstein EJ, Gorbach SL; et al. (2014). "Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the infectious diseases society of America". Clin Infect Dis. 59 (2): 147–59. doi:10.1093/cid/ciu296. PMID 24947530.
  18. ↑ Lappin E, Ferguson AJ (2009). "Gram-positive toxic shock syndromes". Lancet Infect Dis. 9 (5): 281–90. doi:10.1016/S1473-3099(09)70066-0. PMID 19393958.
  19. ↑ Hillis LD, Smith PK, Anderson JL, Bittl JA, Bridges CR, Byrne JG; et al. (2011). "2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery. A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Developed in collaboration with the American Association for Thoracic Surgery, Society of Cardiovascular Anesthesiologists, and Society of Thoracic Surgeons". J Am Coll Cardiol. 58 (24): e123–210. doi:10.1016/j.jacc.2011.08.009. PMID 22070836.
  20. ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
  21. ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
  22. ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
  23. ↑ Bennett, John (2015). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Elsevier/Saunders. ISBN 978-1455748013.
  24. ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
  25. ↑ Bennett, John (2015). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Elsevier/Saunders. ISBN 978-1455748013.
  26. ↑ Bennett, John (2015). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Elsevier/Saunders. ISBN 978-1455748013.
  27. ↑ Bennett, John (2015). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Elsevier/Saunders. ISBN 978-1455748013.
  28. ↑ Bennett, John (2015). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Elsevier/Saunders. ISBN 978-1455748013.
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