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Asymptomatic bacteriuria

Asymptomatic bacteriuria^[1]^[2]

Definitions

For women: two consecutive voided urine specimens with isolation of the same bacterial strain in quantitative counts 􏰁≥ 10⁵ cfu/mL
For men: a single, clean-catch voided urine specimen with 1 bacterial species isolated in a quantitative count 􏰁􏰁≥ 10⁵ cfu/mL
For catheterized urine specimen: a single catheterized urine specimen with 1 bacterial species isolated in a quantitative count 􏰁􏰁≥ 10^>2 cfu/mL

Causative pathogens

Escherichia coli
Klebsiella pneumoniae
Coagulase-negative staphylococci
Enterococcus
Group B streptococci
Gardnerella vaginalis
Pseudomonas aeruginosa, Proteus mirabilis, Providencia stuartii, Morganella morganii (common in patients with long-term urologic device in place)

Empiric antimicrobial therapy

Treatment of asymptomatic bacteriuria is not recommended for the following persons:

Premenopausal, nonpregnant women
Diabetic women
Older persons residing in the community
Elderly, institutionalized subjects
Persons with spinal cord injury
Catheterized patients while the catheter remains in situ

Note: Pyuria accompanying asymptomatic bacteriuria is not indicated for antibiotic therapy.

Specific considerations

Men

Screening for or treatment of asymptomatic bacteriuria in men is not recommended.

Women, premenopausal, nonpregnant

Screening for or treatment of asymptomatic bacteriuria in premenopausal, nonpregnant women is not indicated.

Women, pregnant^[3]

Preferred regimen (1): Nitrofurantoin 100 mg PO bid for 3–5 days (avoid in glucose-6-phosphate dehydrogenase deficiency)
Preferred regimen (2): Amoxicillin 500 mg tid for 3–5 days
Preferred regimen (3): Amoxicillin-Clavulanate 500 mg bid for 3–5 days
Preferred regimen (4): Cephalexin 500 mg tid for 3–5 days
Preferred regimen (5): Fosfomycin 3 g as a single dose
Preferred regimen (6): Trimethoprim bid for 3–5 days (only after first trimester)

Note (1): Pregnant women should be screened for bacteriuria by urine culture at least once in early pregnancy, and they should be treated if the results are positive.

Note (2): Periodic screening for recurrent bacteriuria should be undertaken after therapy.

Note (3): IDSA guidelines recommend 3–7 days of antimicrobial therapy.

Women, diabetic

Screening for or treatment of asymptomatic bacteriuria in diabetic women is not recommended.

Older persons residing in the community

Screening for or treatment of asymptomatic bacteriuria in older persons residing in the community is not recommended.

Elderly institutionalized subjects

Screening for or treatment of asymptomatic bacteriuria in elderly institutionalized residents of longterm care facilities is not recommended.

Subjects with spinal cord injuries

Screening for or treatment of asymptomatic bacteriuria in subjects with spinal cord injuries is not recommended.

Patients with indwelling urethral catheters

Screening for or treatment of asymptomatic bacteriuria in patients with indwelling urethral catheters is not recommended.

Note: Antimicrobial treatment of asymptomatic women with catheter-acquired bacteriuria that persists 48 hours after catheter removal may be considered.

Urologic interventions^[4]

Screening for or treatment of asymptomatic bacteriuria before transurethral resection of the prostate is recommended.
Preferred regimen: Trimethoprim-Sulfamethoxazole DS 1 tab bid for 3 days after obtaining urine cultures

Ectoparasitic Infections

Pediculosis Pubis

Preferred regime: Permethrin 1% cream rinse applied to affected areas and washed off after 10 minutes OR Pyrethrins with piperonyl butoxide applied to the affected area and washed off after 10 minutes

Alternative regime: Malathion 0.5% lotion applied for 8--12 hours and washed off OR Ivermectin 250 µg/kg orally, repeated in 2 weeks

Scabies

Preferred regime: Permethrin cream (5%) applied to all areas of the body from the neck down and washed off after 8--14 hours OR Ivermectin 200ug/kg orally, repeated in 2 weeks
Alternative regime: Lindane (1%) 1 oz. of lotion (or 30 g of cream) applied in a thin layer to all areas of the body from the neck down and thoroughly washed off after 8 hours

Human papillomavirus infection

Genital Warts

External Genital Warts

Patient-Applied:

Preferred regime: Podofilox 0.5% solution or gel OR Imiquimod 5% cream OR Sinecatechins 15% ointment

Provider--Administered:

Preferred regime: Cryotherapy with liquid nitrogen or cryoprobe, repeat applications every 1-2 weeks OR Podophyllin resin 10%-25% in a compound tincture of benzoin OR Trichloroacetic acid (TCA) OR Bichloroacetic acid (BCA) 80%-90% OR Surgical removal either by tangential scissor excision, tangential shave excision, curettage, or electrosurgery.
Alternative regime: intralesional interferon, photodynamic therapy, and topical [[Cidofovir].

Cervical Warts

Preferred regime: For women who have exophytic cervical warts, a biopsy evaluation to exclude high-grade SIL must be performed before treatment is initiated. Management of exophytic cervical warts should include consultation with a specialist.

Vaginal Warts

Preferred regime: Cryotherapy with liquid nitrogen. The use of a cryoprobe in the vagina is not recommended because of the risk for vaginal perforation and fistula formation OR TCA or BCA 80%--90% applied to warts. A small amount should be applied only to warts and allowed to dry, at which time a white frosting develops. If an excess amount of acid is applied, the treated area should be powdered with talc, sodium bicarbonate, or liquid soap preparations to remove unreacted acid. This treatment can be repeated weekly, if necessary.

Urethral Meatus Warts

Preferred regime: Cryotherapy with liquid nitrogen OR Podophyllin 10%--25% in compound tincture of benzoin. The treatment area and adjacent normal skin must be dry before contact with podophyllin. This treatment can be repeated weekly, if necessary. The safety of podophyllin during pregnancy has not been established. Data are limited on the use of podofilox and imiquimod for treatment of distal meatal warts.

Anal Warts

Preferred regime: Cryotherapy with liquid nitrogen OR TCA or BCA 80%--90% applied to warts. A small amount should be applied only to warts and allowed to dry, at which time a white frosting develops. If an excess amount of acid is applied, the treated area should be powdered with talc, sodium bicarbonate, or liquid soap preparations to remove unreacted acid. This treatment can be repeated weekly, if necessary. OR Surgical removal

Vaginal infection

Bacterial vaginosis

Preferred regime: Metronidazole 500 mg orally twice a day for 7 days OR Metronidazole gel 0.75%, one full applicator (5 g) intravaginally, once a day for 5 days OR Clindamycin cream 2%, one full applicator (5 g) intravaginally at bedtime for 7 days

Alternative regime (1): Tinidazole 2 g orally once daily for 3 days

Alternative regime (2): Tinidazole 1 g orally once daily for 5 days

Alternative regime (3): Clindamycin 300 mg orally twice daily for 7 days

Alternative regime (4): Clindamycin ovules 100 mg intravaginally once at bedtime for 3 days

Bacterial vaginosis during pregnancy

Preferred regime: Metronidazole 500 mg orally twice a day for 7 days OR Metronidazole 250 mg orally three times a day for 7 days OR Clindamycin 300 mg orally twice a day for 7 days

Trichomoniasis

T. vaginalis

Preferred regime: Metronidazole 2 g orally in a single dose OR Tinidazole 2 g orally in a single dose

Alternative regime: Metronidazole 500 mg orally twice a day for 7 days

Trichomoniasis during pregnancy

Preferred regime: 2 g Metronidazole in a single dose at any stage of pregnancy, withholding breastfeeding during treatment and for 12--24 hours after the last dose will reduce the exposure of the infant to metronidazole.

Vulvovaginal candidiasis

Uncomplicated VVC

Preferred regime:

Over-the-Counter Intravaginal Agents: Butoconazole 2% cream 5 g intravaginally for 3 days OR Clotrimazole 1% cream 5 g intravaginally for 7--14 days OR Clotrimazole 2% cream 5 g intravaginally for 3 days OR [Miconazole]] 2% cream 5 g intravaginally for 7 days OR Miconazole 4% cream 5 g intravaginally for 3 days OR Miconazole 100 mg vaginal suppository, one suppository for 7 days OR Miconazole 200 mg vaginal suppository, one suppository for 3 days OR Miconazole 1,200 mg vaginal suppository, one suppository for 1 day OR Tioconazole 6.5% ointment 5 g intravaginally in a single application
Prescription Intravaginal Agents: Butoconazole 2% cream (single dose bioadhesive product), 5 g intravaginally for 1 day OR Nystatin 100,000-unit vaginal tablet, one tablet for 14 days OR Terconazole 0.4% cream 5 g intravaginally for 7 days OR Terconazole 0.8% cream 5 g intravaginally for 3 days OR Terconazole 80 mg vaginal suppository, one suppository for 3 days
Oral Agent: Fluconazole 150 mg oral tablet, one tablet in single dose

Complicated VVC

Recurrent Vulvovaginal Candidiasis (RVVC)

Preferred regime: 7-14 days of topical therapy OR a 100-mg, 150-mg, or 200-mg oral dose of Fluconazole every third day for a total of 3 doses followed by Oral Fluconazole (i.e., 100-mg, 150-mg, or 200-mg dose) weekly for 6 months

Severe VVC

Preferred regime: Topical Azole for 7-14 days OR 150 mg of Fluconazole in two sequential doses (second dose 72 hours after initial dose.

Nonalbicans VVC

Preferred regime: nonfluconazole Azole drug (oral or topical) for 7-14 days.

Vulvovaginal candidiasis during pregnancy

Preferred regime: topical Azole therapies for 7 days

Cervicitis

Cervicitis^[5]

Preferred regimen: Azithromycin 1 g PO in a single dose OR Doxycycline 100 mg PO bid for 7 days

Chancroid

Chancroid (Haemophilus ducreyi infection)^[6]

Preferred regimen: Azithromycin 1 g PO as a single dose OR Ceftriaxone 250 mg IM as a single dose OR Ciprofloxacin 500 mg PO bid for 3 days OR Erythromycin 500 mg PO tid for 7 days

Note (1): Ciprofloxacin is contraindicated for pregnant and lactating women.

Note (2): Patients should be tested for HIV infection at the time chancroid is diagnosed. If the initial test results were negative, a serologic test for syphilis and HIV infection should be performed 3 months after the diagnosis of chancroid.

Note (3): HIV-infected patients might require repeated or longer courses of therapy than those recommended for HIV-negative patients.

Note (4): Sex partners of patients who have chancroid should be examined and treated if they had sexual contact with the patient during the 10 days preceding the patient's onset of symptoms.

Chlamydial infections

Chlamydial infections^[7]

Chlamydial infections in adolescents and adults

Preferred regimen: Azithromycin 1 g PO in a single dose OR Doxycycline 100 mg PO bid for 7 days
Alternative regimen (1): Erythromycin base 500 mg PO qid for 7 days
Alternative regimen (2): Erythromycin ethylsuccinate 800 mg PO qid for 7 days
Alternative regimen (3): Levofloxacin 500 mg PO qd for 7 days
Alternative regimen (4): 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 during pregnancy

Preferred regimen: Azithromycin 1 g PO in a single dose OR Amoxicillin 500 mg PO tid for 7 days
Alternative regimen (1): Erythromycin base 500 mg PO qid for 7 days
Alternative regimen (2): Erythromycin base 250 mg PO qid for 14 days
Alternative regimen (3): Erythromycin ethylsuccinate 800 mg PO qid for 7 days
Alternative regimen (4): Erythromycin ethylsuccinate 400 mg PO qid for 14 days

Note: Doxycycline, ofloxacin, and levofloxacin are contraindicated in pregnant women.

Chlamydial infections among infants

Ophthalmia neonatorum caused by C. trachomatis

Preferred regimen: Erythromycin base or ethylsuccinate 50 mg/kg/day PO divided into 4 doses daily for 14 days

Note: The mothers of infants who have chlamydial infection and the sex partners of these women should be evaluated and treated.

Infant pneumonia caused by C. trachomatis

Preferred regimen (< 45 kg): Erythromycin base or ethylsuccinate 50 mg/kg/day PO divided into 4 doses daily for 14 days
Preferred regimen (≥ 45 kg & < 8 years): Azithromycin 1 g PO in a single dose
Preferred regimen (≥ 8 years): Azithromycin 1 g PO in a single dose OR Doxycycline 100 mg PO bid for 7 days

Chorioamnionitis

Antibiotics ^[8]

Preferred regime: Ampicillin 2 g intravenously every 6 h OR Penicillin 5x10⁶ units intravenously every 6 h AND Gentamicin 1.5 mg/kg every 8 h
NOTE (1): Cephalosporins are generally recommended for women with chorioamnionitis who are allergic to Penicillin
NOTE (2): In women with anaphylaxis to Penicillin a recommendation is to substitute Clindamycin 900 mg every 8 h
NOTE (3): In the non-obstetric population, daily dosing of Gentamicin appears to be more effective, convenient, and cost-effective as well as less toxic.
NOTE (4): Recommends the addition of a drug with enhanced anaerobic coverage, such as Clindamycin every 8 hours OR Metronidazole, in those cases of chorioamnionitis that require cesarean delivery
NOTE (5): chorioamnionitis is a contraindication to the administration of Corticosteroids. Women with intra-amniotic infection have traditionally been excluded from randomized trials of corticosteroid therapy.

Supportive measures

Preferred regime: Antipyretics (Acetaminophen)

Prevention ^[9]

Preferred regime: Macrolide (Erythromycin OR Azithromycin) AND Ampicillin for 7–10 days via intravenous (2 days) followed by oral routes.
NOTE: Induction of labor and delivery for preterm premature rupture of membranes (PPROM) after 34 weeks’ gestation is recommended.

Cystitis

Acute Uncomplicated Cystitis

Preferred regime: Nitrofurantoin monohydrate/macrocrystals 100 mg bid 5 days (avoid if early pyelonephritis suspected) OR Trimethoprim-sulfamethoxazole 160/800 mg (one DS tablet) bid 3 days (avoid if resistance prevalence is known to exceed 20 or if used for UTI in previous 3 months) OR Fosfomycin trometamol 3 gm single dose (lower efficacy than some other recommended agents; avoid if early pyelonephritis suspected) OR Pivmecillinam 400 mg bid 5 days (lower efficacy than some other recommended agents; avoid if early pyelonephritis suspected)
Alternative regime (1): Fluoroquinolones, Ofloxacin, Ciprofloxacin, and Levofloxacin, use for 3 days.

Alternative regime (2): β-Lactam agents, including Amoxicillin-clavulanate, Cefdinir, Cefaclor, and Cefpodoxime-proxetil, for 3–7-days

Epididymitis

Preferred regime: Ceftriaxone 250 mg IM in a single dose AND Doxycycline 100 mg orally twice a day for 10 days

For acute epididymitis most likely caused by enteric organisms

Preferred regime: [[Levofloxacin] 500 mg orally once daily for 10 days OR Ofloxacin 300 mg orally twice a day for 10 days

NOTE: Patients who have uncomplicated acute epididymitis and also are infected with HIV should receive the same treatment regimen as those who are HIV negative.

Genital herpes

Genital herpes^[10]

First episode of genital herpes

Preferred regimen: Acyclovir 400 mg PO tid for 7–10 days OR Acyclovir 200 mg PO five times a day for 7–10 days OR Famciclovir 250 mg PO tid for 7–10 days OR Valacyclovir 1 g PO bid for 7–10 days

Note: Treatment can be extended if healing is incomplete after 10 days of therapy.

Recurrent genital herpes

Suppressive therapy

Preferred regimen: Acyclovir 400 mg PO bid for 7–10 days OR Famciclovir 250 mg PO bid for 7–10 days OR Valacyclovir 1000 mg PO qd for 7–10 days OR Valacyclovir 500 mg PO qd for 7–10 days

Note (1): Valacyclovir 500 mg once a day might be less effective than other valacyclovir or acyclovir dosing regimens in patients who have very frequent recurrences (i.e., ≥10 episodes per year).

Note (2): Acyclovir, Famciclovir, and Valacyclovir appear equally effective for episodic treatment of genital herpes, but famciclovir appears somewhat less effective for suppression of viral shedding.

Episodic therapy

Preferred regimen: Acyclovir 400 mg PO tid for 5 days OR Acyclovir 800 mg PO bid a day for 5 days OR Acyclovir 800 mg PO tid for 2 days OR Famciclovir 125 mg PO bid for 5 days OR Famciclovir 1000 mg PO bid for 1 day OR Famciclovir 500 mg PO once, followed by 250 mg PO bid for 2 days OR Valacyclovir 500 mg PO bid for 3 days OR Valacyclovir 1000 mg PO qd for 5 days

Severe genital herpes

Preferred regimen: Acyclovir 5–10 mg/kg IV q8h for 2–7 days or until clinical improvement is observed, followed by PO antiviral therapy to complete at least 10 days of total therapy.

Note (1): Acyclovir dose adjustment is recommended for impaired renal function.

Note (2): Symptomatic sex partners should be evaluated and treated in the same manner as patients who have genital lesions. Asymptomatic sex partners of patients who have genital herpes should be questioned concerning histories of genital lesions and offered type–specific serologic testing for HSV infection.

Genital herpes in HIV-infected patients

Suppressive therapy

Preferred regimen: Acyclovir 400–800 mg PO bid–tid OR Famciclovir 500 mg PO bid OR Valacyclovir 500 mg PO bid

Episodic therapy

Preferred regimen: Acyclovir 400 mg PO tid for 5–10 days OR Famciclovir 500 mg PO bid for 5–10 days OR Valacyclovir 1000 mg PO bid for 5–10 days

Note (1): For severe HSV disease, initiating therapy with Acyclovir 5–10 mg/kg IV q8h might be necessary.

Note (2): If lesions persist or recur in a patient receiving antiviral treatment, HSV resistance should be suspected and a viral isolate should be obtained for sensitivity testing.

Acyclovir-resistant genital herpes

Preferred regimen: Foscarnet 40 mg/kg IV q8h until clinical resolution is attained,
Alternative regimen: Cidofovir 5 mg/kg once weekly OR Imiquimod topically qd for 5 days

Genital herpes in pregnancy

Acyclovir can be administered orally to pregnant women with first episode of genital herpes or recurrent genital herpes.
Acyclovir should be administered IV to pregnant women with severe genital herpes.

Neonatal herpes, known or suspected

Disease limited to the skin and mucous membranes

Preferred regimen: Acyclovir 20 mg/kg IV q8h for 14 days

Disseminated and CNS disease

Preferred regimen: Acyclovir 20 mg/kg IV q8h for 21 days

Gonococcal infections

Gonococcal infections (Neisseria gonorrhoeae infection)^[11]^[12]

Gonococcal infections in adolescents and adults

Uncomplicated gonococcal infections of the cervix, urethra, and rectum

Preferred regimen (1): Ceftriaxone 250 mg IM as a single dose
Preferred regimen (2): Cefixime 400 mg PO as a single dose
Preferred regimen (3): Cephalosporin single-dose injectable regimen AND (Azithromycin 1 g PO as a single dose OR Doxycycline 100 mg PO bid for 7 days)
Alternative regimen: Cefpodoxime 400 mg PO as a single dose OR Azithromycin 2 g PO as a single dose

Uncomplicated gonococcal infections of the pharynx

Preferred regimen: Ceftriaxone 250 mg IM in a single dose AND (Azithromycin 1 g PO as a single dose OR Doxycycline 100 mg PO bid for 7 days)

Gonococcal conjunctivitis

Preferred regimen: Ceftriaxone 1 g IM in a single dose

Disseminated gonococcal infection

Preferred regimen: Ceftriaxone 1 g IV/IM q24h
Alternative regimen: Cefotaxime 1 g IV q8h OR Ceftizoxime 1 g IV q8h

Note: All of the preceding regimens should be continued for 24–48 hours after improvement begins, at which time therapy can be switched to Cefixime 400 mg PO bid to complete at least 1 week of antimicrobial therapy.

Gonococcal meningitis

Preferred regimen: Ceftriaxone 1–2 g IV q12h for 10–14 days

Gonococcal endocarditis

Preferred regimen: Ceftriaxone 1–2 g IV q12h for at least 4 weeks

Gonococcal infections among children

Uncomplicated gonococcal vulvovaginitis, cervicitis, urethritis, pharyngitis, or proctitis

Preferred regimen (> 45 kg): Ceftriaxone 250 mg IM as a single dose OR Cefixime 400 mg PO as a single dose
Preferred regimen (≤ 45 kg): Ceftriaxone 125 mg IM in a single dose

Bacteremia or arthritis

Preferred regimen (> 45 kg): Ceftriaxone 50 mg/kg IM/IV q24h for 7 days
Preferred regimen (≤ 45 kg): Ceftriaxone 50 mg/kg (maximum dose: 1 g) IM/IV q24h for 7 days

Gonococcal infections among infants

Disseminated gonococcal infection and gonococcal scalp abscesses in newborns

Preferred regimen: Ceftriaxone 25–50 mg/kg IV/IM q24h for 7 days (10–14 days if meningitis is documented) OR Cefotaxime 25 mg/kg IV/IM q12h for 7 days (10–14 days if meningitis is documented)

Prophylactic treatment for infants whose mothers have gonococcal infection

Preferred regimen: Ceftriaxone 25–50 mg/kg IV/IM, not to exceed 125 mg

Ophthalmia neonatorum

Preferred regimen: Ceftriaxone 25–50 mg/kg IV/IM in a single dose, not to exceed 125 mg

Ophthalmia neonatorum prophylaxis

Preferred regimen: Erythromycin (0.5%) ophthalmic ointment in each eye in a single application

Granuloma inguinale

Granuloma inguinale (donovanosis)^[13]

Preferred regimen: Doxycycline 100 mg PO bid for at least 3 weeks and until all lesions have completely healed
Alternative regimen (1): Azithromycin 1 g PO once per week for at least 3 weeks and until all lesions have completely healed
Alternative regimen (2): Ciprofloxacin 750 mg PO bid for at least 3 weeks and until all lesions have completely healed
Alternative regimen (3): Erythromycin base 500 mg PO qid for at least 3 weeks and until all lesions have completely healed
Alternative regimen (4): Trimethoprim-Sulfamethoxazole double-strength (160 mg/800 mg) one tablet PO bid for at least 3 weeks and until all lesions have completely healed

Note (1): The addition of an aminoglycoside (e.g., Gentamicin 1 mg/kg IV every 8 hours) to these regimens can be considered if improvement is not evident within the first few days of therapy.

Note (2): Patients should be followed clinically until signs and symptoms have resolved.

Note (3): Persons who have had sexual contact with a patient who has granuloma inguinale within the 60 days before onset of the patient's symptoms should be examined and offered therapy. However, the value of empiric therapy in the absence of clinical signs and symptoms has not been established.

Note (4): Pregnancy is a relative contraindication to the use of sulfonamides. Pregnant and lactating women should be treated with the Erythromycin regimen, and consideration should be given to the addition of a parenteral aminoglycoside (e.g., Gentamicin). Azithromycin might prove useful for treating granuloma inguinale during pregnancy, but published data are lacking. Doxycycline and Ciprofloxacin are contraindicated in pregnant women.

Note (5): Persons with both granuloma inguinale and HIV infection should receive the same regimens as those who are HIV negative; however, the addition of a parenteral aminoglycoside (e.g., Gentamicin) can also be considered.

Lymphogranuloma venereum

Lymphogranuloma venereum (Chlamydia trachomatis serovars L1, L2, or L3 infection)^[14]

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 PO 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 (3): 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 (4): 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.

Pelvic inflammatory disease

Parenteral Treatment

Preferred regime (1): Cefotetan 2 g IV every 12 hours OR Cefoxitin 2 g IV every 6 hours AND Doxycycline 100 mg orally or IV every 12 hours.

Preferred regime (2): Clindamycin 900 mg IV every 8 hours AND Gentamicin loading dose IV or IM (2 mg/kg of body weight), followed by a maintenance dose (1.5 mg/kg) every 8 hours. Single daily dosing (3--5 mg/kg) can be substituted.
Alternative regime: Ampicillin/Sulbactam 3 g IV every 6 hours AND Doxycycline 100 mg orally or IV every 12 hours.

Oral Treatment

Preferred regime (1): Ceftriaxone 250 mg IM in a single dose AND Doxycycline 100 mg orally twice a day for 14 days ± Metronidazole 500 mg orally twice a day for 14 days

Preferred regime (2): Cefoxitin 2 g IM in a single dose and Probenecid, 1 g orally administered concurrently in a single dose AND Doxycycline 100 mg orally twice a day for 14 days ± Metronidazole 500 mg orally twice a day for 14 days

Preferred regime (3): Other parenteral third-generation cephalosporin (e.g., ceftizoxime OR cefotaxime) AND Doxycycline 100 mg orally twice a day for 14 days ± Metronidazole 500 mg orally twice a day for 14 days

Alternative regime (1): Ceftriaxone 250 mg IM single dose and Azithromycin 1 g orally once a week for 2 weeks.

Alternative regime (2): Levofloxacin 500 mg orally once daily or Ofloxacin 400 mg twice daily for 14 days {{withorwithout]] Metronidazole 500 mg orally twice daily for 14 days.

Proctocolitis

Proctitis

Preferred regime: Ceftriaxone 250 mg IM AND Doxycycline 100 mg orally twice a day for 7 days

Prostatitis

Acute Bacterial Prostatitis

Uncomplicated (with low risk of STD pathogens)^[15]

Enterobacteriaceae (especially Escherichia coli)

Preferred regime: Ciprofloxacin 400 mg iv or 500 mg po BID or Levofloxacin 500–750 mg iv/po QD
Alternative regime: TMP-SMX DS (160 mg TMP) BID
NOTE: 2 weeks duration of therapy may be sufficient; if patient remains symptomatic, extend to 4 weeks

Enterococcus species

Preferred regime: Ampicillin 1–2 g IV every 4 h OR Vancomycin 15 mg/kg every 12 h
Alternative regime: Levofloxacin 750 po QD OR Linezolid 600 mg every 12 h
NOTE: Use intravenous therapy if systemically ill; switch to oral therapy when stable

Pseudomonas aeruginosa

Preferred regime: Ciprofloxacin 400 mg TID
Alternative regime: Piperacillin-tazobactam 4.5 g iv every 6 h

Uncomplicated (with risk of STD pathogens)

Neisseria gonorrhoeae or Chlamydia trachomatis <----------oral cephalosporins no longer a recommended treatment for gonococcal infections.

Preferred regime: Ceftriaxone 250 mg IM OR Cefixime 400 mg po x 1 dose AND Doxycycline 100 mg po BID OR Azithromycin 500 mg po QD

Alternative regime: Fluoroquinolones not recommended for gonococcal infection
NOTE: Treat for 2 weeks in most cases. Obtain urine nucleicacid amplification test for N.gonorrhoeae and C.trachomatis

Uncomplicated, with risk of antibiotic resistant pathogen

Fluoroquinolone-resistant Enterobacteriaceae

Preferred regime: Ertapenem 1 g iv QD
Alternative regime: Ceftriaxone 1 g iv QD or Imipenem 500mg iv every 6 h OR Tigecycline 100 mg iv x 1 dose then 50 mg iv every 12 h

ES or AmpC beta lactamase producing Enterobacteriaceae

Preferred regime: Ertapenem 1 g iv QD
Alternative regime: Cefepime 2g iv every 12 h OR Imipenem 500 mg iv every 6 h OR Tigecycline 100 mg iv x 1 dose then 50 mg iv every 12 h

Fluoroquinolone-resistant pseudomonas

Preferred regime: Imipenem 500 mg iv every 6 h
Alternative regime: Meropenem 500 mg iv every 8 h

Complicated by bacteremia or suspected prostatic abscess

Enterobacteriaceae or Enterococcus species

Preferred regime: Ciprofloxacin 400 mg iv every 12 h OR Levofloxacin 500 mg iv every 24 h
Alternative regime: Ceftriaxone 1–2 g iv every 24 h AND Levofloxacin 500–750 mg po QD OR Ertapenem 1 g iv every 24 h OR piperacillin-tazobactam 3.375 g iv every 6 h
NOTE: Treat for 4 weeks. Obtain blood cultures; Consider genitourinary imaging; Change iv to po regimen when blood cultures are sterile and abscess drained.

Chronic Bacterial Prostatitis

Enterobacteriaceae (Enterococcus species)

Preferred regime: Ciprofloxacin 400 mg iv every 12 h OR Levofloxacin 500 mg iv every 24 h

Alternative regime: TMP-SMX x 1 dose DS BID

Staphylococcus species

Preferred regime: Azithromycin 500 mg po QD
Alternative regime: Doxycycline 100 mg BID

NOTE: Duration of therapy 4–6 weeks; Consider suppressive therapy if relapses occur.

Pyelonephritis

Condition 1: patients not requiring hospitalization where the prevalence of resistance of community uropathogens to fluoroquinolones is not known to exceed 10%

Preferred regime: Ciprofloxacin orally 500 mg twice daily for 7 days ± an initial 400-mg dose of intravenous Ciprofloxacin
NOTE (1): If an initial one-time intravenous agent is used, a long-acting antimicrobial, such as 1 g of Ceftriaxone or a consolidated 24-h dose of an Aminoglycoside, could be used in lieu of an intravenous fluoroquinolone
NOTE (2): If the prevalence of fluoroquinolone resistance is thought to exceed 10%, an initial one-time intravenous dose of a long-acting parenteral antimicrobial, such as 1 g of ceftriaxone or a consolidated 24-h dose of an aminoglycoside, is recommended.
Alternative regime: A once-daily oral fluoroquinolone, including Ciprofloxacin 1000 mg extended release for 7 days OR Levofloxacin 750 mg for 5 days.
NOTE: If the prevalence of fluoroquinolone resistance is thought to exceed 10%, an initial intravenous dose of a long-acting parenteral antimicrobial, such as 1 g of Ceftriaxone or a consolidated 24-h dose of an Aminoglycoside, is recommended.

Condition 2: When the uropathogen is known to be susceptible

Preferred regime: Trimethoprim-sulfamethoxazole 160/800 mg (1 double-strength tablet) bid orally for 14 days.
NOTE: If trimethoprim-sulfamethoxazole is used when the susceptibility is not known, an initial intravenous dose of a long-acting parenteral antimicrobial, such as 1 g of ceftriaxone OR a consolidated 24-h dose of an aminoglycoside, is recommended.
NOTE: Oral β-lactam agents are less effective than other available agents for treatment of pyelonephritis. If an oral β-lactam agent is used, an initial intravenous dose of a long-acting parenteral antimicrobial, such as 1 g of ceftriaxone OR a consolidated 24-h dose of an aminoglycoside, is recommended.

Condition 3: Patients require hospitalization (high fever, high white blood cell count, vomiting, dehydration, or evidence of sepsis)

Preferred regime: intravenous antimicrobial regimen, such as a Fluoroquinolone; an Aminoglycoside ± Ampicillin; an extended-spectrum Cephalosporin or extended-spectrum Penicillin ± an Aminoglycoside; Carbapenem
NOTE: The choice between these agents should be based on local resistance data, and the regimen should be tailored on the basis of susceptibility results.

Sterile pyuria

Sterile pyuria

Definitions

Pyuria: the presence of 10 or more white cells per cubic millimeter in a urine specimen, 3 or more white cells per high-power field of unspun urine, a positive result on Gram’s stain of an unspun urine specimen, or a urinary dipstick test that is positive for leukocyte esterase^[16]
Sterile pyuria: the persistent finding of white cells in the urine in the absence of bacteria, as determined by means of aerobic laboratory techniques (on a 5% sheep-blood agar plate and MacConkey agar plate)^[17]
Bacteriuria: bacterial colony counts of more than 1000 colony-forming units (CFU) per milliliter in urine^[18]

Causes^[19]

Infectious etiologies

Gynecologic infection
Urethritis due to chlamydia, Neisseria gonorrhoeae, mycoplasma, or ureaplasma
Prostatitis
Balanitis
Appendicitis
Viral infection of the lower genitourinary tract
Genitourinary tuberculosis
Fungal infection
Parasitic disease such as trichomoniasis or schistosomiasis

Non-infectious etiologies

Current use of antibiotics
Recently treated urinary tract infection (within past 2 weeks)
Presence or recent use of a urinary catheter
Recent cystoscopy or urologic endoscopy
Urinary tract stones
Foreign body such as surgical mesh in the urethra or a retained stent
Urinary tract neoplasm
Pelvic irradiation
Urinary fistula
Polycystic kidney
Rejection of a renal transplant
Renal-vein thrombosis
Interstitial nephritis or analgesic nephropathy
Papillary necrosis
Interstitial cystitis
Inflammatory disease such as systemic lupus erythematosus or Kawasaki’s disease

Pathogen-directed antimicrobial therapy^[20]

Tuberculosis

Preferred regimen: Isoniazid AND Rifampin AND Ethambutol AND Pyrazinamide for 3–6 months

Gonorrhea

Preferred regimen: Ceftriaxone 250 mg IM in a single dose, then (Azithromycin 1 g PO in a single dose OR Doxycycline 100 mg PO bid for 7 days)

Chlamydia

Preferred regimen: Azithromycin 1 g PO in single dose OR Doxycycline 100 mg PO bid for 7 days
Alternative regimen: Erythromycin base 500 mg PO qid for 7 days

Mycoplasma and ureaplasma

Preferred regimen: Azithromycin OR Levofloxacin OR Moxifloxacin

Genital herpes

Preferred regimen: Acyclovir 400 mg PO tid for 7–10 days or Acyclovir 200 mg PO five times a day for 7–10 days OR Famciclovir 250 mg PO tid for 7–10 days OR Valacyclovir 1 g PO bid for 7 days

Trichomoniasis

Preferred regimen: Metronidazole 2 g PO in a single dose) OR Tinidazole 2 g PO in a single dose

Note: Treat patient’s sex partner if trichomoniasis is diagnosed in patient.

Fungal infections

Preferred regimen: Fluconazole OR Posaconazole OR Echinocandins OR Amphotericin B

Schistosomiasis

Preferred regimen: Praziquantel 20 mg/kg PO bid for 1–2 days

Syphilis

Syphilis (Treponema pallidum)^[21]

Non–HIV-infected persons

Primary and secondary syphilis

Preferred regimen (adult): Benzathine penicillin G 2.4 MU IM in a single dose
Preferred regimen (pediatric): Benzathine penicillin G 50,000 units/kg (up to 2.4 MU) IM in a single dose

Latent syphilis

Early latent syphilis

Preferred regimen (adult): Benzathine penicillin G 2.4 MU IM in a single dose
Preferred regimen (pediatric): Benzathine penicillin G 50,000 units/kg (up to 2.4 MU) IM in a single dose

Late latent syphilis or unknown duration

Preferred regimen (adult): Benzathine penicillin G 2.4 MU IM for 3 doses, each at 1-week intervals
Preferred regimen (pediatric): Benzathine penicillin G 50,000 units/kg (up to 2.4 MU) IM, administered as 3 doses at 1-week intervals

Tertiary syphilis

Preferred regimen: Benzathine penicillin G 2.4 MU IM for 3 doses, each at 1-week intervals

Neurosyphilis

Preferred regimen: Aqueous crystalline penicillin G 3–4 MU IV q4h or continuously for 10–14 days
Alternative regimen: Procaine penicillin G 2.4 MU IM q24h for 10–14 days AND Probenecid 500 mg PO qid for 10–14 days

Note: Benzathine penicillin G 2.4 MU IM once per week for up to 3 weeks may be considered after completion of above mentioned regimens to provide a comparable total duration of therapy.

HIV-infected persons

Primary and secondary syphilis

Preferred regimen: Benzathine penicillin G 2.4 MU IM in a single dose

Latent syphilis

Early latent syphilis

Preferred regimen: Benzathine penicillin G 2.4 MU IM in a single dose

Late latent syphilis or unknown duration

Preferred regimen: Benzathine penicillin G 2.4 MU IM for 3 doses, each at 1-week intervals

Tertiary syphilis

Preferred regimen: Benzathine penicillin G 2.4 MU IM for 3 doses, each at 1-week intervals

Neurosyphilis

Preferred regimen: Penicillin G 3–4 MU IV q4h or continuously for 10–14 days
Alternative regimen: Procaine penicillin G 2.4 MU IM q24h for 10–14 days AND Probenecid 500 mg PO qid for 10–14 days

Note: Benzathine penicillin G 2.4 MU IM once per week for up to 3 weeks may be considered after completion of above mentioned regimens to provide a comparable total duration of therapy.

During pregnancy

Preferred regimen: Pregnant women should be treated with the Penicillin regimen appropriate for their stage of infection.

Congenital syphilis

Infants with proven or highly probable disease AND (abnormal physical examination consistent with congenital syphilis OR nontreponemal serologic titer fourfold higher than the mother's titer OR a positive darkfield test of body fluids)

Preferred regimen: Aqueous crystalline penicillin G 50,000 U/kg IV q12h during the first 7 days of life and q8h thereafter for a total of 10 days OR Procaine penicillin G 50,000 U/kg IM in a single daily dose for 10 days

Note (1): If more than 1 day of therapy is missed, the entire course should be restarted.

Note (2): Maternal history of infection with T. pallidum and treatment for syphilis must be considered.

Infants who have a normal physical examination AND nontreponemal serologic titer the same or less than fourfold the maternal titer AND (mother was not treated adequately OR mother has no documentation of having received treatment OR mother was treated with Erythromycin or another non-Penicillin regimen OR mother received treatment < 4 weeks before delivery)

Preferred regimen: Aqueous crystalline penicillin G 50,000 U/kg IV q12h during the first 7 days of life and q8h thereafter for a total of 10 days OR Procaine penicillin G 50,000 U/kg IM in a single daily dose for 10 days OR Benzathine penicillin G 50,000 U/kg IM in a single dose

Note: If the mother has untreated early syphilis at delivery, 10 days of parenteral therapy may be considered.

Infants who have a normal physical examination AND nontreponemal serologic titer the same or less than fourfold the maternal titer AND mother was treated during pregnancy AND treatment was appropriate for the stage of infection AND treatment administered > 4 weeks before delivery AND mother has no evidence of reinfection or relapse

Preferred regimen: Benzathine penicillin G 50,000 U/kg IM in a single dose

Note: Another approach involves not treating the infant, but rather providing close serologic follow-up in those whose mother's nontreponemal titers decreased fourfold after appropriate therapy for early syphilis or remained stable or low for late syphilis.

Infants who have a normal physical examination AND nontreponemal serologic titer the same or less than fourfold the maternal titer AND mother's treatment was adequate before pregnancy AND mother's nontreponemal serologic titer remained low and stable before and during pregnancy and at delivery (VDRL < 1:2; RPR < 1:4)

Preferred regimen: Aqueous crystalline penicillin G 50,000 U/kg q4–6h for 10 days

Note (1): If the child has no clinical manifestations of disease, the CSF examination is normal, and the CSF VDRL test result is negative, treatment with up to 3 weekly doses of Benzathine penicillin G 50,000 U/kg IM may be considered.

Note (2): Any child who is suspected of having congenital syphilis or who has neurologic involvement should be treated with a single dose of Benzathine penicillin G 50,000 U/kg IM after the 10-day course of Aqueous crystalline penicillin G.

Urethritis

Urethritis^[22]

Nongonococcal urethritis

Preferred regimen: Azithromycin 1 g PO in a single dose OR Doxycycline 100 mg PO bid for 7 days
Alternative regimen (1): Erythromycin base 500 mg PO qid for 7 days
Alternative regimen (2): Erythromycin ethylsuccinate 800 mg PO qid for 7 days
Alternative regimen (3): Levofloxacin 500 mg PO qd for 7 days
Alternative regimen (4): Ofloxacin 300 mg PO bid for 7 days

Recurrent and persistent urethritis

Preferred regimen: Metronidazole 2 g PO in a single dose OR Tinidazole 2 g PO in a single dose AND Azithromycin 1 g PO in a single dose

References

↑ Nicolle, Lindsay E.; Bradley, Suzanne; Colgan, Richard; Rice, James C.; Schaeffer, Anthony; Hooton, Thomas M.; Infectious Diseases Society of America; American Society of Nephrology; American Geriatric Society (2005-03-01). "Infectious Diseases Society of America guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults". Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. 40 (5): 643–654. doi:10.1086/427507. ISSN 1537-6591. PMID 15714408.
↑ "Guidelines on Urological Infections".
↑ "Guidelines on Urological Infections".
↑ Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
↑ Workowski, Kimberly A.; Berman, Stuart; Centers for Disease Control and Prevention (CDC) (2010–12–17). "Sexually transmitted diseases treatment guidelines, 2010". MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control. 59 (RR–12): 1–110. ISSN 1545-8601. PMID 21160459. Check date values in: |date= (help)
↑ Workowski, Kimberly A.; Berman, Stuart; Centers for Disease Control and Prevention (CDC) (2010–12–17). "Sexually transmitted diseases treatment guidelines, 2010". MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control. 59 (RR–12): 1–110. ISSN 1545-8601. PMID 21160459. Check date values in: |date= (help)
↑ Workowski, Kimberly A.; Berman, Stuart; Centers for Disease Control and Prevention (CDC) (2010–12–17). "Sexually transmitted diseases treatment guidelines, 2010". MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control. 59 (RR–12): 1–110. ISSN 1545-8601. PMID 21160459. Check date values in: |date= (help)
↑ Tita AT, Andrews WW (2010). "Diagnosis and management of clinical chorioamnionitis". Clin Perinatol. 37 (2): 339–54. doi:10.1016/j.clp.2010.02.003. PMC 3008318. PMID 20569811.CS1 maint: PMC format (link)
↑ Fishman SG, Gelber SE (2012). "Evidence for the clinical management of chorioamnionitis". Semin Fetal Neonatal Med. 17 (1): 46–50. doi:10.1016/j.siny.2011.09.002. PMID 21962477.
↑ Workowski, Kimberly A.; Berman, Stuart; Centers for Disease Control and Prevention (CDC) (2010–12–17). "Sexually transmitted diseases treatment guidelines, 2010". MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control. 59 (RR–12): 1–110. ISSN 1545-8601. PMID 21160459. Check date values in: |date= (help)
↑ Workowski, Kimberly A.; Berman, Stuart; Centers for Disease Control and Prevention (CDC) (2010–12–17). "Sexually transmitted diseases treatment guidelines, 2010". MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control. 59 (RR–12): 1–110. ISSN 1545-8601. PMID 21160459. Check date values in: |date= (help)
↑ Centers for Disease Control and Prevention (CDC) (2012–08–10). "Update to CDC's Sexually transmitted diseases treatment guidelines, 2010: oral cephalosporins no longer a recommended treatment for gonococcal infections". MMWR. Morbidity and mortality weekly report. 61 (31): 590–594. ISSN 1545-861X. PMID 22874837. Check date values in: |date= (help)
↑ Workowski, Kimberly A.; Berman, Stuart; Centers for Disease Control and Prevention (CDC) (2010–12–17). "Sexually transmitted diseases treatment guidelines, 2010". MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control. 59 (RR–12): 1–110. ISSN 1545-8601. PMID 21160459. Check date values in: |date= (help)
↑ Workowski, Kimberly A.; Berman, Stuart; Centers for Disease Control and Prevention (CDC) (2010–12–17). "Sexually transmitted diseases treatment guidelines, 2010". MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control. 59 (RR–12): 1–110. ISSN 1545-8601. PMID 21160459. Check date values in: |date= (help)
↑ Lipsky BA, Byren I, Hoey CT (2010). "Treatment of bacterial prostatitis". Clin Infect Dis. 50 (12): 1641–52. doi:10.1086/652861. PMID 20459324.
↑ Horan, Teresa C.; Andrus, Mary; Dudeck, Margaret A. (2008-06). "CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting". American Journal of Infection Control. 36 (5): 309–332. doi:10.1016/j.ajic.2008.03.002. ISSN 1527-3296. PMID 18538699. Check date values in: |date= (help)
↑ Wise, Gilbert J.; Schlegel, Peter N. (2015-03-12). "Sterile pyuria". The New England Journal of Medicine. 372 (11): 1048–1054. doi:10.1056/NEJMra1410052. ISSN 1533-4406. PMID 25760357.
↑ Kwon, Jennie H.; Fausone, Maureen K.; Du, Hongyan; Robicsek, Ari; Peterson, Lance R. (2012-05). "Impact of laboratory-reported urine culture colony counts on the diagnosis and treatment of urinary tract infection for hospitalized patients". American Journal of Clinical Pathology. 137 (5): 778–784. doi:10.1309/AJCP4KVGQZEG1YDM. ISSN 1943-7722. PMID 22523217. Check date values in: |date= (help)
↑ Dieter, R. S. (2000). "Sterile pyuria: a differential diagnosis". Comprehensive Therapy. 26 (3): 150–152. ISSN 0098-8243. PMID 10984817.
↑ Wise, Gilbert J.; Schlegel, Peter N. (2015-03-12). "Sterile pyuria". The New England Journal of Medicine. 372 (11): 1048–1054. doi:10.1056/NEJMra1410052. ISSN 1533-4406. PMID 25760357.
↑ Workowski, Kimberly A.; Berman, Stuart; Centers for Disease Control and Prevention (CDC) (2010–12–17). "Sexually transmitted diseases treatment guidelines, 2010". MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control. 59 (RR–12): 1–110. ISSN 1545-8601. PMID 21160459. Check date values in: |date= (help)
↑ Workowski, Kimberly A.; Berman, Stuart; Centers for Disease Control and Prevention (CDC) (2010–12–17). "Sexually transmitted diseases treatment guidelines, 2010". MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control. 59 (RR–12): 1–110. ISSN 1545-8601. PMID 21160459. Check date values in: |date= (help)

[1] Nicolle, Lindsay E.; Bradley, Suzanne; Colgan, Richard; Rice, James C.; Schaeffer, Anthony; Hooton, Thomas M.; Infectious Diseases Society of America; American Society of Nephrology; American Geriatric Society (2005-03-01). "Infectious Diseases Society of America guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults". Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. 40 (5): 643–654. doi:10.1086/427507. ISSN 1537-6591. PMID 15714408.

[2] "Guidelines on Urological Infections".

[3] "Guidelines on Urological Infections".

[4] Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.

[5] Workowski, Kimberly A.; Berman, Stuart; Centers for Disease Control and Prevention (CDC) (2010–12–17). "Sexually transmitted diseases treatment guidelines, 2010". MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control. 59 (RR–12): 1–110. ISSN 1545-8601. PMID 21160459. Check date values in: |date= (help)

[6] Workowski, Kimberly A.; Berman, Stuart; Centers for Disease Control and Prevention (CDC) (2010–12–17). "Sexually transmitted diseases treatment guidelines, 2010". MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control. 59 (RR–12): 1–110. ISSN 1545-8601. PMID 21160459. Check date values in: |date= (help)

[7] Workowski, Kimberly A.; Berman, Stuart; Centers for Disease Control and Prevention (CDC) (2010–12–17). "Sexually transmitted diseases treatment guidelines, 2010". MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control. 59 (RR–12): 1–110. ISSN 1545-8601. PMID 21160459. Check date values in: |date= (help)

[pmid20569811-8] Tita AT, Andrews WW (2010). "Diagnosis and management of clinical chorioamnionitis". Clin Perinatol. 37 (2): 339–54. doi:10.1016/j.clp.2010.02.003. PMC 3008318. PMID 20569811.CS1 maint: PMC format (link)

[pmid21962477-9] Fishman SG, Gelber SE (2012). "Evidence for the clinical management of chorioamnionitis". Semin Fetal Neonatal Med. 17 (1): 46–50. doi:10.1016/j.siny.2011.09.002. PMID 21962477.

[10] Workowski, Kimberly A.; Berman, Stuart; Centers for Disease Control and Prevention (CDC) (2010–12–17). "Sexually transmitted diseases treatment guidelines, 2010". MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control. 59 (RR–12): 1–110. ISSN 1545-8601. PMID 21160459. Check date values in: |date= (help)

[11] Workowski, Kimberly A.; Berman, Stuart; Centers for Disease Control and Prevention (CDC) (2010–12–17). "Sexually transmitted diseases treatment guidelines, 2010". MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control. 59 (RR–12): 1–110. ISSN 1545-8601. PMID 21160459. Check date values in: |date= (help)

[12] Centers for Disease Control and Prevention (CDC) (2012–08–10). "Update to CDC's Sexually transmitted diseases treatment guidelines, 2010: oral cephalosporins no longer a recommended treatment for gonococcal infections". MMWR. Morbidity and mortality weekly report. 61 (31): 590–594. ISSN 1545-861X. PMID 22874837. Check date values in: |date= (help)

[13] Workowski, Kimberly A.; Berman, Stuart; Centers for Disease Control and Prevention (CDC) (2010–12–17). "Sexually transmitted diseases treatment guidelines, 2010". MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control. 59 (RR–12): 1–110. ISSN 1545-8601. PMID 21160459. Check date values in: |date= (help)

[14] Workowski, Kimberly A.; Berman, Stuart; Centers for Disease Control and Prevention (CDC) (2010–12–17). "Sexually transmitted diseases treatment guidelines, 2010". MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control. 59 (RR–12): 1–110. ISSN 1545-8601. PMID 21160459. Check date values in: |date= (help)

[pmid20459324-15] Lipsky BA, Byren I, Hoey CT (2010). "Treatment of bacterial prostatitis". Clin Infect Dis. 50 (12): 1641–52. doi:10.1086/652861. PMID 20459324.

[16] Horan, Teresa C.; Andrus, Mary; Dudeck, Margaret A. (2008-06). "CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting". American Journal of Infection Control. 36 (5): 309–332. doi:10.1016/j.ajic.2008.03.002. ISSN 1527-3296. PMID 18538699. Check date values in: |date= (help)

[17] Wise, Gilbert J.; Schlegel, Peter N. (2015-03-12). "Sterile pyuria". The New England Journal of Medicine. 372 (11): 1048–1054. doi:10.1056/NEJMra1410052. ISSN 1533-4406. PMID 25760357.

[18] Kwon, Jennie H.; Fausone, Maureen K.; Du, Hongyan; Robicsek, Ari; Peterson, Lance R. (2012-05). "Impact of laboratory-reported urine culture colony counts on the diagnosis and treatment of urinary tract infection for hospitalized patients". American Journal of Clinical Pathology. 137 (5): 778–784. doi:10.1309/AJCP4KVGQZEG1YDM. ISSN 1943-7722. PMID 22523217. Check date values in: |date= (help)

[19] Dieter, R. S. (2000). "Sterile pyuria: a differential diagnosis". Comprehensive Therapy. 26 (3): 150–152. ISSN 0098-8243. PMID 10984817.

[20] Wise, Gilbert J.; Schlegel, Peter N. (2015-03-12). "Sterile pyuria". The New England Journal of Medicine. 372 (11): 1048–1054. doi:10.1056/NEJMra1410052. ISSN 1533-4406. PMID 25760357.

[21] Workowski, Kimberly A.; Berman, Stuart; Centers for Disease Control and Prevention (CDC) (2010–12–17). "Sexually transmitted diseases treatment guidelines, 2010". MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control. 59 (RR–12): 1–110. ISSN 1545-8601. PMID 21160459. Check date values in: |date= (help)

[22] Workowski, Kimberly A.; Berman, Stuart; Centers for Disease Control and Prevention (CDC) (2010–12–17). "Sexually transmitted diseases treatment guidelines, 2010". MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control. 59 (RR–12): 1–110. ISSN 1545-8601. PMID 21160459. Check date values in: |date= (help)

[1]

[2]

[3]

[4]

[5]

[6]

[7]

[8]

[9]

[10]

[11]

[12]

[13]

[14]

[15]

[16]

[17]

[18]

[19]

[20]

[21]

[22]

@@ Line 1: / Line 1: @@
-==Empiric Therapy==
+===Asymptomatic bacteriuria===
-<SMALL><font color="#FF4C4C">'''▸ Click on the following categories to expand treatment regimens.'''</font><ref name="van de Beek-2010">{{Cite journal  | last1 = van de Beek | first1 = D. | last2 = Drake | first2 = JM. | last3 = Tunkel | first3 = AR. | title = Nosocomial bacterial meningitis. | journal = N Engl J Med | volume = 362 | issue = 2 | pages = 146-54 | month = Jan | year = 2010 | doi = 10.1056/NEJMra0804573 | PMID = 20071704 }}</ref><ref name="van de Beek-2012">{{Cite journal  | last1 = van de Beek | first1 = D. | last2 = Brouwer | first2 = MC. | last3 = Thwaites | first3 = GE. | last4 = Tunkel | first4 = AR. | title = Advances in treatment of bacterial meningitis. | journal = Lancet | volume = 380 | issue = 9854 | pages = 1693-702 | month = Nov | year = 2012 | doi = 10.1016/S0140-6736(12)61186-6 | PMID = 23141618 }}</ref></SMALL>
+* Asymptomatic bacteriuria<ref>{{Cite journal| doi = 10.1086/427507| issn = 1537-6591| volume = 40| issue = 5| pages = 643–654| last1 = Nicolle| first1 = Lindsay E.| last2 = Bradley| first2 = Suzanne| last3 = Colgan| first3 = Richard| last4 = Rice| first4 = James C.| last5 = Schaeffer| first5 = Anthony| last6 = Hooton| first6 = Thomas M.| last7 = Infectious Diseases Society of America| last8 = American Society of Nephrology| last9 = American Geriatric Society| title = Infectious Diseases Society of America guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults| journal = Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America| date = 2005-03-01| pmid = 15714408}}</ref><ref>{{Cite web | title = Guidelines on Urological Infections | url = http://uroweb.org/guideline/urological-infections/ }}</ref>
+:* '''Definitions'''
+::* For women: two consecutive voided urine specimens with isolation of the same bacterial strain in quantitative counts 􏰁≥ 10<sup>5</sup> cfu/mL
+::* For men: a single, clean-catch voided urine specimen with 1 bacterial species isolated in a quantitative count 􏰁􏰁≥ 10<sup>5</sup> cfu/mL
+::* For catheterized urine specimen: a single catheterized urine specimen with 1 bacterial species isolated in a quantitative count 􏰁􏰁≥ 10<sup>>2</sup> cfu/mL
-{|
+:* '''Causative pathogens'''
-| valign=top |
+::* Escherichia coli
-<div style="border-radius: 5px 5px 0 0; border: solid 1px #20538D; border-bottom: 0px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #A1BCDD; text-align: center;">
+::* Klebsiella pneumoniae
-<font color="#FFF">
+::* Coagulase-negative staphylococci
-'''Community-Acquired'''
+::* Enterococcus
-</font>
+::* Group B streptococci
-</div>
+::* Gardnerella vaginalis
+::* Pseudomonas aeruginosa, Proteus mirabilis, Providencia stuartii, Morganella morganii (common in patients with long-term urologic device in place)
-<div class="mw-customtoggle-table01" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
+:* '''Empiric antimicrobial therapy'''
-<font color="#FFF">
+::* Treatment of asymptomatic bacteriuria is '''<u>not</u>''' recommended for the following persons:
-&nbsp;&nbsp;▸&nbsp;&nbsp;'''Newborns, Age <1 Week'''
+:::* Premenopausal, nonpregnant women
-</font>
+:::* Diabetic women
-</div>
+:::* Older persons residing in the community
+:::* Elderly, institutionalized subjects
+:::* Persons with spinal cord injury
+:::* Catheterized patients while the catheter remains in situ
+:::: Note: Pyuria accompanying asymptomatic bacteriuria is not indicated for antibiotic therapy.
-<div class="mw-customtoggle-table02" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
+:* Specific considerations
-<font color="#FFF">
+::* '''Men'''
-&nbsp;&nbsp;▸&nbsp;&nbsp;'''Newborns, Age 1—4 Weeks'''
+:::* Screening for or treatment of asymptomatic bacteriuria in men is not recommended.
-</font>
-</div>
-<div class="mw-customtoggle-table03" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
+::* '''Women, premenopausal, nonpregnant'''
-<font color="#FFF">
+:::* Screening for or treatment of asymptomatic bacteriuria in premenopausal, nonpregnant women is not indicated.
-&nbsp;&nbsp;▸&nbsp;&nbsp;'''Infants & Children'''
-</font>
-</div>
-<div class="mw-customtoggle-table04" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
+::* '''Women, pregnant'''<ref>{{Cite web | title = Guidelines on Urological Infections | url = http://uroweb.org/guideline/urological-infections/ }}</ref>
-<font color="#FFF">
+:::* Preferred regimen (1): [[Nitrofurantoin]] 100 mg PO bid for 3–5 days (avoid in glucose-6-phosphate dehydrogenase deficiency)
-&nbsp;&nbsp;▸&nbsp;&nbsp;'''Adults, Age <50 Years'''
+:::* Preferred regimen (2): [[Amoxicillin]] 500 mg tid for 3–5 days
-</font>
+:::* Preferred regimen (3): [[Amoxicillin-Clavulanate]] 500 mg bid for 3–5 days
-</div>
+:::* Preferred regimen (4): [[Cephalexin]] 500 mg tid for 3–5 days
+:::* Preferred regimen (5): [[Fosfomycin]] 3 g as a single dose
+:::* Preferred regimen (6): [[Trimethoprim]] bid for 3–5 days (only after first trimester)
+:::: Note (1): Pregnant women should be screened for bacteriuria by urine culture at least once in early pregnancy, and they should be treated if the results are positive.
+:::: Note (2): Periodic screening for recurrent bacteriuria should be undertaken after therapy.
+:::: Note (3): IDSA guidelines recommend 3–7 days of antimicrobial therapy.
-<div class="mw-customtoggle-table05" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
+::* '''Women, diabetic'''
-<font color="#FFF">
+:::* Screening for or treatment of asymptomatic bacteriuria in diabetic women is not recommended.
-&nbsp;&nbsp;▸&nbsp;&nbsp;'''Adults, Age >50 Years'''
-</font>
-</div>
-<div class="mw-customtoggle-table06" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
+::* '''Older persons residing in the community'''
-<font color="#FFF">
+:::* Screening for or treatment of asymptomatic bacteriuria in older persons residing in the community is not recommended.
-&nbsp;&nbsp;▸&nbsp;&nbsp;'''Immunocompromised'''
-</font>
-</div>
-<div class="mw-customtoggle-table07" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
+::* '''Elderly institutionalized subjects'''
-<font color="#FFF">
+:::* Screening for or treatment of asymptomatic bacteriuria in elderly institutionalized residents of longterm care facilities is not recommended.
-&nbsp;&nbsp;▸&nbsp;&nbsp;'''Recurrent'''
-</font>
-</div>
-<div style="border-radius: 0 0 0 0; border: solid 1px #20538D; border-bottom: 0px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #A1BCDD; text-align: center;">
+::* '''Subjects with spinal cord injuries'''
-<font color="#FFF">
+:::* Screening for or treatment of asymptomatic bacteriuria in subjects with spinal cord injuries is not recommended.
-'''Nosocomial'''
-</font>
-</div>
-<div class="mw-customtoggle-table08" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
+::* '''Patients with indwelling urethral catheters'''
-<font color="#FFF">
+:::* Screening for or treatment of asymptomatic bacteriuria in patients with indwelling urethral catheters is not recommended.
-&nbsp;&nbsp;▸&nbsp;&nbsp;'''Postneurosurgical Infection'''
+:::: Note: Antimicrobial treatment of asymptomatic women with catheter-acquired bacteriuria that persists 48 hours after catheter removal may be considered.
-</font>
-</div>
-<div class="mw-customtoggle-table09" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
+::* '''Urologic interventions'''<ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
-<font color="#FFF">
+:::* Screening for or treatment of asymptomatic bacteriuria before transurethral resection of the prostate is recommended.
-&nbsp;&nbsp;▸&nbsp;&nbsp;'''CSF Shunt Infection'''
+:::* Preferred regimen: [[Trimethoprim-Sulfamethoxazole]] DS 1 tab bid for 3 days after obtaining urine cultures
-</font>
-</div>
-<div class="mw-customtoggle-table10" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
+===Ectoparasitic Infections===
-<font color="#FFF">
+===='''Pediculosis Pubis'''====
-&nbsp;&nbsp;▸&nbsp;&nbsp;'''Penetrating Trauma'''
+:* Preferred regime: [[Permethrin]] 1% cream rinse applied to affected areas and washed off after 10 minutes {{or}} [[Pyrethrins]] with [[piperonyl butoxide]] applied to the affected area and washed off after 10 minutes
-</font>
-</div>
-<div class="mw-customtoggle-table11" style="cursor: pointer; border-radius: 0 0 5px 5px; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
+:* Alternative regime: [[Malathion]] 0.5% lotion applied for 8--12 hours and washed off {{or}} [[Ivermectin]] 250 µg/kg orally, repeated in 2 weeks
-<font color="#FFF">
-&nbsp;&nbsp;▸&nbsp;&nbsp;'''Basilar Skull Fracture'''
-</font>
-</div>
-| valign=top |
-{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table01" style="background: #FFFFFF;"
-| valign=top |
-{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
-! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Newborns, Age <1 Week}}
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Ampicillin]] 50 mg/kg IV q8h'''''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | PLUS
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Cefotaxime]] 50 mg/kg IV q8—12h'''''
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen'''''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Ampicillin]] 50 mg/kg IV q8h'''''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | PLUS
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Gentamicin]] 2.5 mg/kg IV q12h'''''
-|-
-|}
-|}
-{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table02" style="background: #FFFFFF;"
-| valign=top |
-{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
-! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Newborns, Age 1—4 Weeks}}
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Ampicillin]] 200 mg/kg/day IV q6—8h'''''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | PLUS
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Cefotaxime]] 50 mg/kg IV q6—8h'''''
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen'''''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Ampicillin]] 200 mg/kg/day IV q6—8h'''''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | PLUS
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Gentamicin]] 2.5 mg/kg IV q8h''''' <BR> OR <BR> ▸ '''''[[Tobramycin]] 2.5 mg/kg IV q8h''''' <BR> OR <BR> ▸ '''''[[Amikacin]] 10 mg/kg IV q8h'''''
-|-
-|}
-|}
-{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table03" style="background: #FFFFFF;"
-| valign=top |
-{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
-! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Infants & Children}}
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''<sup>†</sup>
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Vancomycin]] 15 mg/kg IV q6h''''' <SMALL>(trough 15—20 μg/mL)</SMALL>
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | PLUS
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Cefotaxime]] 75 mg/kg IV q6—8h''''' <BR> OR <BR> ▸ '''''[[Ceftriaxone]] 80—100 mg/kg/day IV q12—24h'''''
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen'''''<sup>†</sup>
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Vancomycin]] 15 mg/kg IV q6h''''' <SMALL>(trough 15—20 μg/mL)</SMALL>
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | PLUS
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Meropenem]] 40 mg/kg IV q8h'''''
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=left | <SMALL><sup>†</sup> Add '''''[[Ampicillin]] 75 mg/kg IV q6h''''' if suspecting ''[[Listeria monocytogenes]]''.</SMALL>
-|-
-|}
-|}
-{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table04" style="background: #FFFFFF;"
-| valign=top |
-{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
-! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Adults, Age <50 Years}}
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''<sup>†</sup>
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Vancomycin]] 15 mg/kg IV q8—12h''''' <SMALL>(trough 15—20 μg/mL)</SMALL>
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | PLUS
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Cefotaxime]] 2 g IV q4—6h'''''<BR> OR <BR> ▸ '''''[[Ceftriaxone]] 2 g IV q12h'''''
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen'''''<sup>†</sup>
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Vancomycin]] 15 mg/kg IV q8—12h''''' <SMALL>(trough 15—20 μg/mL)</SMALL>
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | PLUS
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Meropenem]] 2 g IV q8h'''''
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=left | <SMALL><sup>†</sup> Add '''''[[Ampicillin]] 2 g IV q4h''''' if suspecting ''[[Listeria monocytogenes]]''.</SMALL>
-|-
-|}
-|}
-{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table05" style="background: #FFFFFF;"
-| valign=top |
-{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
-! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Adults, Age >50 Years}}
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Vancomycin]] 15 mg/kg IV q8—12h''''' <SMALL>(trough 15—20 μg/mL)</SMALL>
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | PLUS
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Cefotaxime]] 2 g IV q4—6h'''''<BR> OR <BR> ▸ '''''[[Ceftriaxone]] 2 g IV q12h'''''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | PLUS
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Ampicillin]] 2 g IV q4h'''''
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen'''''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Vancomycin]] 15 mg/kg IV q8—12h''''' <SMALL>(trough 15—20 μg/mL)</SMALL>
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | PLUS
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Aztreonam]] 2 g IV q6—8h'''''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | PLUS
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[TMP/SMZ]] 5 mg/kg IV q6—12h''''' <SMALL>(TMP component)</SMALL>
-|-
-|}
-|}
-{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table06" style="background: #FFFFFF;"
-| valign=top |
-{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
-! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Immunocompromised}}
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Vancomycin]] 15 mg/kg IV q8—12h''''' <SMALL>(trough 15—20 μg/mL)</SMALL>
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | PLUS
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Cefepime]] 2 g IV q8h'''''<BR> OR <BR> ▸ '''''[[Meropenem]] 2 g IV q8h'''''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | PLUS
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Ampicillin]] 2 g IV q4h'''''
-|-
-|}
-|}
-{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table07" style="background: #FFFFFF;"
-| valign=top |
-{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
-! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Recurrent}}
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Vancomycin]] 15 mg/kg IV q8—12h''''' <SMALL>(trough 15—20 μg/mL)</SMALL>
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | PLUS
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Cefotaxime]] 2 g IV q4—6h'''''<BR> OR <BR> ▸ '''''[[Ceftriaxone]] 2 g IV q12h'''''
-|-
-|}
-|}
-{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table08" style="background: #FFFFFF;"
-| valign=top |
-{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
-! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Postneurosurgical Infection}}
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Vancomycin]] 15 mg/kg IV q8—12h''''' <SMALL>(trough 15—20 μg/mL)</SMALL>
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | PLUS
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Cefepime]] 2 g IV q8h'''''<BR> OR <BR> ▸ '''''[[Ceftazidime]] 2 g IV q8h'''''<BR> OR <BR> ▸ '''''[[Meropenem]] 2 g IV q8h'''''
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen'''''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Vancomycin]] 15 mg/kg IV q8—12h''''' <SMALL>(trough 15—20 μg/mL)</SMALL>
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | PLUS
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Aztreonam]] 2 g IV q6—8h'''''<BR> OR <BR> ▸ '''''[[Ciprofloxacin]] 400 mg IV q8—12h'''''
-|-
-|}
-|}
-{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table09" style="background: #FFFFFF;"
-| valign=top |
-{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
-! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|CSF Shunt Infection}}
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Vancomycin]] 15 mg/kg IV q8—12h''''' <SMALL>(trough 15—20 μg/mL)</SMALL>
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | PLUS
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Cefepime]] 2 g IV q8h'''''<BR> OR <BR> ▸ '''''[[Ceftazidime]] 2 g IV q8h'''''<BR> OR <BR> ▸ '''''[[Meropenem]] 2 g IV q8h'''''
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen'''''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Vancomycin]] 15 mg/kg IV q8—12h''''' <SMALL>(trough 15—20 μg/mL)</SMALL>
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | PLUS
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Aztreonam]] 2 g IV q6—8h'''''<BR> OR <BR> ▸ '''''[[Ciprofloxacin]] 400 mg IV q8—12h'''''
-|-
-|}
-|}
-{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table10" style="background: #FFFFFF;"
-| valign=top |
-{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
-! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Penetrating Trauma}}
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Vancomycin]] 15 mg/kg IV q8—12h''''' <SMALL>(trough 15—20 μg/mL)</SMALL>
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | PLUS
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Cefepime]] 2 g IV q8h'''''<BR> OR <BR> ▸ '''''[[Ceftazidime]] 2 g IV q8h'''''<BR> OR <BR> ▸ '''''[[Meropenem]] 2 g IV q8h'''''
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen'''''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Vancomycin]] 15 mg/kg IV q8—12h''''' <SMALL>(trough 15—20 μg/mL)</SMALL>
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | PLUS
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Aztreonam]] 2 g IV q6—8h'''''<BR> OR <BR> ▸ '''''[[Ciprofloxacin]] 400 mg IV q8—12h'''''
-|-
-|}
-|}
-{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table11" style="background: #FFFFFF;"
-| valign=top |
-{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
-! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Basilar Skull Fracture}}
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Vancomycin]] 15 mg/kg IV q8—12h''''' <SMALL>(trough 15—20 μg/mL)</SMALL>
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | PLUS
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Cefotaxime]] 2 g IV q4—6h'''''<BR> OR <BR> ▸ '''''[[Ceftriaxone]] 2 g IV q12h'''''
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen'''''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Vancomycin]] 15 mg/kg IV q8—12h''''' <SMALL>(trough 15—20 μg/mL)</SMALL>
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | PLUS
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Aztreonam]] 2 g IV q6—8h'''''<BR> OR <BR> ▸ '''''[[Ciprofloxacin]] 400 mg IV q8—12h'''''
-|-
-|}
-|}
-|}
+===='''Scabies'''====
+:* Preferred regime: [[Permethrin]] cream (5%) applied to all areas of the body from the neck down and washed off after 8--14 hours {{or}} [[Ivermectin]] 200ug/kg orally, repeated in 2 weeks
+:* Alternative regime: [[Lindane]] (1%) 1 oz. of lotion (or 30 g of cream) applied in a thin layer to all areas of the body from the neck down and thoroughly washed off after 8 hours
-==CSF Gram Stain-Based Therapy==
+===Human papillomavirus infection===
+===='''Genital Warts'''====
+====='''External Genital Warts'''=====
+*Patient-Applied:
-<SMALL><font color="#FF4C4C">'''▸ Click on the following categories to expand treatment regimens.'''</font><ref name="pmid15494903">Tunkel AR, Hartman BJ, Kaplan SL, Kaufman BA, Roos KL, Scheld WM et al. (2004) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=15494903 Practice guidelines for the management of bacterial meningitis.] ''Clin Infect Dis'' 39 (9):1267-84. [http://dx.doi.org/10.1086/425368 DOI:10.1086/425368] PMID: [http://pubmed.gov/1549490315494903]</ref><ref name="van de Beek-2012">{{Cite journal  | last1 = van de Beek | first1 = D. | last2 = Brouwer | first2 = MC. | last3 = Thwaites | first3 = GE. | last4 = Tunkel | first4 = AR. | title = Advances in treatment of bacterial meningitis. | journal = Lancet | volume = 380 | issue = 9854 | pages = 1693-702 | month = Nov | year = 2012 | doi = 10.1016/S0140-6736(12)61186-6 | PMID = 23141618 }}</ref></SMALL>
+:* Preferred regime: [[Podofilox]] 0.5% solution or gel {{or}} [[Imiquimod]] 5% cream {{or}} [[Sinecatechins]] 15% ointment
+*Provider--Administered:
+:* Preferred regime: [[Cryotherapy]] with liquid nitrogen or cryoprobe, repeat applications every 1-2 weeks {{or}} [[Podophyllin]] resin 10%-25% in a compound tincture of benzoin {{or}} [[Trichloroacetic acid]] (TCA) {{or}} [[Bichloroacetic]] acid (BCA) 80%-90% {{or}} Surgical removal either by tangential scissor excision, tangential shave excision, curettage, or electrosurgery.
+:* Alternative regime: intralesional [[interferon]], photodynamic therapy, and topical [[Cidofovir].
-{|
+====='''Cervical Warts'''=====
-| valign=top |
+:* Preferred regime: For women who have exophytic cervical warts, a biopsy evaluation to exclude high-grade SIL must be performed before treatment is initiated. Management of exophytic cervical warts should include consultation with a specialist.
-<div style="border-radius: 5px 5px 0 0; border: solid 1px #20538D; border-bottom: 0px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #A1BCDD; text-align: center;">
+====='''Vaginal Warts'''=====
-<font color="#FFF">
+:* Preferred regime: Cryotherapy with liquid nitrogen. The use of a cryoprobe in the vagina is not recommended because of the risk for vaginal perforation and fistula formation {{or}} TCA or BCA 80%--90% applied to warts. A small amount should be applied only to warts and allowed to dry, at which time a white frosting develops. If an excess amount of acid is applied, the treated area should be powdered with talc, sodium bicarbonate, or liquid soap preparations to remove unreacted acid. This treatment can be repeated weekly, if necessary.
-'''Gram-Positive'''
+====='''Urethral Meatus Warts'''=====
-</font>
+:* Preferred regime: Cryotherapy with liquid nitrogen {{or}} [[Podophyllin]] 10%--25% in compound tincture of benzoin. The treatment area and adjacent normal skin must be dry before contact with podophyllin. This treatment can be repeated weekly, if necessary. The safety of podophyllin during pregnancy has not been established. Data are limited on the use of podofilox and imiquimod for treatment of distal meatal warts.
-</div>
+====='''Anal Warts'''=====
+:* Preferred regime: Cryotherapy with liquid nitrogen {{or}} TCA or BCA 80%--90% applied to warts. A small amount should be applied only to warts and allowed to dry, at which time a white frosting develops. If an excess amount of acid is applied, the treated area should be powdered with talc, sodium bicarbonate, or liquid soap preparations to remove unreacted acid. This treatment can be repeated weekly, if necessary. {{or}} Surgical removal
-<div class="mw-customtoggle-table12" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
+===Vaginal infection===
-<font color="#FFF">
-&nbsp;&nbsp;▸&nbsp;&nbsp;'''Gram-Positive Cocci in Chains'''
-</font>
-</div>
-<div class="mw-customtoggle-table13" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
+===='''Bacterial vaginosis'''====
-<font color="#FFF">
+:* Preferred regime: [[Metronidazole]] 500 mg orally twice a day for 7 days {{or}} [[Metronidazole]] gel 0.75%, one full applicator (5 g) intravaginally, once a day for 5 days {{or}} [[Clindamycin]] cream 2%, one full applicator (5 g) intravaginally at bedtime for 7 days
-&nbsp;&nbsp;▸&nbsp;&nbsp;'''Gram-Positive Cocci in Pairs'''
-</font>
-</div>
-<div class="mw-customtoggle-table14" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
+:* Alternative regime (1): [[Tinidazole]] 2 g orally once daily for 3 days
-<font color="#FFF">
-&nbsp;&nbsp;▸&nbsp;&nbsp;'''Gram-Positive (Cocco-)Bacilli'''
-</font>
-</div>
-<div style="border-radius: 0 0 0 0; border: solid 1px #20538D; border-bottom: 0px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #A1BCDD; text-align: center;">
+:* Alternative regime (2): [[Tinidazole]] 1 g orally once daily for 5 days
-<font color="#FFF">
-'''Gram-Negative'''
-</font>
-</div>
-<div class="mw-customtoggle-table15" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
+:* Alternative regime (3): [[Clindamycin]] 300 mg orally twice daily for 7 days
-<font color="#FFF">
-&nbsp;&nbsp;▸&nbsp;&nbsp;'''Gram-Negative Cocci in Pairs'''
-</font>
-</div>
-<div class="mw-customtoggle-table16" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
+:* Alternative regime (4): [[Clindamycin]] ovules 100 mg intravaginally once at bedtime for 3 days
-<font color="#FFF">
-&nbsp;&nbsp;▸&nbsp;&nbsp;'''Gram-Negative Coccobacilli'''
-</font>
-</div>
-<div class="mw-customtoggle-table17" style="cursor: pointer; border-radius: 0 0 5px 5px; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
+====='''Bacterial vaginosis during pregnancy'''=====
-<font color="#FFF">
+:* Preferred regime: [[Metronidazole]] 500 mg orally twice a day for 7 days {{or}} [[Metronidazole]] 250 mg orally three times a day for 7 days {{or}} [[Clindamycin]] 300 mg orally twice a day for 7 days
-&nbsp;&nbsp;▸&nbsp;&nbsp;'''Gram-Negative Bacilli'''
-</font>
-</div>
-| valign=top |
+===='''Trichomoniasis'''====
-{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table12" style="background: #FFFFFF;"
+''T. vaginalis''
-| valign=top |
+:* Preferred regime: [[Metronidazole]] 2 g orally in a single dose {{or}} [[Tinidazole]] 2 g orally in a single dose
-{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
-! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Gram-Positive Cocci in Chains}}
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''''Preferred Regimen'''''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Vancomycin]] 15 mg/kg IV q8—12h''''' <SMALL>(trough 15—20 μg/mL)</SMALL>
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | PLUS
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Cefotaxime]] 2 g IV q4—6h'''''<BR> OR <BR> ▸ '''''[[Ceftriaxone]] 2 g IV q12h'''''
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''''Alternative Regimen'''''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Meropenem]] 2 g IV q8h'''''<BR> OR <BR> ▸ '''''[[Moxifloxacin]] 400 mg IV q24h'''''
-|-
-|}
-|}
-{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table13" style="background: #FFFFFF;"
-| valign=top |
-{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
-! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Gram-Positive Cocci in Pairs}}
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''''Preferred Regimen'''''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Ampicillin]] 2 g IV q4h'''''<BR> OR <BR> ▸ '''''[[Penicillin G]] 4 MU IV q4h'''''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | PLUS
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Gentamicin]] 1.7 mg/kg IV q8h'''''
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''''Alternative Regimen'''''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Cefotaxime]] 2 g IV q4—6h'''''<BR> OR <BR> ▸ '''''[[Ceftriaxone]] 2 g IV q12h'''''
-|-
-|}
-|}
-{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table14" style="background: #FFFFFF;"
-| valign=top |
-{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
-! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Gram-Positive (Cocco-)Bacilli}}
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''''Preferred Regimen'''''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Ampicillin]] 2 g IV q4h'''''<BR> OR <BR> ▸ '''''[[Penicillin G]] 4 MU IV q4h'''''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | PLUS
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Gentamicin]] 1.7 mg/kg IV q8h'''''
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''''Alternative Regimen'''''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[TMP/SMZ]] 5 mg/kg IV q6—12h''''' <SMALL>(TMP component)</SMALL><BR> OR <BR> ▸ '''''[[Meropenem]] 2 g IV q8h'''''
-|-
-|}
-|}
-{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table15" style="background: #FFFFFF;"
-| valign=top |
-{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
-! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Gram-Negative Cocci in Pairs}}
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''''Preferred Regimen'''''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Cefotaxime]] 2 g IV q4—6h'''''<BR> OR <BR> ▸ '''''[[Ceftriaxone]] 2 g IV q12h'''''
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''''Alternative Regimen'''''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Penicillin G]] 4 MU IV q4h'''''<BR> OR <BR> ▸ '''''[[Ampicillin]] 2 g IV q4h'''''<BR> OR <BR> ▸ '''''[[Chloramphenicol]] 1—1.5 g IV q6h'''''<BR> OR <BR> ▸ '''''[[Moxifloxacin]] 400 mg IV q24h'''''<BR> OR <BR> ▸ '''''[[Aztreonam]] 2 g IV q6—8h'''''
-|-
-|}
-|}
-{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table16" style="background: #FFFFFF;"
-| valign=top |
-{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
-! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Gram-Negative Coccobacilli}}
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''''Preferred Regimen'''''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Cefotaxime]] 2 g IV q4—6h'''''<BR> OR <BR> ▸ '''''[[Ceftriaxone]] 2 g IV q12h'''''
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''''Alternative Regimen'''''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Chloramphenicol]] 1—1.5 g IV q6h'''''<BR> OR <BR> ▸ '''''[[Cefepime]] 2 g IV q8h'''''<BR> OR <BR> ▸ '''''[[Meropenem]] 2 g IV q8h'''''<BR> OR <BR> ▸ '''''[[Moxifloxacin]] 400 mg IV q24h'''''
-|-
-|}
-|}
-{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table17" style="background: #FFFFFF;"
-| valign=top |
-{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
-! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Gram-Negative Bacilli}}
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''''Preferred Regimen'''''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Cefotaxime]] 2 g IV q4—6h'''''<BR> OR <BR> ▸ '''''[[Ceftriaxone]] 2 g IV q12h'''''
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''''Alternative Regimen'''''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Cefepime]] 2 g IV q8h'''''<BR> OR <BR> ▸ '''''[[Meropenem]] 2 g IV q8h'''''<BR> OR <BR> ▸ '''''[[Aztreonam]] 2 g IV q6—8h'''''<BR> OR <BR> ▸ '''''[[Moxifloxacin]] 400 mg IV q24h'''''<BR> OR <BR> ▸ '''''[[TMP/SMZ]] 5 mg/kg IV q6—12h''''' <SMALL>(TMP component)</SMALL>
-|-
-|}
-|}
-|}
+:* Alternative regime: [[Metronidazole]] 500 mg orally twice a day for 7 days
-==Pathogen-Based Therapy — Bacteria==
+====='''Trichomoniasis during pregnancy'''=====
+:* Preferred regime: 2 g [[Metronidazole]] in a single dose at any stage of pregnancy, withholding breastfeeding during treatment and for 12--24 hours after the last dose will reduce the exposure of the infant to metronidazole.
-<SMALL><font color="#FF4C4C">'''▸ Click on the following categories to expand treatment regimens.'''</font><ref name="pmid15494903">Tunkel AR, Hartman BJ, Kaplan SL, Kaufman BA, Roos KL, Scheld WM et al. (2004) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=15494903 Practice guidelines for the management of bacterial meningitis.] ''Clin Infect Dis'' 39 (9):1267-84. [http://dx.doi.org/10.1086/425368 DOI:10.1086/425368] PMID: [http://pubmed.gov/1549490315494903]</ref><ref name="van de Beek-2012">{{Cite journal  | last1 = van de Beek | first1 = D. | last2 = Brouwer | first2 = MC. | last3 = Thwaites | first3 = GE. | last4 = Tunkel | first4 = AR. | title = Advances in treatment of bacterial meningitis. | journal = Lancet | volume = 380 | issue = 9854 | pages = 1693-702 | month = Nov | year = 2012 | doi = 10.1016/S0140-6736(12)61186-6 | PMID = 23141618 }}</ref></SMALL>
+===='''Vulvovaginal candidiasis'''====
-{|
+====='''Uncomplicated VVC'''=====
-| valign=top |
+:* Preferred regime:
-<div style="border-radius: 5px 5px 0 0; border: solid 1px #20538D; border-bottom: 0px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #A1BCDD; text-align: center;">
+::* Over-the-Counter Intravaginal Agents: [[Butoconazole]] 2% cream 5 g intravaginally for 3 days {{or}} [[Clotrimazole]] 1% cream 5 g intravaginally for 7--14 days {{or}} [[Clotrimazole]] 2% cream 5 g intravaginally for 3 days {{or}} [Miconazole]] 2% cream 5 g intravaginally for 7 days {{or}} [[Miconazole]] 4% cream 5 g intravaginally for 3 days {{or}} [[Miconazole]] 100 mg vaginal suppository, one suppository for 7 days {{or}} [[Miconazole]] 200 mg vaginal suppository, one suppository for 3 days {{or}} [[Miconazole]] 1,200 mg vaginal suppository, one suppository for 1 day {{or}} [[Tioconazole]] 6.5% ointment 5 g intravaginally in a single application
-<font color="#FFF">
+::* Prescription Intravaginal Agents: [[Butoconazole]] 2% cream (single dose bioadhesive product), 5 g intravaginally for 1 day {{or}} [[Nystatin]] 100,000-unit vaginal tablet, one tablet for 14 days {{or}} [[Terconazole]] 0.4% cream 5 g intravaginally for 7 days {{or}} [[Terconazole]] 0.8% cream 5 g intravaginally for 3 days {{or}} [[Terconazole]] 80 mg vaginal suppository, one suppository for 3 days
-'''Bacteria'''
+::* Oral Agent: [[Fluconazole]] 150 mg oral tablet, one tablet in single dose
-</font>
-</div>
-<div class="mw-customtoggle-table18" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
+====='''Complicated VVC'''=====
-<font color="#FFF">
+*Recurrent Vulvovaginal Candidiasis (RVVC)
-&nbsp;&nbsp;▸&nbsp;&nbsp;'''''Acinetobacter baumannii'''''
-</font>
-</div>
-<div class="mw-customtoggle-table19" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
+:* Preferred regime: 7-14 days of topical therapy {{or}} a 100-mg, 150-mg, or 200-mg oral dose of [[Fluconazole]] every third day for a total of 3 doses followed by Oral [[Fluconazole]] (i.e., 100-mg, 150-mg, or 200-mg dose) weekly for 6 months
-<font color="#FFF">
-&nbsp;&nbsp;▸&nbsp;&nbsp;'''''Enterobacteriaceae'''''
-</font>
-</div>
-<div class="mw-customtoggle-table20" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
+*Severe VVC
-<font color="#FFF">
+:* Preferred regime: Topical [[Azole]] for 7-14 days {{or}} 150 mg of [[Fluconazole]] in two sequential doses (second dose 72 hours after initial dose.
-&nbsp;&nbsp;▸&nbsp;&nbsp;'''''Haemophilus influenzae'''''
-</font>
-</div>
-<div class="mw-customtoggle-table21" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
+*Nonalbicans VVC
-<font color="#FFF">
+:* Preferred regime: nonfluconazole [[Azole]] drug (oral or topical) for 7-14 days.
-&nbsp;&nbsp;▸&nbsp;&nbsp;'''''Listeria monocytogenes'''''
-</font>
-</div>
-<div class="mw-customtoggle-table22" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
+====='''Vulvovaginal candidiasis during pregnancy'''=====
-<font color="#FFF">
+:* Preferred regime: topical [[Azole]] therapies for 7 days
-&nbsp;&nbsp;▸&nbsp;&nbsp;'''''Neisseria meningitidis'''''
-</font>
-</div>
-<div class="mw-customtoggle-table23" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
+===Cervicitis===
-<font color="#FFF">
-&nbsp;&nbsp;▸&nbsp;&nbsp;'''''Pseudomonas aeruginosa'''''
-</font>
-</div>
-<div class="mw-customtoggle-table24" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
+* Cervicitis<ref>{{Cite journal| issn = 1545–8601| volume = 59| issue = RR–12| pages = 1–110| last1 = Workowski| first1 = Kimberly A.| last2 = Berman| first2 = Stuart| last3 = Centers for Disease Control and Prevention (CDC)| title = Sexually transmitted diseases treatment guidelines, 2010| journal = MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control| date = 2010–12–17| pmid = 21160459}}</ref>
-<font color="#FFF">
+:* Preferred regimen: [[Azithromycin]] 1 g PO in a single dose {{or}} [[Doxycycline]] 100 mg PO bid for 7 days
-&nbsp;&nbsp;▸&nbsp;&nbsp;'''''Staphylococcus aureus'''''
-</font>
-</div>
-<div class="mw-customtoggle-table25" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
+===Chancroid===
-<font color="#FFF">
-&nbsp;&nbsp;▸&nbsp;&nbsp;'''''Staphylococcus epidermidis'''''
-</font>
-</div>
-<div class="mw-customtoggle-table26" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
+* Chancroid (''Haemophilus ducreyi'' infection)<ref>{{Cite journal| issn = 1545–8601| volume = 59| issue = RR–12| pages = 1–110| last1 = Workowski| first1 = Kimberly A.| last2 = Berman| first2 = Stuart| last3 = Centers for Disease Control and Prevention (CDC)| title = Sexually transmitted diseases treatment guidelines, 2010| journal = MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control| date = 2010–12–17| pmid = 21160459}}</ref>
-<font color="#FFF">
+:* Preferred regimen: [[Azithromycin]] 1 g PO as a single dose {{or}} [[Ceftriaxone]] 250 mg IM as a single dose {{or}} [[Ciprofloxacin]] 500 mg PO bid for 3 days {{or}} [[Erythromycin]] 500 mg PO tid for 7 days
-&nbsp;&nbsp;▸&nbsp;&nbsp;'''''Streptococcus agalactiae'''''
+:: Note (1): Ciprofloxacin is contraindicated for pregnant and lactating women.
-</font>
+:: Note (2): Patients should be tested for HIV infection at the time chancroid is diagnosed. If the initial test results were negative, a serologic test for syphilis and HIV infection should be performed 3 months after the diagnosis of chancroid.
-</div>
+:: Note (3): HIV-infected patients might require repeated or longer courses of therapy than those recommended for HIV-negative patients.
+:: Note (4): Sex partners of patients who have chancroid should be examined and treated if they had sexual contact with the patient during the 10 days preceding the patient's onset of symptoms.
-<div class="mw-customtoggle-table27" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
+===Chlamydial infections===
-<font color="#FFF">
-&nbsp;&nbsp;▸&nbsp;&nbsp;'''''Streptococcus pneumoniae'''''
-</font>
-</div>
-<div style="border-radius: 0 0 0 0; border: solid 1px #20538D; border-bottom: 0px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #A1BCDD; text-align: center;">
+* Chlamydial infections<ref>{{Cite journal| issn = 1545–8601| volume = 59| issue = RR–12| pages = 1–110| last1 = Workowski| first1 = Kimberly A.| last2 = Berman| first2 = Stuart| last3 = Centers for Disease Control and Prevention (CDC)| title = Sexually transmitted diseases treatment guidelines, 2010| journal = MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control| date = 2010–12–17| pmid = 21160459}}</ref>
-<font color="#FFF">
+:* '''Chlamydial infections in adolescents and adults'''
-'''Mycobacteria'''
+::* Preferred regimen: [[Azithromycin]] 1 g PO in a single dose {{or}} [[Doxycycline]] 100 mg PO bid for 7 days
-</font>
+::* Alternative regimen (1): [[Erythromycin]] base 500 mg PO qid for 7 days
-</div>
+::* Alternative regimen (2): [[Erythromycin ethylsuccinate]] 800 mg PO qid for 7 days
+::* Alternative regimen (3): [[Levofloxacin]] 500 mg PO qd for 7 days
+::* Alternative regimen (4): [[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.
-<div class="mw-customtoggle-table28" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
+:* '''Chlamydial infections during pregnancy'''
-<font color="#FFF">
+::* Preferred regimen: [[Azithromycin]] 1 g PO in a single dose {{or}} [[Amoxicillin]] 500 mg PO tid for 7 days
-&nbsp;&nbsp;▸&nbsp;&nbsp;'''''Mycobacterium tuberculosis'''''
+::* Alternative regimen (1): [[Erythromycin]] base 500 mg PO qid for 7 days
-</font>
+::* Alternative regimen (2): [[Erythromycin]] base 250 mg PO qid for 14 days
-</div>
+::* Alternative regimen (3): [[Erythromycin ethylsuccinate]] 800 mg PO qid for 7 days
+::* Alternative regimen (4): [[Erythromycin ethylsuccinate]] 400 mg PO qid for 14 days
+::: Note: Doxycycline, ofloxacin, and levofloxacin are contraindicated in pregnant women.
-<div style="border-radius: 0 0 0 0; border: solid 1px #20538D; border-bottom: 0px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #A1BCDD; text-align: center;">
+:* '''Chlamydial infections among infants'''
-<font color="#FFF">
+::* Ophthalmia neonatorum caused by ''C. trachomatis''
-'''Spirochetes'''
+:::* Preferred regimen: [[Erythromycin]] base or ethylsuccinate 50 mg/kg/day PO divided into 4 doses daily for 14 days
-</font>
+:::: Note: The mothers of infants who have chlamydial infection and the sex partners of these women should be evaluated and treated.
-</div>
-<div class="mw-customtoggle-table29" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
+::* Infant pneumonia caused by ''C. trachomatis''
-<font color="#FFF">
+:::* Preferred regimen (< 45 kg): [[Erythromycin]] base or ethylsuccinate 50 mg/kg/day PO divided into 4 doses daily for 14 days
-&nbsp;&nbsp;▸&nbsp;&nbsp;'''''Borrelia burgdorferi'''''
+:::* Preferred regimen (≥ 45 kg & < 8 years): [[Azithromycin]] 1 g PO in a single dose
-</font>
+:::* Preferred regimen (≥ 8 years): [[Azithromycin]] 1 g PO in a single dose {{or}} [[Doxycycline]] 100 mg PO bid for 7 days
-</div>
-<div class="mw-customtoggle-table30" style="cursor: pointer; border-radius: 0 0 5px 5px; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
+===Chorioamnionitis===
-<font color="#FFF">
+* Antibiotics <ref name="pmid20569811">{{cite journal| author=Tita AT, Andrews WW| title=Diagnosis and management of clinical chorioamnionitis. | journal=Clin Perinatol | year= 2010 | volume= 37 | issue= 2 | pages= 339-54 | pmid=20569811 | doi=10.1016/j.clp.2010.02.003 | pmc=PMC3008318 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20569811  }} </ref>
-&nbsp;&nbsp;▸&nbsp;&nbsp;'''''Treponema pallidum'''''
+:* Preferred regime: [[Ampicillin]] 2 g intravenously every 6 h {{or}} [[Penicillin]] 5x10<sup>6</sup> units intravenously every 6 h {{and}} [[Gentamicin]] 1.5 mg/kg every 8 h
-</font>
+:* NOTE (1): [[Cephalosporins]] are generally recommended for women with chorioamnionitis who are allergic to [[Penicillin]]
-</div>
+:* NOTE (2): In women with anaphylaxis to [[Penicillin]] a recommendation is to substitute [[Clindamycin]] 900 mg every 8 h
-| valign=top |
+:* NOTE (3): In the non-obstetric population, daily dosing of [[Gentamicin]] appears to be more effective, convenient, and cost-effective as well as less toxic.
-{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table18" style="background: #FFFFFF;"
+:* NOTE (4): Recommends the addition of a drug with enhanced anaerobic coverage, such as [[Clindamycin]] every 8 hours {{or}} [[Metronidazole]], in those cases of chorioamnionitis that require cesarean delivery
-| valign=top |
+:* NOTE (5): chorioamnionitis is a contraindication to the administration of [[Corticosteroids]]. Women with intra-amniotic infection have traditionally been excluded from randomized trials of corticosteroid therapy.
-{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
-! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|''Acinetobacter baumannii''}}
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Preferred Regimen'''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Meropenem]] 2 g IV q8h'''''
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Alternative Regimen'''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Colistin]] 1.25 mg/kg IV q6—12h'''''<BR> OR <BR> ▸ '''''[[Polymyxin B]] 0.75—1.25 mg/kg IV q12h'''''
-|-
-|}
-|}
-{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table19" style="background: #FFFFFF;"
-| valign=top |
-{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
-! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|''Enterobacteriaceae''}}
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Preferred Regimen'''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Cefotaxime]] 2 g IV q4—6h'''''<BR> OR <BR> ▸ '''''[[Ceftriaxone]] 2 g IV q12h'''''
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Alternative Regimen'''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Aztreonam]] 2 g IV q6—8h'''''<BR> OR <BR> ▸ '''''[[Moxifloxacin]] 400 mg IV q24h'''''<BR> OR <BR> ▸ '''''[[TMP/SMZ]] 5 mg/kg IV q6—12h''''' <SMALL>(TMP component)</SMALL><BR> OR <BR> ▸ '''''[[Meropenem]] 2 g IV q8h'''''<BR> OR <BR> ▸ '''''[[Ampicillin]] 2 g IV q4h'''''
-|-
-|}
-|}
-{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table20" style="background: #FFFFFF;"
-| valign=top |
-{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
-! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|''H. influenzae'', β-lactamase Negative}}
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Preferred Regimen'''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Ampicillin]] 2 g IV q4h'''''
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Alternative Regimen'''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Cefotaxime]] 2 g IV q4—6h'''''<BR> OR <BR> ▸ '''''[[Ceftriaxone]] 2 g IV q12h'''''<BR> OR <BR> ▸ '''''[[Cefepime]] 2 g IV q8h'''''<BR> OR <BR> ▸ '''''[[Chloramphenicol]] 1—1.5 g IV q6h'''''<BR> OR <BR> ▸ '''''[[Aztreonam]] 2 g IV q6—8h'''''<BR> OR <BR> ▸ '''''[[Moxifloxacin]] 400 mg IV q24h'''''
-|-
-! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|''H. influenzae'', β-lactamase Positive}}
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Preferred Regimen'''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Cefotaxime]] 2 g IV q4—6h'''''<BR> OR <BR> ▸ '''''[[Ceftriaxone]] 2 g IV q12h'''''
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Alternative Regimen'''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Cefepime]] 2 g IV q8h'''''<BR> OR <BR> ▸ '''''[[Chloramphenicol]] 1—1.5 g IV q6h'''''<BR> OR <BR> ▸ '''''[[Aztreonam]] 2 g IV q6—8h'''''<BR> OR <BR> ▸ '''''[[Moxifloxacin]] 400 mg IV q24h'''''
-|-
-! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|''H. influenzae'', β-lactamase Negative, Ampicillin Resistant}}
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Preferred Regimen'''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Meropenem]] 2 g IV q8h'''''
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Alternative Regimen'''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Moxifloxacin]] 400 mg IV q24h'''''
-|-
-|}
-|}
-{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table21" style="background: #FFFFFF;"
-| valign=top |
-{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
-! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|''Listeria monocytogenes''}}
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Preferred Regimen'''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Ampicillin]] 2 g IV q4h'''''<BR> OR <BR> ▸ '''''[[Penicillin G]] 4 MU IV q4h'''''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | PLUS
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Gentamicin]] 1.7 mg/kg IV q8h'''''
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Alternative Regimen'''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[TMP/SMZ]] 5 mg/kg IV q6—12h''''' <SMALL>(TMP component)</SMALL>
-|-
-|}
-|}
-{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table22" style="background: #FFFFFF;"
-| valign=top |
-{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
-! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|''N. meningitidis'', Penicillin MIC <0.1 μg/mL}}
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Preferred Regimen'''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Penicillin G]] 4 MU IV q4h'''''<BR> OR <BR> ▸ '''''[[Ampicillin]] 2 g IV q4h'''''
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Alternative Regimen'''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Cefotaxime]] 2 g IV q4—6h'''''<BR> OR <BR> ▸ '''''[[Ceftriaxone]] 2 g IV q12h'''''<BR> OR <BR> ▸ '''''[[Chloramphenicol]] 1—1.5 g IV q6h'''''
-|-
-! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|''N. meningitidis'', Penicillin MIC ≥0.1 μg/mL}}
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Preferred Regimen'''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Cefotaxime]] 2 g IV q4—6h'''''<BR> OR <BR> ▸ '''''[[Ceftriaxone]] 2 g IV q12h'''''
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Alternative Regimen'''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Cefepime]] 2 g IV q8h'''''<BR> OR <BR> ▸ '''''[[Chloramphenicol]] 1—1.5 g IV q6h'''''<BR> OR <BR> ▸ '''''[[Moxifloxacin]] 400 mg IV q24h'''''<BR> OR <BR> ▸ '''''[[Meropenem]] 2 g IV q8h'''''
-|-
-|}
-|}
-{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table23" style="background: #FFFFFF;"
-| valign=top |
-{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
-! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|''Pseudomonas aeruginosa''}}
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Preferred Regimen'''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Ceftazidime]] 2 g IV q8h'''''<BR> OR <BR> ▸ '''''[[Cefepime]] 2 g IV q8h'''''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | PLUS
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Gentamicin]] 1.7 mg/kg IV q8h'''''
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Alternative Regimen'''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Aztreonam]] 2 g IV q6—8h'''''<BR> OR <BR> ▸ '''''[[Meropenem]] 2 g IV q8h'''''<BR> OR <BR> ▸ '''''[[Ciprofloxacin]] 400 mg IV q8—12h'''''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | PLUS
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Gentamicin]] 1.7 mg/kg IV q8h'''''
-|-
-|}
-|}
-{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table24" style="background: #FFFFFF;"
-| valign=top |
-{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
-! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|''Staphylococcus aureus'', Methicillin sensitive}}
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Preferred Regimen'''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Nafcillin]] 1.5—2 g IV q4h'''''<BR> OR <BR> ▸ '''''[[Oxacillin]] 1.5—2 g IV q4h'''''
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Alternative Regimen'''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Vancomycin]] 15 mg/kg IV q6h''''' <SMALL>(trough 15—20 μg/mL)</SMALL><BR> OR <BR> ▸ '''''[[Linezolid]] 600 mg IV q12h'''''<BR> OR <BR> ▸ '''''[[Daptomycin]] 6 mg/kg IV q24h'''''
-|-
-! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|''Staphylococcus aureus'', Methicillin resistant}}
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Preferred Regimen'''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Vancomycin]] 15 mg/kg IV q6h''''' <SMALL>(trough 15—20 μg/mL)</SMALL>
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | PLUS
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Rifampin]] 600 mg IV q24h'''''
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Alternative Regimen'''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[TMP/SMZ]] 5 mg/kg IV q6—12h''''' <SMALL>(TMP component)</SMALL><BR> OR <BR> ▸ '''''[[Linezolid]] 600 mg IV q12h'''''<BR> OR <BR> ▸ '''''[[Daptomycin]] 6 mg/kg IV q24h'''''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | PLUS
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Rifampin]] 600 mg IV q24h'''''
-|-
-|}
-|}
-{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table25" style="background: #FFFFFF;"
-| valign=top |
-{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
-! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|''Staphylococcus epidermidis''}}
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Preferred Regimen'''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Vancomycin]] 15 mg/kg IV q6h''''' <SMALL>(trough 15—20 μg/mL)</SMALL>
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | PLUS
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Rifampin]] 600 mg IV q24h'''''
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Alternative Regimen'''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Linezolid]] 600 mg IV q12h'''''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | PLUS
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Rifampin]] 600 mg IV q24h'''''
-|-
-|}
-|}
-{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table26" style="background: #FFFFFF;"
-| valign=top |
-{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
-! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|''Streptococcus agalactiae''}}
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Preferred Regimen'''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Ampicillin]] 2 g IV q4h'''''<BR> OR <BR> ▸ '''''[[Penicillin G]] 4 MU IV q4h'''''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | PLUS
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Gentamicin]] 1.7 mg/kg IV q8h'''''
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Alternative Regimen'''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Cefotaxime]] 2 g IV q4—6h'''''<BR> OR <BR> ▸ '''''[[Ceftriaxone]] 2 g IV q12h'''''<BR> OR <BR> ▸ '''''[[Vancomycin]] 15 mg/kg IV q6h''''' <SMALL>(trough 15—20 μg/mL)</SMALL>
-|-
-|}
-|}
-{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table27" style="background: #FFFFFF;"
-| valign=top |
-{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
-! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|''S. pneumoniae'', Penicillin MIC ≤0.06 μg/mL}}
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Preferred Regimen'''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Penicillin G]] 4 MU IV q4h'''''<BR> OR <BR> ▸ '''''[[Ampicillin]] 2 g IV q4h'''''
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Alternative Regimen'''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Cefotaxime]] 2 g IV q4—6h'''''<BR> OR <BR> ▸ '''''[[Ceftriaxone]] 2 g IV q12h'''''<BR> OR <BR> ▸ '''''[[Chloramphenicol]] 1—1.5 g IV q6h'''''
-|-
-! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|''S. pneumoniae'', Penicillin MIC ≥0.12 μg/mL, Cefotaxime/Ceftriaxone MIC <1.0 μg/mL}}
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Preferred Regimen'''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Cefotaxime]] 2 g IV q4—6h'''''<BR> OR <BR> ▸ '''''[[Ceftriaxone]] 2 g IV q12h'''''
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Alternative Regimen'''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Cefepime]] 2 g IV q8h'''''<BR> OR <BR> ▸ '''''[[Meropenem]] 2 g IV q8h'''''
-|-
-! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|''S. pneumoniae'', Penicillin MIC ≥0.12 μg/mL, Cefotaxime/Ceftriaxone MIC ≥1.0 μg/mL}}
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Preferred Regimen'''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Vancomycin]] 15 mg/kg IV q6h''''' <SMALL>(trough 15—20 μg/mL)</SMALL>
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | PLUS
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Cefotaxime]] 2 g IV q4—6h'''''<BR> OR <BR> ▸ '''''[[Ceftriaxone]] 2 g IV q12h'''''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | PLUS
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Rifampin]] 600 mg IV q24h'''''
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Alternative Regimen'''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Vancomycin]] 15 mg/kg IV q6h''''' <SMALL>(trough 15—20 μg/mL)</SMALL>
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | PLUS
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Moxifloxacin]] 400 mg IV q24h'''''
-|-
-|}
-|}
-{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table28" style="background: #FFFFFF;"
-| valign=top |
-{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
-! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|''Mycobacterium tuberculosis (New Patients)''}}
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Intensive Phase'''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Isoniazid]] 5 mg/kg PO qd × 2 months'''''<BR> OR <BR> ▸ '''''[[Isoniazid]] 10 mg/kg PO 3 times per week × 2 months'''''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | PLUS
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Rifampicin]] 10 mg/kg PO qd × 2 months'''''<BR> OR <BR> ▸ '''''[[Rifampicin]] 10 mg/kg PO 3 times per week × 2 months'''''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | PLUS
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Pyrazinamide]] 25 mg/kg PO qd × 2 months'''''<BR> OR <BR> ▸ '''''[[Pyrazinamide]] 35 mg/kg PO 3 times per week × 2 months'''''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | PLUS
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Streptomycin]] 15 mg/kg PO qd × 2 months'''''<BR> OR <BR> ▸ '''''[[Streptomycin]] 15 mg/kg PO 3 times per week × 2 months'''''
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Continuation Phase'''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Isoniazid]] 5 mg/kg PO qd × 4 months'''''<BR> OR <BR> ▸ '''''[[Isoniazid]] 10 mg/kg PO 3 times per week × 2 months'''''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | PLUS
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Rifampicin]] 10 mg/kg PO qd × 4 months'''''<BR> OR <BR> ▸ '''''[[Rifampicin]] 10 mg/kg PO 3 times per week × 2 months'''''
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5" align=left | <SMALL>Adapted from ''Treatment of Tuberculosis: Guidelines.''<ref>{{Cite book  | last1 =  | first1 =  | last2 =  | first2 =  | title = Treatment of tuberculosis : guidelin | date = 2010 | publisher = World Health Organization | location = Geneva | isbn = 978-92-4-154783-3 | pages =  }}</ref></SMALL>
-|-
-|}
-|}
-{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table29" style="background: #FFFFFF;"
-| valign=top |
-{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
-! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center |{{fontcolor|#FFF|''Borrelia burgdorferi''}}
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Preferred Regimen'''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Ceftriaxone]] 2 g IV q24h × 10—28 days'''''
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Alternative Regimen'''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Cefotaxime]] 2 g IV q8h × 10—28 days'''''<BR> OR <BR> ▸ '''''[[Penicillin G]] 3—4 MU IV q4h × 10—28 days'''''<BR> OR <BR> ▸ '''''[[Doxycycline]] 100—200 mg PO q12h × 10—28 days'''''
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5" align=left | <SMALL>Adapted from ''Clin Infect Dis. 2006;43(9):1089-134.''<ref name="Wormser-2006">{{Cite journal  | last1 = Wormser | first1 = GP. | last2 = Dattwyler | first2 = RJ. | last3 = Shapiro | first3 = ED. | last4 = Halperin | first4 = JJ. | last5 = Steere | first5 = AC. | last6 = Klempner | first6 = MS. | last7 = Krause | first7 = PJ. | last8 = Bakken | first8 = JS. | last9 = Strle | first9 = F. | title = The clinical assessment, treatment, and prevention of lyme disease, human granulocytic anaplasmosis, and babesiosis: clinical practice guidelines by the Infectious Diseases Society of America. | journal = Clin Infect Dis | volume = 43 | issue = 9 | pages = 1089-134 | month = Nov | year = 2006 | doi = 10.1086/508667 | PMID = 17029130 }}</ref></SMALL>
-|-
-|}
-|}
-{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table30" style="background: #FFFFFF;"
-| valign=top |
-{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
-! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center |{{fontcolor|#FFF|''Treponema pallidum''}}
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Preferred Regimen'''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Penicillin G]] 3—4 MU IV q4h × 10—14 days'''''
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Alternative Regimen'''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Procaine penicillin]] 2.4 MU IM q24h × 10—14 days'''''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | PLUS
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Probenecid]] 500 mg PO q6h × 10—14 days'''''
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5" align=left | <SMALL>Adapted from ''MMWR Recomm Rep. 2006;55(RR-11):1-94.''<ref name="Workowski-2006">{{Cite journal  | last1 = Workowski | first1 = KA. | last2 = Berman | first2 = SM. | title = Sexually transmitted diseases treatment guidelines, 2006. | journal = MMWR Recomm Rep | volume = 55 | issue = RR-11 | pages = 1-94 | month = Aug | year = 2006 | doi =  | PMID = 16888612 }}</ref></SMALL>
-|-
-|}
-|}
-|}
+* Supportive measures
+:* Preferred regime: Antipyretics ([[Acetaminophen]])
-==Pathogen-Based Therapy — Fungi, Helminths, and Protozoan==
+* Prevention <ref name="pmid21962477">{{cite journal| author=Fishman SG, Gelber SE| title=Evidence for the clinical management of chorioamnionitis. | journal=Semin Fetal Neonatal Med | year= 2012 | volume= 17 | issue= 1 | pages= 46-50 | pmid=21962477 | doi=10.1016/j.siny.2011.09.002 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21962477  }} </ref>
+:* Preferred regime: Macrolide ([[Erythromycin]] {{or}} [[Azithromycin]]) {{and}} [[Ampicillin]] for 7–10 days via intravenous (2 days) followed by oral routes.
+:* NOTE: Induction of labor and delivery for  preterm premature rupture of membranes (PPROM) after 34 weeks’ gestation is recommended.
-<SMALL><font color="#FF4C4C">'''▸ Click on the following categories to expand treatment regimens.'''</font></SMALL>
+===Cystitis===
+*  Acute Uncomplicated Cystitis
+:* Preferred regime: [[Nitrofurantoin]] monohydrate/[[macrocrystals]] 100 mg bid 5 days (avoid if early pyelonephritis suspected) {{or}} [[Trimethoprim-sulfamethoxazole]] 160/800 mg (one DS tablet) bid 3 days (avoid if resistance prevalence is known to exceed 20 or if used for UTI in previous 3 months) {{or}} [[Fosfomycin]] trometamol 3 gm single dose (lower efficacy than some other recommended agents; avoid if early pyelonephritis suspected) {{or}} [[Pivmecillinam]] 400 mg bid 5 days (lower efficacy than some other recommended agents; avoid if early pyelonephritis suspected)
+:* Alternative regime (1): [[Fluoroquinolones]], [[Ofloxacin]], [[Ciprofloxacin]], and [[Levofloxacin]], use for 3 days.
-{|
+:* Alternative regime (2): β-Lactam agents, including [[Amoxicillin-clavulanate]], [[Cefdinir]], [[Cefaclor]], and [[Cefpodoxime]]-proxetil, for 3–7-days
-| valign=top |
-<div style="border-radius: 5px 5px 0 0; border: solid 1px #20538D; border-bottom: 0px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #A1BCDD; text-align: center;">
-<font color="#FFF">
-'''Fungi'''
-</font>
-</div>
-<div class="mw-customtoggle-table31" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
+===Epididymitis===
-<font color="#FFF">
+:* Preferred regime: [[Ceftriaxone]] 250 mg IM in a single dose {{and}} D[[oxycycline]] 100 mg orally twice a day for 10 days
-&nbsp;&nbsp;▸&nbsp;&nbsp;'''''Blastomyces dermatitidis'''''
-</font>
-</div>
-<div class="mw-customtoggle-table32" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
+*For acute epididymitis most likely caused by enteric organisms
-<font color="#FFF">
-&nbsp;&nbsp;▸&nbsp;&nbsp;'''''Candida spp.'''''
-</font>
-</div>
-<div class="mw-customtoggle-table33" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
+:* Preferred regime: [[Levofloxacin] 500 mg orally once daily for 10 days {{or}} [[Ofloxacin]] 300 mg orally twice a day for 10 days
-<font color="#FFF">
+*NOTE: Patients who have uncomplicated acute epididymitis and also are infected with HIV should receive the same treatment regimen as those who are HIV negative.
-&nbsp;&nbsp;▸&nbsp;&nbsp;'''''Coccidioides immitis'''''
-</font>
-</div>
-<div class="mw-customtoggle-table34" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
+===Genital herpes===
-<font color="#FFF">
-&nbsp;&nbsp;▸&nbsp;&nbsp;'''''Cryptococcus neoformans'''''
-</font>
-</div>
-<div class="mw-customtoggle-table35" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
+* Genital herpes<ref>{{Cite journal| issn = 1545–8601| volume = 59| issue = RR–12| pages = 1–110| last1 = Workowski| first1 = Kimberly A.| last2 = Berman| first2 = Stuart| last3 = Centers for Disease Control and Prevention (CDC)| title = Sexually transmitted diseases treatment guidelines, 2010| journal = MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control| date = 2010–12–17| pmid = 21160459}}</ref>
-<font color="#FFF">
+:* '''First episode of genital herpes'''
-&nbsp;&nbsp;▸&nbsp;&nbsp;'''''Histoplasma capsulatum'''''
+::* Preferred regimen: [[Acyclovir]] 400 mg PO tid for 7–10 days {{or}} [[Acyclovir]] 200 mg PO five times a day for 7–10 days {{or}} [[Famciclovir]] 250 mg PO tid for 7–10 days {{or}} [[Valacyclovir]] 1 g PO bid for 7–10 days
-</font>
+::: Note: Treatment can be extended if healing is incomplete after 10 days of therapy.
-</div>
-<div style="border-radius: 0 0 0 0; border: solid 1px #20538D; border-bottom: 0px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #A1BCDD; text-align: center;">
+:* '''Recurrent genital herpes'''
-<font color="#FFF">
+::* Suppressive therapy
-'''Helminths'''
+:::* Preferred regimen: [[Acyclovir]] 400 mg PO bid for 7–10 days {{or}} [[Famciclovir]] 250 mg PO bid for 7–10 days {{or}} [[Valacyclovir]] 1000 mg PO qd for 7–10 days {{or}} [[Valacyclovir]] 500 mg PO qd for 7–10 days
-</font>
+:::: Note (1): Valacyclovir 500 mg once a day might be less effective than other valacyclovir or acyclovir dosing regimens in patients who have very frequent recurrences (i.e., ≥10 episodes per year).
-</div>
+:::: Note (2): Acyclovir, Famciclovir, and Valacyclovir appear equally effective for episodic treatment of genital herpes, but famciclovir appears somewhat less effective for suppression of viral shedding.
-<div class="mw-customtoggle-table36" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
+::* Episodic therapy
-<font color="#FFF">
+:::* Preferred regimen: [[Acyclovir]] 400 mg PO tid for 5 days {{or}} [[Acyclovir]] 800 mg PO bid a day for 5 days {{or}} [[Acyclovir]] 800 mg PO tid for 2 days {{or}} [[Famciclovir]] 125 mg PO bid for 5 days {{or}} [[Famciclovir]] 1000 mg PO bid for 1 day {{or}} [[Famciclovir]] 500 mg PO once, followed by 250 mg PO bid for 2 days {{or}} [[Valacyclovir]] 500 mg PO bid for 3 days {{or}} [[Valacyclovir]] 1000 mg PO qd for 5 days
-&nbsp;&nbsp;▸&nbsp;&nbsp;'''''Angiostrongylus cantonensis'''''
-</font>
-</div>
-<div class="mw-customtoggle-table37" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
+:* '''Severe genital herpes'''
-<font color="#FFF">
+::* Preferred regimen: [[Acyclovir]] 5–10 mg/kg IV q8h for 2–7 days or until clinical improvement is observed, followed by PO antiviral therapy to complete at least 10 days of total therapy.
-&nbsp;&nbsp;▸&nbsp;&nbsp;'''''Baylisascaris procyonis'''''
+::: Note (1): Acyclovir dose adjustment is recommended for impaired renal function.
-</font>
+::: Note (2): Symptomatic sex partners should be evaluated and treated in the same manner as patients who have genital lesions.  Asymptomatic sex partners of patients who have genital herpes should be questioned concerning histories of genital lesions and offered type–specific serologic testing for HSV infection.
-</div>
-<div class="mw-customtoggle-table38" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
+:* '''Genital herpes in HIV-infected patients'''
-<font color="#FFF">
+::* Suppressive therapy
-&nbsp;&nbsp;▸&nbsp;&nbsp;'''''Gnathostoma spinigerum'''''
+:::* Preferred regimen: [[Acyclovir]] 400–800 mg PO bid–tid {{or}} [[Famciclovir]] 500 mg PO bid {{or}} [[Valacyclovir]] 500 mg PO bid
-</font>
+::* Episodic therapy
-</div>
+:::* Preferred regimen: [[Acyclovir]] 400 mg PO tid for 5–10 days {{or}} [[Famciclovir]] 500 mg PO bid for 5–10 days {{or}} [[Valacyclovir]] 1000 mg PO bid for 5–10 days
+:::: Note (1): For severe HSV disease, initiating therapy with [[Acyclovir]] 5–10 mg/kg IV q8h might be necessary.
+:::: Note (2): If lesions persist or recur in a patient receiving antiviral treatment, HSV resistance should be suspected and a viral isolate should be obtained for sensitivity testing.
-<div style="border-radius: 0 0 0 0; border: solid 1px #20538D; border-bottom: 0px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #A1BCDD; text-align: center;">
+:* '''Acyclovir-resistant genital herpes'''
-<font color="#FFF">
+::* Preferred regimen: [[Foscarnet]] 40 mg/kg IV q8h until clinical resolution is attained,
-'''Protozoan'''
+::* Alternative regimen: [[Cidofovir]] 5 mg/kg once weekly {{or}} [[Imiquimod]] topically qd for 5 days
-</font>
-</div>
-<div class="mw-customtoggle-table39" style="cursor: pointer; border-radius: 0 0 5px 5px; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
+:* '''Genital herpes in pregnancy'''
-<font color="#FFF">
+::* [[Acyclovir]] can be administered orally to pregnant women with first episode of genital herpes or recurrent genital herpes.
-&nbsp;&nbsp;▸&nbsp;&nbsp;'''''Naegleria fowleri'''''</font>
+::* [[Acyclovir]] should be administered IV to pregnant women with severe genital herpes.
-</div>
-| valign=top |
+:* '''Neonatal herpes, known or suspected'''
-{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table31" style="background: #FFFFFF;"
+::* Disease limited to the skin and mucous membranes
-| valign=top |
+:::* Preferred regimen: [[Acyclovir]] 20 mg/kg IV q8h for 14 days
-{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
+::* Disseminated and CNS disease
-! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center |{{fontcolor|#FFF|''Blastomyces dermatitidis''}}
+:::* Preferred regimen: [[Acyclovir]] 20 mg/kg IV q8h for 21 days
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Preferred Regimen'''
+===Gonococcal infections===
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Liposomal Amphotericin B]] 5 mg/kg/day IV × 4—6 weeks'''''
+* Gonococcal infections (''Neisseria gonorrhoeae'' infection)<ref>{{Cite journal| issn = 1545–8601| volume = 59| issue = RR–12| pages = 1–110| last1 = Workowski| first1 = Kimberly A.| last2 = Berman| first2 = Stuart| last3 = Centers for Disease Control and Prevention (CDC)| title = Sexually transmitted diseases treatment guidelines, 2010| journal = MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control| date = 2010–12–17| pmid = 21160459}}</ref><ref>{{Cite journal| issn = 1545–861X| volume = 61| issue = 31| pages = 590–594| last = Centers for Disease Control and Prevention (CDC)| title = Update to CDC's Sexually transmitted diseases treatment guidelines, 2010: oral cephalosporins no longer a recommended treatment for gonococcal infections| journal = MMWR. Morbidity and mortality weekly report| date = 2012–08–10| pmid = 22874837}}</ref>
-|-
+:* Gonococcal infections in adolescents and adults
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | FOLLOWED BY
+::* '''Uncomplicated gonococcal infections of the cervix, urethra, and rectum'''
-|-
+:::* Preferred regimen (1): [[Ceftriaxone]] 250 mg IM as a single dose
-| style="font-size: 85%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Fluconazole]] 800 mg PO qd × ≥12 months until CSF abnl resolves'''''<BR> OR <BR> ▸ '''''[[Itraconazole]] 200 mg PO bid—tid × ≥12 months until CSF abnl resolves'''''<BR> OR <BR> ▸ '''''[[Voriconazole]] 200—400 mg PO bid × ≥12 months until CSF abnl resolves'''''
+:::* Preferred regimen (2): [[Cefixime]] 400 mg PO as a single dose
-|-
+:::* Preferred regimen (3): [[Cephalosporin]] single-dose injectable regimen {{and}} ([[Azithromycin]] 1 g PO as a single dose {{or}} [[Doxycycline]] 100 mg PO bid for 7 days)
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5" align=left | <SMALL>Adapted from ''Clin Infect Dis. 2008;46(12):1801-12.''<ref name="Chapman-2008">{{Cite journal  | last1 = Chapman | first1 = SW. | last2 = Dismukes | first2 = WE. | last3 = Proia | first3 = LA. | last4 = Bradsher | first4 = RW. | last5 = Pappas | first5 = PG. | last6 = Threlkeld | first6 = MG. | last7 = Kauffman | first7 = CA. | title = Clinical practice guidelines for the management of blastomycosis: 2008 update by the Infectious Diseases Society of America. | journal = Clin Infect Dis | volume = 46 | issue = 12 | pages = 1801-12 | month = Jun | year = 2008 | doi = 10.1086/588300 | PMID = 18462107 }}</ref></SMALL>
+:::* Alternative regimen: [[Cefpodoxime]] 400 mg PO as a single dose {{or}} [[Azithromycin]] 2 g PO as a single dose
-|-
-|}
+::* '''Uncomplicated gonococcal infections of the pharynx'''
-|}
+:::* Preferred regimen: [[Ceftriaxone]] 250 mg IM in a single dose {{and}} ([[Azithromycin]] 1 g PO as a single dose {{or}} [[Doxycycline]] 100 mg PO bid for 7 days)
-{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table32" style="background: #FFFFFF;"
-| valign=top |
+::* '''Gonococcal conjunctivitis'''
-{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
+:::* Preferred regimen: [[Ceftriaxone]] 1 g IM in a single dose
-! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center |{{fontcolor|#FFF|''Candida spp.''}}
-|-
+::* '''Disseminated gonococcal infection'''
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Preferred Regimen'''
+:::* Preferred regimen: [[Ceftriaxone]] 1 g IV/IM q24h
-|-
+:::* Alternative regimen: [[Cefotaxime]] 1 g IV q8h {{or}} [[Ceftizoxime]] 1 g IV q8h
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Liposomal Amphotericin B]] 3—5 mg/kg/day IV'''''
+:::: Note: All of the preceding regimens should be continued for 24–48 hours after improvement begins, at which time therapy can be switched to [[Cefixime]] 400 mg PO bid to complete at least 1 week of antimicrobial therapy.
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | WITH OR WITHOUT
+::* '''Gonococcal meningitis '''
-|-
+:::* Preferred regimen: [[Ceftriaxone]] 1–2 g IV q12h for 10–14 days
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Flucytosine]] 25 mg/kg PO qid'''''
-|-
+::* '''Gonococcal endocarditis'''
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Alternative Regimen'''
+:::* Preferred regimen: [[Ceftriaxone]] 1–2 g IV q12h for at least 4 weeks
-|-
-| style="font-size: 85%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Fluconazole]] 400—800 mg PO qd (6—12 mg/kg IV q24h)'''''<BR> OR <BR> ▸ '''''[[Voriconazole]] 400 mg PO bid × 2 doses''''' FOLLOWED BY '''''200 mg PO bid'''''<BR> OR <BR> ▸ '''''[[Voriconazole]] 6 mg/kg IV q12h × 2 doses''''' FOLLOWED BY '''''3 mg/kg IV q12h'''''
+:* Gonococcal infections among children
-|-
+::* '''Uncomplicated gonococcal vulvovaginitis, cervicitis, urethritis, pharyngitis, or proctitis'''
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5" align=left | <SMALL>Adapted from ''Clin Infect Dis. 2009;48(5):503-35.''<ref name="Pappas-2009">{{Cite journal  | last1 = Pappas | first1 = PG. | last2 = Kauffman | first2 = CA. | last3 = Andes | first3 = D. | last4 = Benjamin | first4 = DK. | last5 = Calandra | first5 = TF. | last6 = Edwards | first6 = JE. | last7 = Filler | first7 = SG. | last8 = Fisher | first8 = JF. | last9 = Kullberg | first9 = BJ. | title = Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America. | journal = Clin Infect Dis | volume = 48 | issue = 5 | pages = 503-35 | month = Mar | year = 2009 | doi = 10.1086/596757 | PMID = 19191635 }}</ref></SMALL>
+:::* Preferred regimen (> 45 kg): [[Ceftriaxone]] 250 mg IM as a single dose {{or}} [[Cefixime]] 400 mg PO as a single dose
-|-
+:::* Preferred regimen (≤ 45 kg): [[Ceftriaxone]] 125 mg IM in a single dose
-|}
-|}
+::* '''Bacteremia or arthritis'''
-{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table33" style="background: #FFFFFF;"
+:::* Preferred regimen (> 45 kg): [[Ceftriaxone]] 50 mg/kg IM/IV q24h for 7 days
-| valign=top |
+:::* Preferred regimen (≤ 45 kg): [[Ceftriaxone]] 50 mg/kg (maximum dose: 1 g) IM/IV q24h for 7 days
-{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
-! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center |{{fontcolor|#FFF|''Coccidioides immitis''}}
+:* Gonococcal infections among infants
-|-
+::* '''Disseminated gonococcal infection and gonococcal scalp abscesses in newborns'''
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Preferred Regimen'''
+:::* Preferred regimen: [[Ceftriaxone]] 25–50 mg/kg IV/IM q24h for 7 days (10–14 days if meningitis is documented) {{or}} [[Cefotaxime]] 25 mg/kg IV/IM q12h for 7 days (10–14 days if meningitis is documented)
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Fluconazole]] 400 mg PO qd'''''
+::* '''Prophylactic treatment for infants whose mothers have gonococcal infection'''
-|-
+:::* Preferred regimen: [[Ceftriaxone]] 25–50 mg/kg IV/IM, not to exceed 125 mg
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Alternative Regimen'''
-|-
+::* '''Ophthalmia neonatorum'''
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Itraconazole]] 200 mg PO bid—tid'''''
+:::* Preferred regimen: [[Ceftriaxone]] 25–50 mg/kg IV/IM in a single dose, not to exceed 125 mg
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5" align=left | <SMALL>Adapted from ''Clin Infect Dis. 2005;41(9):1217-23.''<ref name="Galgiani-2005">{{Cite journal  | last1 = Galgiani | first1 = JN. | last2 = Ampel | first2 = NM. | last3 = Blair | first3 = JE. | last4 = Catanzaro | first4 = A. | last5 = Johnson | first5 = RH. | last6 = Stevens | first6 = DA. | last7 = Williams | first7 = PL. | title = Coccidioidomycosis. | journal = Clin Infect Dis | volume = 41 | issue = 9 | pages = 1217-23 | month = Nov | year = 2005 | doi = 10.1086/496991 | PMID = 16206093 }}</ref></SMALL>
+::* '''Ophthalmia neonatorum prophylaxis'''
-|-
+:::* Preferred regimen: [[Erythromycin]] (0.5%) ophthalmic ointment in each eye in a single application
-|}
-|}
+===Granuloma inguinale===
-{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table34" style="background: #FFFFFF;"
-| valign=top |
+* '''Granuloma inguinale (donovanosis)'''<ref>{{Cite journal| issn = 1545–8601| volume = 59| issue = RR–12| pages = 1–110| last1 = Workowski| first1 = Kimberly A.| last2 = Berman| first2 = Stuart| last3 = Centers for Disease Control and Prevention (CDC)| title = Sexually transmitted diseases treatment guidelines, 2010| journal = MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control| date = 2010–12–17| pmid = 21160459}}</ref>
-{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
+:* Preferred regimen: [[Doxycycline]] 100 mg PO bid for at least 3 weeks and until all lesions have completely healed
-! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center |{{fontcolor|#FFF|''C. neoformans, HIV–infected''}}
+:* Alternative regimen (1): [[Azithromycin]] 1 g PO once per week for at least 3 weeks and until all lesions have completely healed
-|-
+:* Alternative regimen (2): [[Ciprofloxacin]] 750 mg PO bid for at least 3 weeks and until all lesions have completely healed
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Induction Therapy:''' Preferred Regimen 1
+:* Alternative regimen (3): [[Erythromycin]] base 500 mg PO qid for at least 3 weeks and until all lesions have completely healed
-|-
+:* Alternative regimen (4): [[Trimethoprim-Sulfamethoxazole]] double-strength (160 mg/800 mg) one tablet PO bid for at least 3 weeks and until all lesions have completely healed
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Amphotericin B]] 0.7—1.0 mg/kg IV q24h for ≥2 weeks'''''<BR> OR <BR> ▸ '''''[[Liposomal Amphotericin B]] 3—4 mg/kg IV q24h for ≥2 weeks'''''<BR> OR <BR> ▸ '''''[[Amphotericin B lipid complex]] 5 mg/kg IV q24h for ≥2 weeks'''''
+:: Note (1): The addition of an aminoglycoside (e.g., [[Gentamicin]] 1 mg/kg IV every 8 hours) to these regimens can be considered if improvement is not evident within the first few days of therapy.
-|-
+:: Note (2): Patients should be followed clinically until signs and symptoms have resolved.
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | PLUS
+:: Note (3): Persons who have had sexual contact with a patient who has granuloma inguinale within the 60 days before onset of the patient's symptoms should be examined and offered therapy. However, the value of empiric therapy in the absence of clinical signs and symptoms has not been established.
-|-
+:: Note (4): Pregnancy is a relative contraindication to the use of sulfonamides. Pregnant and lactating women should be treated with the [[Erythromycin]] regimen, and consideration should be given to the addition of a parenteral aminoglycoside (e.g., [[Gentamicin]]). [[Azithromycin]] might prove useful for treating granuloma inguinale during pregnancy, but published data are lacking. [[Doxycycline]] and [[Ciprofloxacin]] are contraindicated in pregnant women.
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Flucytosine]] 25 mg/kg PO q6h for ≥2 weeks'''''
+:: Note (5): Persons with both granuloma inguinale and HIV infection should receive the same regimens as those who are HIV negative; however, the addition of a parenteral aminoglycoside (e.g., [[Gentamicin]]) can also be considered.
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Induction Therapy:''' Preferred Regimen 2
+===Lymphogranuloma venereum===
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Amphotericin B]] 0.7—1.0 mg/kg IV q24h for 4—6 weeks'''''<BR> OR <BR> ▸ '''''[[Liposomal Amphotericin B]] 3—4 mg/kg IV q24h for 4—6 weeks'''''<BR> OR <BR> ▸ '''''[[Amphotericin B lipid complex]] 5 mg/kg IV q24h for 4—6 weeks'''''
+* '''Lymphogranuloma venereum (''Chlamydia trachomatis'' serovars L1, L2, or L3 infection)'''<ref>{{Cite journal| issn = 1545–8601| volume = 59| issue = RR–12| pages = 1–110| last1 = Workowski| first1 = Kimberly A.| last2 = Berman| first2 = Stuart| last3 = Centers for Disease Control and Prevention (CDC)| title = Sexually transmitted diseases treatment guidelines, 2010| journal = MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control| date = 2010–12–17| pmid = 21160459}}</ref>
-|-
+:* Preferred regimen: [[Doxycycline]] 100 mg PO bid for 21 days
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Induction Therapy:''' Alternative Regimen 1
+:* Alternative regimen: [[Erythromycin]] base 500 mg PO qid for 21 days
-|-
+:: Note (1): [[Azithromycin]] 1 g PO 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.
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Amphotericin B]] 0.7 mg/kg IV q24h for 2 weeks'''''
+:: Note (2): Patients should be followed clinically until signs and symptoms have resolved.
-|-
+:: Note (3): 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.
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | PLUS
+:: Note (4): 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.
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Fluconazole]] 800 mg PO q24h for 2 weeks'''''
+===Pelvic inflammatory disease===
-|-
+*Parenteral Treatment
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Induction Therapy:''' Alternative Regimen 2
+:* Preferred regime (1): [[Cefotetan]] 2 g IV every 12 hours {{or}} [[Cefoxitin]] 2 g IV every 6 hours {{and}} [[Doxycycline]] 100 mg orally or IV every 12 hours.
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Fluconazole]] 1200 mg PO q24h for 6 weeks'''''
+:* Preferred regime (2): [[Clindamycin]] 900 mg IV every 8 hours {{and}} [[Gentamicin]] loading dose IV or IM (2 mg/kg of body weight), followed by a maintenance dose (1.5 mg/kg) every 8 hours. Single daily dosing (3--5 mg/kg) can be substituted.
-|-
+:* Alternative regime: [[Ampicillin]]/[[Sulbactam]] 3 g IV every 6 hours {{and}} [[Doxycycline]] 100 mg orally or IV every 12 hours.
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | PLUS
-|-
+*Oral Treatment
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Flucytosine]] 100 mg/kg PO q24h for 6 weeks'''''
+:* Preferred regime (1): [[Ceftriaxone]] 250 mg IM in a single dose {{and}} [[Doxycycline]] 100 mg orally twice a day for 14 days {{withorwithout}} [[Metronidazole]] 500 mg orally twice a day for 14 days
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Induction Therapy:''' Alternative Regimen 3
+:* Preferred regime (2): [[Cefoxitin]] 2 g IM in a single dose and Probenecid, 1 g orally administered concurrently in a single dose {{and}} [[Doxycycline]] 100 mg orally twice a day for 14 days {{withorwithout}} [[Metronidazole]] 500 mg orally twice a day for 14 days
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Fluconazole]] 800—2000 mg PO q24h for 10—12 weeks'''''
+:* Preferred regime (3): Other parenteral third-generation cephalosporin (e.g., [[ceftizoxime]] {{or}} [[cefotaxime]]) {{and}} [[Doxycycline]] 100 mg orally twice a day for 14 days {{withorwithout}} [[Metronidazole]] 500 mg orally twice a day for 14 days
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Induction Therapy:''' Alternative Regimen 4
+:* Alternative regime (1): [[Ceftriaxone]] 250 mg IM single dose and [[Azithromycin]] 1 g orally once a week for 2 weeks.
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Itraconazole]] 200 mg PO q12h for 10—12 weeks'''''
+:* Alternative regime (2): [[Levofloxacin]] 500 mg orally once daily or [[Ofloxacin]] 400 mg twice daily for 14 days {{withorwithout]] [[Metronidazole]] 500 mg orally twice daily for 14 days.
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Consolidation Therapy'''
+===Proctocolitis===
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Fluconazole]] 400 mg PO q24h for 8 weeks'''''
+* Proctitis
-|-
+:* Preferred regime: [[Ceftriaxone]] 250 mg IM {{and}} [[Doxycycline]] 100 mg orally twice a day for 7 days
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Maintenance Therapy'''
-|-
+===Prostatitis===
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Fluconazole]] 200 mg PO q24h for ≥1 year'''''<BR> OR <BR> ▸ '''''[[Itraconazole]] 400 mg PO q24h for ≥1 year'''''<BR> OR <BR> ▸ '''''[[Amphotericin B]] 1.0 mg/kg/week IV for ≥1 year'''''
+====Acute Bacterial Prostatitis====
-|-
+* Uncomplicated (with low risk of STD pathogens)<ref name="pmid20459324">{{cite journal| author=Lipsky BA, Byren I, Hoey CT| title=Treatment of bacterial prostatitis. | journal=Clin Infect Dis | year= 2010 | volume= 50 | issue= 12 | pages= 1641-52 | pmid=20459324 | doi=10.1086/652861 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20459324  }} </ref>
-! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center |{{fontcolor|#FFF|''C. neoformans, Organ Transplant Recipients''}}
+: ''Enterobacteriaceae'' (especially ''Escherichia coli'')
-|-
+::* Preferred regime: [[Ciprofloxacin]] 400 mg iv or 500 mg po BID or [[Levofloxacin]] 500–750 mg iv/po QD
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Induction Therapy:''' Preferred Regimen
+::* Alternative regime: [[TMP-SMX]] DS (160 mg TMP) BID
-|-
+::* NOTE: 2 weeks duration of therapy may be sufficient; if patient remains symptomatic, extend to 4 weeks
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Liposomal Amphotericin B]] 3—4 mg/kg IV q24h for ≥2 weeks'''''<BR> OR <BR> ▸ '''''[[Amphotericin B lipid complex]] 5 mg/kg IV q24h for ≥2 weeks'''''
-|-
+: ''Enterococcus species''
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | PLUS
-|-
+::* Preferred regime: [[Ampicillin]] 1–2 g IV every 4 h {{or}} [[Vancomycin]] 15 mg/kg every 12 h
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Flucytosine]] 25 mg/kg PO q6h for ≥2 weeks'''''
+::* Alternative regime: [[Levofloxacin]] 750 po QD {{or}} [[Linezolid]] 600 mg every 12 h
-|-
+::* NOTE: Use intravenous therapy if systemically ill; switch to oral therapy when stable
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Induction Therapy:''' Alternative Regimen
+: ''Pseudomonas aeruginosa''
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Liposomal Amphotericin B]] 3—4 mg/kg IV q24h for 4—6 weeks'''''<BR> OR <BR> ▸ '''''[[Amphotericin B lipid complex]] 5 mg/kg IV q24h for 4—6 weeks'''''
+::* Preferred regime: [[Ciprofloxacin]] 400 mg TID
-|-
+::* Alternative regime: [[Piperacillin-tazobactam]] 4.5 g iv every 6 h
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Consolidation Therapy'''
-|-
+* Uncomplicated (with risk of STD pathogens)
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Fluconazole]] 400—800 mg PO q24h for 8 weeks'''''
-|-
+: ''Neisseria gonorrhoeae'' or ''Chlamydia trachomatis''  <----------oral cephalosporins no longer a recommended treatment for gonococcal infections.
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Maintenance Therapy'''
+::* Preferred regime: [[Ceftriaxone]] 250 mg IM {{or}} [[Cefixime]] 400 mg po x 1 dose {{and}} [[Doxycycline]] 100 mg po BID {{or}} [[Azithromycin]] 500 mg po QD
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Fluconazole]] 200—400 mg PO q24h for 6—12 months'''''
+::* Alternative regime: Fluoroquinolones not recommended for gonococcal infection
-|-
+::* NOTE: Treat for 2 weeks in most cases. Obtain urine nucleicacid amplification test for ''N.gonorrhoeae'' and ''C.trachomatis''
-! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center |{{fontcolor|#FFF|''C. neoformans, Non–HIV-Infected and Nontransplant Hosts''}}
+* Uncomplicated, with risk of antibiotic resistant pathogen
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Induction Therapy:''' Preferred Regimen
+: Fluoroquinolone-resistant ''Enterobacteriaceae''
-|-
+::* Preferred regime: [[Ertapenem]] 1 g iv QD
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Amphotericin B]] 0.7—1.0 mg/kg IV q24h for 4—6 weeks'''''<BR> OR <BR> ▸ '''''[[Liposomal Amphotericin B]] 3—4 mg/kg IV q24h for 4—6 weeks'''''<BR> OR <BR> ▸ '''''[[Amphotericin B lipid complex]] 5 mg/kg IV q24h for 4—6 weeks'''''
+::* Alternative regime: [[Ceftriaxone]] 1 g iv QD or [[Imipenem]] 500mg iv every 6 h {{or}} [[Tigecycline]] 100 mg iv x 1 dose then 50 mg iv every 12 h
-|-
+: ES or AmpC beta lactamase producing ''Enterobacteriaceae''
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | PLUS
-|-
+::* Preferred regime: [[Ertapenem]] 1 g iv QD
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Flucytosine]] 25 mg/kg PO q6h for 4—6 weeks'''''
+::* Alternative regime: [[Cefepime]] 2g iv every 12 h {{or}} [[Imipenem]] 500 mg iv every 6 h {{or}} [[Tigecycline]] 100 mg iv x 1 dose then 50 mg iv every 12 h
-|-
+: Fluoroquinolone-resistant ''pseudomonas''
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Consolidation Therapy'''
-|-
+::* Preferred regime: [[Imipenem]] 500 mg iv every 6 h
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Fluconazole]] 400—800 mg PO q24h for 8 weeks'''''
+::* Alternative regime: [[Meropenem]] 500 mg iv every 8 h
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Maintenance Therapy'''
+* Complicated by bacteremia or suspected prostatic abscess
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Fluconazole]] 200 mg PO q24h for 6—12 months'''''
+: ''Enterobacteriaceae'' or ''Enterococcus'' species
-|-
+::* Preferred regime: [[Ciprofloxacin]] 400 mg iv every 12 h {{or}} [[Levofloxacin]] 500 mg iv every 24 h
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5" align=left | <SMALL>Adapted from ''Clin Infect Dis. 2010;50(3):291-322.''<ref name="Perfect-2010">{{Cite journal  | last1 = Perfect | first1 = JR. | last2 = Dismukes | first2 = WE. | last3 = Dromer | first3 = F. | last4 = Goldman | first4 = DL. | last5 = Graybill | first5 = JR. | last6 = Hamill | first6 = RJ. | last7 = Harrison | first7 = TS. | last8 = Larsen | first8 = RA. | last9 = Lortholary | first9 = O. | title = Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the infectious diseases society of america. | journal = Clin Infect Dis | volume = 50 | issue = 3 | pages = 291-322 | month = Feb | year = 2010 | doi = 10.1086/649858 | PMID = 20047480 }}</ref></SMALL>
+::* Alternative regime: [[Ceftriaxone]] 1–2 g iv every 24 h {{and}} [[Levofloxacin]] 500–750 mg po QD {{or}} [[Ertapenem]] 1 g iv every 24 h {{or}} piperacillin-tazobactam 3.375 g iv every 6 h
-|-
+::* NOTE: Treat for 4 weeks. Obtain blood cultures; Consider genitourinary imaging; Change iv to po regimen when blood cultures are sterile and abscess drained.
-|}
-|}
+====Chronic Bacterial Prostatitis====
-{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table35" style="background: #FFFFFF;"
+:''Enterobacteriaceae'' (Enterococcus species)
-| valign=top |
+::* Preferred regime: [[Ciprofloxacin]] 400 mg iv every 12 h {{or}} [[Levofloxacin]] 500 mg iv every 24 h
-{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
-! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center |{{fontcolor|#FFF|''Histoplasma capsulatum''}}
+::* Alternative regime: [[TMP-SMX]] x 1 dose DS BID
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | '''Preferred Regimen'''
+:''Staphylococcus species''
-|-
+::* Preferred regime: [[Azithromycin]] 500 mg po QD
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Liposomal Amphotericin B]] 5 mg/kg IV q24h for 4—6 weeks'''''
+::* Alternative regime: [[Doxycycline]] 100 mg BID
-|-
+:NOTE: Duration of therapy 4–6 weeks; Consider suppressive therapy if relapses occur.
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | FOLLOWED BY
-|-
+===Pyelonephritis===
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Itraconazole]] 200 mg PO bid—tid for ≥12 months'''''
+* Condition 1: patients not requiring hospitalization where the prevalence of resistance of community uropathogens to fluoroquinolones is not known to exceed 10%
-|-
+:* Preferred regime: [[Ciprofloxacin]] orally 500 mg twice daily for 7 days {{withorwithout}} an initial 400-mg dose of intravenous [[Ciprofloxacin]]
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5" align=left | <SMALL>Adapted from ''Clin Infect Dis. 2007;45(7):807-25.''<ref name="Wheat-2007">{{Cite journal  | last1 = Wheat | first1 = LJ. | last2 = Freifeld | first2 = AG. | last3 = Kleiman | first3 = MB. | last4 = Baddley | first4 = JW. | last5 = McKinsey | first5 = DS. | last6 = Loyd | first6 = JE. | last7 = Kauffman | first7 = CA. | title = Clinical practice guidelines for the management of patients with histoplasmosis: 2007 update by the Infectious Diseases Society of America. | journal = Clin Infect Dis | volume = 45 | issue = 7 | pages = 807-25 | month = Oct | year = 2007 | doi = 10.1086/521259 | PMID = 17806045 }}</ref></SMALL>
+:* NOTE (1): If an initial one-time intravenous agent is used, a long-acting antimicrobial, such as 1 g of [[Ceftriaxone]] or a consolidated 24-h dose of an [[Aminoglycoside]], could be used in lieu of an intravenous fluoroquinolone
-|-
+:* NOTE (2): If the prevalence of fluoroquinolone resistance is thought to exceed 10%, an initial one-time intravenous dose of a long-acting parenteral antimicrobial, such as 1 g of ceftriaxone or a consolidated 24-h dose of an aminoglycoside, is recommended.
-|}
+:* Alternative regime: A once-daily oral fluoroquinolone, including [[Ciprofloxacin]] 1000 mg extended release for 7 days {{or}} [[Levofloxacin]] 750 mg for 5 days.
-|}
+:* NOTE: If the prevalence of fluoroquinolone resistance is thought to exceed 10%, an initial intravenous dose of a long-acting parenteral antimicrobial, such as 1 g of [[Ceftriaxone]] or a consolidated 24-h dose of an [[Aminoglycoside]], is recommended.
-{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table36" style="background: #FFFFFF;"
-| valign=top |
+* Condition 2: When the uropathogen is known to be susceptible
-{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
+:* Preferred regime: [[Trimethoprim-sulfamethoxazole]] 160/800 mg (1 double-strength tablet) bid orally for 14 days.
-! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center |{{fontcolor|#FFF|''Angiostrongylus cantonensis''}}
+:* NOTE: If [[trimethoprim-sulfamethoxazole]] is used when the susceptibility is not known, an initial intravenous dose of a long-acting parenteral antimicrobial, such as 1 g of ceftriaxone {{or}} a consolidated 24-h dose of an aminoglycoside, is recommended.
-|-
+:* NOTE: Oral [[β-lactam]] agents are less effective than other available agents for treatment of pyelonephritis. If an oral β-lactam agent is used, an initial intravenous dose of a long-acting parenteral antimicrobial, such as 1 g of ceftriaxone {{or}} a consolidated 24-h dose of an aminoglycoside, is recommended.
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | Preferred Regimen
-|-
+* Condition 3: Patients require hospitalization (high fever, high white blood cell count, vomiting, dehydration, or evidence of sepsis)
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Albendazole]] 15–20 mg/kg/day PO qd–bid for 10–20 days'''''
+:* Preferred regime: intravenous antimicrobial regimen, such as a [[Fluoroquinolone]]; an [[Aminoglycoside]] {{withorwithout}} [[Ampicillin]]; an extended-spectrum [[Cephalosporin]] or extended-spectrum [[Penicillin]] {{withorwithout}} an [[Aminoglycoside]]; [[Carbapenem]]
-|-
+:* NOTE: The choice between these agents should be based on local resistance data, and the regimen should be tailored on the basis of susceptibility results.
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | PLUS
-|-
+===Sterile pyuria===
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Dexamethasone]] 10–20 mg PO qd for 10–20 days'''''
-|-
+* Sterile pyuria
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | Alternative Regimen
+:* Definitions
-|-
+::* '''Pyuria''': the presence of 10 or more white cells per cubic millimeter in a urine specimen, 3 or more white cells per high-power field of unspun urine, a positive result on Gram’s stain of an unspun urine specimen, or a urinary dipstick test that is positive for leukocyte esterase<ref>{{Cite journal| doi = 10.1016/j.ajic.2008.03.002| issn = 1527-3296| volume = 36| issue = 5| pages = 309–332| last1 = Horan| first1 = Teresa C.| last2 = Andrus| first2 = Mary| last3 = Dudeck| first3 = Margaret A.| title = CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting| journal = American Journal of Infection Control| date = 2008-06| pmid = 18538699}}</ref>
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Mebendazole]] 100 mg PO bid for 10–20 days'''''
+::* '''Sterile pyuria''': the persistent finding of white cells in the urine in the absence of bacteria, as determined by means of aerobic laboratory techniques (on a 5% sheep-blood agar plate and MacConkey agar plate)<ref>{{Cite journal| doi = 10.1056/NEJMra1410052| issn = 1533-4406| volume = 372| issue = 11| pages = 1048–1054| last1 = Wise| first1 = Gilbert J.| last2 = Schlegel| first2 = Peter N.| title = Sterile pyuria| journal = The New England Journal of Medicine| date = 2015-03-12| pmid = 25760357}}</ref>
-|-
+::* '''Bacteriuria''': bacterial colony counts of more than 1000 colony-forming units (CFU) per milliliter in urine<ref>{{Cite journal| doi = 10.1309/AJCP4KVGQZEG1YDM| issn = 1943-7722| volume = 137| issue = 5| pages = 778–784| last1 = Kwon| first1 = Jennie H.| last2 = Fausone| first2 = Maureen K.| last3 = Du| first3 = Hongyan| last4 = Robicsek| first4 = Ari| last5 = Peterson| first5 = Lance R.| title = Impact of laboratory-reported urine culture colony counts on the diagnosis and treatment of urinary tract infection for hospitalized patients| journal = American Journal of Clinical Pathology| date = 2012-05| pmid = 22523217}}</ref>
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | PLUS
-|-
+:* Causes<ref>{{Cite journal| issn = 0098-8243| volume = 26| issue = 3| pages = 150–152| last = Dieter| first = R. S.| title = Sterile pyuria: a differential diagnosis| journal = Comprehensive Therapy| date = 2000| pmid = 10984817}}</ref>
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Dexamethasone]] 10–20 mg PO qd for 10–20 days'''''
+::* '''Infectious etiologies'''
-|-
+:::* Gynecologic infection
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5" align=left | <SMALL>Adapted from ''Lancet Infect Dis. 2008;8(10):621-30.'' and ''Clin Infect Dis. 2009;48(3):322-7.''<ref name="Wang-2008">{{Cite journal  | last1 = Wang | first1 = QP. | last2 = Lai | first2 = DH. | last3 = Zhu | first3 = XQ. | last4 = Chen | first4 = XG. | last5 = Lun | first5 = ZR. | title = Human angiostrongyliasis. | journal = Lancet Infect Dis | volume = 8 | issue = 10 | pages = 621-30 | month = Oct | year = 2008 | doi = 10.1016/S1473-3099(08)70229-9 | PMID = 18922484 }}</ref><ref name="Ramirez-Avila-2009">{{Cite journal  | last1 = Ramirez-Avila | first1 = L. | last2 = Slome | first2 = S. | last3 = Schuster | first3 = FL. | last4 = Gavali | first4 = S. | last5 = Schantz | first5 = PM. | last6 = Sejvar | first6 = J. | last7 = Glaser | first7 = CA. | title = Eosinophilic meningitis due to Angiostrongylus and Gnathostoma species. | journal = Clin Infect Dis | volume = 48 | issue = 3 | pages = 322-7 | month = Feb | year = 2009 | doi = 10.1086/595852 | PMID = 19123863 }}</ref></SMALL>
+:::* Urethritis due to chlamydia, Neisseria gonorrhoeae, mycoplasma, or ureaplasma
-|-
+:::* Prostatitis
-|}
+:::* Balanitis
-|}
+:::* Appendicitis
-{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table37" style="background: #FFFFFF;"
+:::* Viral infection of the lower genitourinary tract
-| valign=top |
+:::* Genitourinary tuberculosis
-{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
+:::* Fungal infection
-! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center |{{fontcolor|#FFF|''Baylisascaris procyonis''}}
+:::* Parasitic disease such as trichomoniasis or schistosomiasis
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | Preferred Regimen
+::* '''Non-infectious etiologies'''
-|-
+:::* Current use of antibiotics
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Albendazole]] 25–50 mg/kg PO qd or 400 mg PO bid for 10 days'''''
+:::* Recently treated urinary tract infection (within past 2 weeks)
-|-
+:::* Presence or recent use of a urinary catheter
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | PLUS
+:::* Recent cystoscopy or urologic endoscopy
-|-
+:::* Urinary tract stones
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Dexamethasone]] 10–20 mg PO qd for 10 days'''''
+:::* Foreign body such as surgical mesh in the urethra or a retained stent
-|-
+:::* Urinary tract neoplasm
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | Alternative Regimen
+:::* Pelvic irradiation
-|-
+:::* Urinary fistula
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Thiabendazole]] 50 mg/kg/day PO bid for 10 days'''''
+:::* Polycystic kidney
-|-
+:::* Rejection of a renal transplant
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | PLUS
+:::* Renal-vein thrombosis
-|-
+:::* Interstitial nephritis or analgesic nephropathy
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Dexamethasone]] 10–20 mg PO qd for 10 days'''''
+:::* Papillary necrosis
-|-
+:::* Interstitial cystitis
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5" align=left | <SMALL>Adapted from ''Clin Microbiol Rev. 2005;18(4):703-18.'' and ''Clin Infect Dis. 2004;15;39(10):1484-92.''<ref name="Gavin-2005">{{Cite journal  | last1 = Gavin | first1 = PJ. | last2 = Kazacos | first2 = KR. | last3 = Shulman | first3 = ST. | title = Baylisascariasis. | journal = Clin Microbiol Rev | volume = 18 | issue = 4 | pages = 703-18 | month = Oct | year = 2005 | doi = 10.1128/CMR.18.4.703-718.2005 | PMID = 16223954 }}</ref><ref name="Murray-2004">{{Cite journal  | last1 = Murray | first1 = WJ. | last2 = Kazacos | first2 = KR. | title = Raccoon roundworm encephalitis. | journal = Clin Infect Dis | volume = 39 | issue = 10 | pages = 1484-92 | month = Nov | year = 2004 | doi = 10.1086/425364 | PMID = 15546085 }}</ref></SMALL>
+:::* Inflammatory disease such as systemic lupus erythematosus or Kawasaki’s disease
-|-
-|}
+:* Pathogen-directed antimicrobial therapy<ref>{{Cite journal| doi = 10.1056/NEJMra1410052| issn = 1533-4406| volume = 372| issue = 11| pages = 1048–1054| last1 = Wise| first1 = Gilbert J.| last2 = Schlegel| first2 = Peter N.| title = Sterile pyuria| journal = The New England Journal of Medicine| date = 2015-03-12| pmid = 25760357}}</ref>
-|}
+::* '''Tuberculosis'''
-{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table38" style="background: #FFFFFF;"
+:::* Preferred regimen: [[Isoniazid]] {{and}} [[Rifampin]] {{and}} [[Ethambutol]] {{and}} [[Pyrazinamide]] for 3–6 months
-| valign=top |
-{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
+::* '''Gonorrhea'''
-! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center |{{fontcolor|#FFF|''Gnathostoma spinigerum''}}
+:::* Preferred regimen: [[Ceftriaxone]] 250 mg IM in a single dose, then ([[Azithromycin]] 1 g PO in a single dose {{or}} [[Doxycycline]] 100 mg PO bid for 7 days)
-|-
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | Preferred Regimen
+::* '''Chlamydia'''
-|-
+:::* Preferred regimen: [[Azithromycin]] 1 g PO in single dose {{or}} [[Doxycycline]] 100 mg PO bid for 7 days
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Albendazole]] 400 mg PO bid for 3 weeks'''''
+:::* Alternative regimen: [[Erythromycin|Erythromycin base]] 500 mg PO qid for 7 days
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | PLUS
+::* '''Mycoplasma and ureaplasma'''
-|-
+:::* Preferred regimen: [[Azithromycin]] {{or}} [[Levofloxacin]] {{or}} [[Moxifloxacin]]
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Dexamethasone]] 10–20 mg PO qd for 3 weeks'''''
-|-
+::* '''Genital herpes'''
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | Alternative Regimen
+:::* Preferred regimen: [[Acyclovir]] 400 mg PO tid for 7–10 days or [[Acyclovir]] 200 mg PO five times a day for 7–10 days {{or}} [[Famciclovir]] 250 mg PO tid for 7–10 days {{or}} [[Valacyclovir]] 1 g PO bid for 7 days
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Ivermectin]] 0.2 mg/kg PO qd for 2 days'''''
+::* '''Trichomoniasis'''
-|-
+:::* Preferred regimen: [[Metronidazole]] 2 g PO in a single dose) {{or}} [[Tinidazole]] 2 g PO in a single dose
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | PLUS
+:::: Note: Treat patient’s sex partner if trichomoniasis is diagnosed in patient.
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Dexamethasone]] 10–20 mg PO qd for 3 weeks'''''
+::* '''Fungal infections'''
-|-
+:::* Preferred regimen: [[Fluconazole]] {{or}} [[Posaconazole]] {{or}} [[Echinocandins]] {{or}} [[Amphotericin B]]
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5" align=left | <SMALL>Adapted from ''Clin Microbiol Rev. 2009;22(3):484-92.'' and ''Clin Infect Dis. 2009;48(3):322-7.''<ref name="Herman-2009">{{Cite journal  | last1 = Herman | first1 = JS. | last2 = Chiodini | first2 = PL. | title = Gnathostomiasis, another emerging imported disease. | journal = Clin Microbiol Rev | volume = 22 | issue = 3 | pages = 484-92 | month = Jul | year = 2009 | doi = 10.1128/CMR.00003-09 | PMID = 19597010 }}</ref><ref name="Ramirez-Avila-2009">{{Cite journal  | last1 = Ramirez-Avila | first1 = L. | last2 = Slome | first2 = S. | last3 = Schuster | first3 = FL. | last4 = Gavali | first4 = S. | last5 = Schantz | first5 = PM. | last6 = Sejvar | first6 = J. | last7 = Glaser | first7 = CA. | title = Eosinophilic meningitis due to Angiostrongylus and Gnathostoma species. | journal = Clin Infect Dis | volume = 48 | issue = 3 | pages = 322-7 | month = Feb | year = 2009 | doi = 10.1086/595852 | PMID = 19123863 }}</ref></SMALL>
-|-
+::* '''Schistosomiasis'''
-|}
+:::* Preferred regimen: [[Praziquantel]] 20 mg/kg PO bid for 1–2 days
-|}
-{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table39" style="background: #FFFFFF;"
+===Syphilis===
-| valign=top |
-{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
+* Syphilis (''Treponema pallidum'')<ref>{{Cite journal| issn = 1545–8601| volume = 59| issue = RR–12| pages = 1–110| last1 = Workowski| first1 = Kimberly A.| last2 = Berman| first2 = Stuart| last3 = Centers for Disease Control and Prevention (CDC)| title = Sexually transmitted diseases treatment guidelines, 2010| journal = MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control| date = 2010–12–17| pmid = 21160459}}</ref>
-! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center |{{fontcolor|#FFF|''Gnathostoma spinigerum''}}
+:* Non–HIV-infected persons
-|-
+::* '''Primary and secondary syphilis'''
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | Preferred Regimen
+:::* Preferred regimen (adult): [[Benzathine penicillin G]] 2.4 MU IM in a single dose
-|-
+:::* Preferred regimen (pediatric): [[Benzathine penicillin G]] 50,000 units/kg (up to 2.4 MU) IM in a single dose
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Amphotericin B]] 1.5 mg/kg/day IV q12h for 3 days'''''
-|-
+::* '''Latent syphilis'''
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | FOLLOWED BY
+:::* Early latent syphilis
-|-
+::::* Preferred regimen (adult): [[Benzathine penicillin G]] 2.4 MU IM in a single dose
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Amphotericin B]] 1 mg/kg/day IV for 6 days'''''
+::::* Preferred regimen (pediatric): [[Benzathine penicillin G]] 50,000 units/kg (up to 2.4 MU) IM in a single dose
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | PLUS
+:::* Late latent syphilis or unknown duration
-|-
+::::* Preferred regimen (adult): [[Benzathine penicillin G]] 2.4 MU IM for 3 doses, each at 1-week intervals
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Amphotericin B]] 1.5 mg/kg/day intrathecal for 2 days'''''
+::::* Preferred regimen (pediatric): [[Benzathine penicillin G]] 50,000 units/kg (up to 2.4 MU) IM, administered as 3 doses at 1-week intervals
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | FOLLOWED BY
+::* '''Tertiary syphilis'''
-|-
+:::* Preferred regimen: [[Benzathine penicillin G]] 2.4 MU IM for 3 doses, each at 1-week intervals
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Amphotericin B]] 1 mg/kg/day intrathecal qod for 8 days'''''
-|-
+::* '''Neurosyphilis'''
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | Alternative Regimen
+:::* Preferred regimen: [[Aqueous crystalline penicillin G]] 3–4 MU IV q4h or continuously for 10–14 days
-|-
+:::* Alternative regimen: [[Procaine penicillin G]] 2.4 MU IM q24h for 10–14 days {{and}} [[Probenecid]] 500 mg PO qid for 10–14 days
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Amphotericin B]] 0.25–1 mg/kg/day IV q24h for 2 weeks'''''
+:::: Note: [[Benzathine penicillin G]] 2.4 MU IM once per week for up to 3 weeks may be considered after completion of above mentioned regimens to provide a comparable total duration of therapy.
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | PLUS
+:* HIV-infected persons
-|-
+::* '''Primary and secondary syphilis'''
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Fluconazole]] 10 mg/kg IV q24h for 30 days'''''
+:::* Preferred regimen: [[Benzathine penicillin G]] 2.4 MU IM in a single dose
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | PLUS
+::* '''Latent syphilis'''
-|-
+:::* Early latent syphilis
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Rifampicin]] 10 mg/kg PO qd for 30 days'''''
+::::* Preferred regimen: [[Benzathine penicillin G]] 2.4 MU IM in a single dose
-|-
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | PLUS
+:::* Late latent syphilis or unknown duration
-|-
+::::* Preferred regimen: [[Benzathine penicillin G]] 2.4 MU IM for 3 doses, each at 1-week intervals
-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Dexamethasone]] 0.15 mg/kg IV q6h for 30 days'''''
-|-
+::* '''Tertiary syphilis'''
-| style="padding: 0 5px; font-size: 90%; background: #F5F5F5" align=left | <SMALL>Adapted from ''MMWR Morb Mortal Wkly Rep. 2008;57(21):573-7.'' and ''Arch Med Res. 2005;36(1):83-6.''<ref name="-2008">{{Cite journal  | title = Primary amebic meningoencephalitis--Arizona, Florida, and Texas, 2007. | journal = MMWR Morb Mortal Wkly Rep | volume = 57 | issue = 21 | pages = 573-7 | month = May | year = 2008 | doi =  | PMID = 18509301 }}</ref><ref name="Vargas-Zepeda-">{{Cite journal  | last1 = Vargas-Zepeda | first1 = J. | last2 = Gómez-Alcalá | first2 = AV. | last3 = Vásquez-Morales | first3 = JA. | last4 = Licea-Amaya | first4 = L. | last5 = De Jonckheere | first5 = JF. | last6 = Lares-Villa | first6 = F. | title = Successful treatment of Naegleria fowleri meningoencephalitis by using intravenous amphotericin B, fluconazole and rifampicin. | journal = Arch Med Res | volume = 36 | issue = 1 | pages = 83-6 | month =  | year =  | doi =  | PMID = 15900627 }}</ref>
+:::* Preferred regimen: [[Benzathine penicillin G]] 2.4 MU IM for 3 doses, each at 1-week intervals
-|-
-|}
+::* '''Neurosyphilis'''
-|}
+:::* Preferred regimen: [[Penicillin G]] 3–4 MU IV q4h or continuously for 10–14 days
-|}
+:::* Alternative regimen: [[Procaine penicillin G]] 2.4 MU IM q24h for 10–14 days {{and}} [[Probenecid]] 500 mg PO qid for 10–14 days
+:::: Note: [[Benzathine penicillin G]] 2.4 MU IM once per week for up to 3 weeks may be considered after completion of above mentioned regimens to provide a comparable total duration of therapy.
+:* '''During pregnancy'''
+::* Preferred regimen: Pregnant women should be treated with the [[Penicillin]] regimen appropriate for their stage of infection.
+:* '''Congenital syphilis'''
+::* Infants with proven or highly probable disease {{and}} (abnormal physical examination consistent with congenital syphilis {{or}} nontreponemal serologic titer fourfold higher than the mother's titer {{or}} a positive darkfield test of body fluids)
+:::* Preferred regimen: [[Aqueous crystalline penicillin G]] 50,000 U/kg IV q12h during the first 7 days of life and q8h thereafter for a total of 10 days {{or}} [[Procaine penicillin G]] 50,000 U/kg IM in a single daily dose for 10 days
+:::: Note (1): If more than 1 day of therapy is missed, the entire course should be restarted.
+:::: Note (2): Maternal history of infection with ''T. pallidum'' and treatment for syphilis must be considered.
+::* Infants who have a normal physical examination {{and}} nontreponemal serologic titer the same or less than fourfold the maternal titer {{and}} (mother was not treated adequately {{or}} mother has no documentation of having received treatment {{or}} mother was treated with Erythromycin or another non-Penicillin regimen {{or}} mother received treatment < 4 weeks before delivery)
+:::* Preferred regimen: [[Aqueous crystalline penicillin G]] 50,000 U/kg IV q12h during the first 7 days of life and q8h thereafter for a total of 10 days  {{or}} [[Procaine penicillin G]] 50,000 U/kg IM in a single daily dose for 10 days {{or}} [[Benzathine penicillin G]] 50,000 U/kg IM in a single dose
+:::: Note: If the mother has untreated early syphilis at delivery, 10 days of parenteral therapy may be considered.
+::* Infants who have a normal physical examination {{and}} nontreponemal serologic titer the same or less than fourfold the maternal titer {{and}} mother was treated during pregnancy {{and}} treatment was appropriate for the stage of infection {{and}} treatment administered > 4 weeks before delivery {{and}} mother has no evidence of reinfection or relapse
+:::* Preferred regimen: [[Benzathine penicillin G]] 50,000 U/kg IM in a single dose
+:::: Note: Another approach involves not treating the infant, but rather providing close serologic follow-up in those whose mother's nontreponemal titers decreased fourfold after appropriate therapy for early syphilis or remained stable or low for late syphilis.
+::* Infants who have a normal physical examination {{and}} nontreponemal serologic titer the same or less than fourfold the maternal titer {{and}} mother's treatment was adequate before pregnancy {{and}} mother's nontreponemal serologic titer remained low and stable before and during pregnancy and at delivery (VDRL < 1:2; RPR < 1:4)
+:::* Preferred regimen: [[Aqueous crystalline penicillin G]] 50,000 U/kg q4–6h for 10 days
+:::: Note (1): If the child has no clinical manifestations of disease, the CSF examination is normal, and the CSF VDRL test result is negative, treatment with up to 3 weekly doses of [[Benzathine penicillin G]] 50,000 U/kg IM may be considered.
+:::: Note (2): Any child who is suspected of having congenital syphilis or who has neurologic involvement should be treated with a single dose of [[Benzathine penicillin G]] 50,000 U/kg IM after the 10-day course of [[Aqueous crystalline penicillin G]].
+===Urethritis===
+* Urethritis<ref>{{Cite journal| issn = 1545–8601| volume = 59| issue = RR–12| pages = 1–110| last1 = Workowski| first1 = Kimberly A.| last2 = Berman| first2 = Stuart| last3 = Centers for Disease Control and Prevention (CDC)| title = Sexually transmitted diseases treatment guidelines, 2010| journal = MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control| date = 2010–12–17| pmid = 21160459}}</ref>
+:* '''Nongonococcal urethritis'''
+::* Preferred regimen: [[Azithromycin]] 1 g PO in a single dose {{or}} [[Doxycycline]] 100 mg PO bid for 7 days
+::* Alternative regimen (1): [[Erythromycin]] base 500 mg PO qid for 7 days
+::* Alternative regimen (2): [[Erythromycin ethylsuccinate]] 800 mg PO qid for 7 days
+::* Alternative regimen (3): [[Levofloxacin]] 500 mg PO qd for 7 days
+::* Alternative regimen (4): [[Ofloxacin]] 300 mg PO bid for 7 days
+:* '''Recurrent and persistent urethritis'''
+::* Preferred regimen: [[Metronidazole]] 2 g PO in a single dose {{or}} [[Tinidazole]] 2 g PO in a single dose {{and}} [[Azithromycin]] 1 g PO in a single dose
 ==References==
-{{Reflist|2}}
+{{reflist|2}}

Sandbox g42: Difference between revisions

Latest revision as of 01:42, 20 June 2015

Asymptomatic bacteriuria

Ectoparasitic Infections

Pediculosis Pubis

Scabies

Human papillomavirus infection

Genital Warts

External Genital Warts

Cervical Warts

Vaginal Warts

Urethral Meatus Warts

Anal Warts

Vaginal infection

Bacterial vaginosis

Bacterial vaginosis during pregnancy

Trichomoniasis

Trichomoniasis during pregnancy

Vulvovaginal candidiasis

Uncomplicated VVC

Complicated VVC

Vulvovaginal candidiasis during pregnancy

Cervicitis

Chancroid

Chlamydial infections

Chorioamnionitis

Cystitis

Epididymitis

Genital herpes

Gonococcal infections

Granuloma inguinale

Lymphogranuloma venereum

Pelvic inflammatory disease

Proctocolitis

Prostatitis

Acute Bacterial Prostatitis

Chronic Bacterial Prostatitis

Pyelonephritis

Sterile pyuria

Syphilis

Urethritis

References

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