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Pathogens of Clinical Relevance

Bacteria – Gram-Positive Cocci


  • Staphylococcus aureus
  • (1)Infectious endocarditis
  • In adults
  • (2) 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.
  • (3) Purulent cellulitis (defined as cellulitis associated with purulent drainage or exudate in the absence of a drainable abscess)
  • In adults
  • In childern
  • Preferred regimen: Clindamycin 10–13 mg/kg/dose PO q6–8 h, not to exceed 40 mg/kg/day OR Trimethoprim 4–6 mg/kg/dose, Sulfamethoxazole 20–30 mg/kg/dose PO q12h OR Doxycycline <45kg: 2 mg/kg/dose PO every 12 h .45kg: adult dose OR Minocycline 4 mg/kg PO once, then 2 mg/kg/dose PO every 12 h OR Linezolid 10 mg/kg/dose PO every 8 h, not to exceed 600 mg/dose
  • Nonpurulent cellulitis (defined as cellulitis with no purulent drainage or exudate and no associated abscess)
  • In adults
Note: Empirical therapy for b-hemolytic streptococci is recommended. Empirical coverage for CA-MRSA is recommended in patients who do not respond to b-lactam therapy and may be considered in those with systemic toxicity.
Note: Provide coverage for both b-hemolytic streptococci and CA-MRSA b-lactam (eg, amoxicillin) and/or TMP-SMX or a tetracycline
  • In childern
Note (1): Clindamycin causes Clostridium difficile–associated disease may occur more frequently, compared with other oral agents.
Note (2): Trimethoprim-Sulfamethoxazole not recommended for women in the third trimester of pregnancy and for children ,2 months of age.
Note (3): Tetracyclines are not recommended for children under 8 years of age and are pregnancy category D.


  • 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)
  • (5) 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.
  • (7) 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.
  • (8) 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.
  • (9) 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.
  • (10) Acute conjunctivitis [13]
  • Methicillin-resistant Staphylococcus aureus (MRSA)
  • (11) 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
  • (12) 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
  • (13) 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
  • (14) 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)
  • (15) 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
  • (16) Empyema
  • (17) 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
  • (18) 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.
  • (19) 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)
  • (20) 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.
  • (21) 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)
  • (22) Diabetic foot osteomyelitis
  • High Risk for MRSA
  • (23) Necrotizing fasciitis[17]
  • In adult
  • In childern
  • (24) 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.
  • Chlamydial Infections in Adolescents and Adults
  • Preferred regimen : Doxycycline 100 mg PO bid for 7 days OR Azithromycin 1 g PO in a single dose
  • Alternative regimen (1): Erythromycin base 500 mg PO qid for 7 days OR Erythromycin ethylsuccinate 800 mg PO qid for 7 days
  • Alternative regimen (2): Levofloxacin 500 mg PO qd for 7 days OR Ofloxacin 300 mg PO bid for 7 days.
  • Note: Patients should be instructed to refer their sex partners for evaluation, testing, and treatment if they had sexual contact with the patient during the 60 days preceding onset of the patient's symptoms or chlamydia diagnosis.
  • Chlamydial Infections in patients with HIV Infection
  • Pregancy
  • Chlamydial infection among neonates
  • Ophthalmia Neonatorumcaused by C. trachomatis
  • Preferred regimen :Erythromycin base or ethylsuccinate ,PO 50 mg/kg/ day divided into 4 doses daily for 14 days
  • Alternative regimen : Azithromycin suspension, PO 20 mg/kg /day qd for 3 days
  • Note: The mothers of infants who have chlamydial infection and the sex partners of these women should be evaluated and treated.
  • Infant Pneumonia
  • Preferred regimen :Erythromycin base or ethylsuccinate PO 50 mg/kg/ day divided into 4 doses daily for 14 days
  • Alternative regimen : Azithromycin suspension, PO 20 mg/kg /day qd for 3 days
  • Chlamydial infection among infants and childern
  • Infants and childern who weigh < 45 kg
  • Preferred regimen :Erythromycin base or ethylsuccinate PO 50 mg/kg/ day divided into 4 doses daily for 14 days
  • Infants and childern who weigh >45 kg but who are aged <8 years
  • Infants and childern aged >8 years
  • Lymphogranuloma venereum (LGV)
  • Lymphogranuloma venereum (LGV) is caused by C. trachomatis serovars L1, L2, or L3[26]
  • Preferred regimen : Doxycycline 100 mg PO bid for 21 days
  • Alternative regimen: Erythromycin base 500 mg PO qid for 21 days
  • Note (1): azithromycin 1 g orally once weekly for 3 weeks is probably effective based on its chlamydial antimicrobial activity. Fluoroquinolone-based treatments might also be effective, but extended treatment intervals are likely required.
  • Note (2): Patients should be followed clinically until signs and symptoms have resolved.
  • Note (2): Pregnant and lactating women should be treated with erythromycin. Azithromycin might prove useful for treatment of LGV in pregnancy, but no published data are available regarding its safety and efficacy. Doxycycline is contraindicated in pregnant women.
  • Note (3): Persons with both LGV and HIV infection should receive the same regimens as those who are HIV negative. Prolonged therapy might be required, and delay in resolution of symptoms might occur.
  • Note(4): Persons who have had sexual contact with a patient who has LGV within the 60 days before onset of the patient’s symptoms should be examined and tested for urethral, cervical, or rectal chlamydial infection depending on anatomic site of exposure. They should be presumptively treated with a chlamydia regimen ( Azithromycin 1 g PO single dose OR Doxycycline 100 mg PO bid for 7 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. ↑ "Chlamydial Infections".
  26. ↑ "LGV".
  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.
  29. ↑ Bennett, John (2015). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Elsevier/Saunders. ISBN 978-1455748013.
  30. ↑ 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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