Empiric Regimens Flashcards
Empiric Regimens
Community-acquired pneumonia
Common pathogens
S. pneumoniae H. influenzae Mycoplasma pneumoniae Chlamydophila pneumoniae Legionella pneumophila
Empiric Regimens Community-acquired pneumonia Outpatient, otherwise healthy No recent antibiotic exposure Treatment
Doxycycline or Azithromycin or Clarithromycin
Empiric Regimens Community-acquired pneumonia Outpatient Comorbidities and/or recent antibiotic exposure Treatment
Amoxicillin or Amox/Clav
or
Cefuroxime Plus
Azithromycin or Clarithromycin
OR
Levo/Moxi/Gemifloxacin
Empiric Regimens
Community-acquired pneumonia
Inpatient; non-ICU
Treatment
Ceftriaxone or Cefotaxime or Ampicillin or Ertapenem Plus Azithromycin or Clarithromycin or Doxycycline
OR
Levo/Moxifloxacin
Empiric Regimens
Community-acquired pneumonia
Inpatient, ICU
Treatment
Ceftriaxone or Cefotaxime or Amp/Sulb Plus Azithromycin or Levo/Moxifloxacin
Empiric Regimens
Healthcare-associated pneumonia
Early onset (within 5 days of hospitalization) and no recent antibiotic exposure
Common pathogens
S. pneumoniae H. influenzae MSSA E. coli Klebsiella pneumoniae
Empiric Regimens
Healthcare-associated pneumonia
Early onset (within 5 days of hospitalization) and no recent antibiotic exposure
Treatment
Ceftriaxone or Amp/Sulb or Ertapenem or Levo/Moxifloxacin
Empiric Regimens
Healthcare-associated pneumonia
Late onset (after 5 days of hospitalization) and/or recent antibiotic exposure
Common pathogens
MRSA Enterobacter sp Proteus sp Serratia sp P. aeruginosa
Plus
S. pneumoniae H. influenzae MSSA E. coli Klebsiella pneumoniae
Empiric Regimens
Healthcare-associated pneumonia
Late onset (after 5 days of hospitalization) and/or recent antibiotic exposure
Treatment
Cefepime or Ceftazidime or Imipenem Or Meropenem or Pip/Tazo or Aztreonam Plus Cipro/Levofloxacin or Gent/Tobra or Amikacin Plus Vancomycin or Linezolid
Otitis Media
Common Pathogens
Viruses
S. pneumoniae
H. influenzae
Moraxaella catarrhalis
Otitis Media
Mild-moderate otalgia with temperature less than 39C
Treatment
Amoxicillin or Cefuroxime or Cefpodoxime or Azithromycin
Otitis Media
Severe otalgia and/or temperature greater than 39C
Treatment
Amox/Clav
or
Ceftriaxone
Pharyngitis
Common pathogens
Viruses
S. pyogenes
Pharyngitis
Documented or high risk for S. pyogenes
Treatment
Penicillin VK or Cephalexin or Azithromycin
Urinary Tract Infection
Uncomplicated community acquired lower UTI in healthy women less than 50 yo
and
Community acquired complicated UTI or pyelonephritis
Common pathogens
E. coli Proteus sp K. pneumoniae S. saphrophyticus Enterococcus sp
Urinary Tract Infection
Nosocomial complicated UTI or pyelonephritis
Common pathogens
Enterobacter sp
P. aeruginosa
Plus
E. coli Proteus sp K. pneumoniae S. saphrophyticus Enterococcus sp
Urinary Tract Infection
Uncomplicated community acquired lower UTI in healthy women less than 50 yo
Treatment
T/S or Nitrofurantoin or Fosfomycin or Cipro/Levofloxacin
Urinary Tract Infection
Community acquired complicated UTI or pyelonephritis
Treatment
Cipro/Levofloxacin or Ceftriaxone or Ertapenem
Urinary Tract Infection
Nosocomial complicated UTI or pyelonephritis
Treatment
Ceftazidime or Pip/Tazo or Cefepime or Mero/Imipenem
Skin/soft tissue infections
(General)
Common pathogens
Strep pyogenes
Staph aureus
Skin/soft tissue infections
Diabetic foot infection (mod-severe)
Common pathogens
E. coli Proteus sp K. pneumoniae Bacteroides fragilis Enterococcus sp P. aeruginosa
Plus
S. pyogenes
S. aureus
Skin/soft tissue infections
(General)
Low risk for MRSA
Treatment
Cefazolin or Nafcillin or Cephalexin or Dicloxacillin
Skin/soft tissue infections
(General)
High risk for MRSA
Treatment
Vancomycin or Linezolid or Clindamycin
OR
Cephalexin or Dicloxacillin Plus Doxycycline or T/S
Skin/soft tissue infections
Diabetic foot infection (mod-severe)
Treatment
Ceftriaxone or Amp/Sulb or Pip/Tazo or Ertapenem
OR
Levo/Ciprofloxacin
Plus
Clindamycin
All with or without Vancomycin
Intra-abdominal infections
Community-acquired, mild-mod severity
Common pathogens
E. coli Proteus sp K. pneumoniae B. fragilis Enterococcus sp Viridans strep
Intra-abdominal infections Community-acquired, high severity or high risk patient OR Nosocomial (any severity or patient) Common pathogens
P. aeruginosa
Enterobacter sp
Serratia sp
Plus
E. coli Proteus sp K. pneumoniae B. fragilis Enterococcus sp Viridans strep
Intra-abdominal infections
Community-acquired, mild-mod severity
Treatment
Ertapenem or Moxifloxacin or Tigecycline
OR
Cefazolin or Ceftriaxone or Levo/Ciprofloxacin Plus Metronidazole
Intra-abdominal infections Community-acquired, high severity or high risk patient OR Nosocomial (any severity or patient) Treatment
Pip/Tazo or Imipenem or Meropenem
OR
Ceftazidime or Cefepime Plus Metronidazole
All with or without Vancomycin
Community-acquired meningitis
Otherwise healthy, 2-50 yo
Common pathogens
S. pneumoniae
Neisseria meningitidis
Community-acquired meningitis
Greater than 50 yo or immunocompromised
Common pathogens
Listeria monocytogenes
Plus
S. pneumoniae
Neisseria meningitidis
Community-acquired meningitis
Otherwise healthy, 2-50 yo
Treatment
Ceftriaxone
Plus
Vancomycin
Community-acquired meningitis
Greater than 50 yo or immunocompromised
Treatment
Ceftriaxone Plus Vancomycin Plus Ampicillin
Healthcare associated infectious
diarrhea
Common pathogens
Clostridium difficile
Healthcare associated infectious
diarrhea
Mild-mod infection
Treatment
Metronidazole (oral)
Healthcare associated infectious
diarrhea
Severe infection
Treatment
Vancomycin (oral)
or
Fidaxomicin
Healthcare associated infectious
diarrhea
Severe complicated infection (eg., ileus)
Treatment
Vancomycin (oral)
Plus
Metronidazole (IV)
Community-acquired infectious diarrhea
Common pathogens
Shigella Salmonella E. coli Campylobacter C. difficile (uncommon)
Community-acquired infectious diarrhea
Treatment (if antibiotic therapy necessary)
FQ
or
T/S
