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32 Cards in this Set
- Front
- Back
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Rocky Mountain spotted fever
empiric therapy |
Ceftriaxone 2g IV q12h
Doxycycline 100mg IV or PO q12h |
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Neisseria meningitidis septicemia (meningococcemia)
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3rd gen cephalosporin (ceftriaxone 2g IV q12h
---------------------------- Chloramphenicol 100mg/kg/day IV divided q6h in beta-lactam allergic patient x 10-14d |
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RMSF
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doxycycline 100mg q12h IV or PO x 7d
---------------------------- chloramphenicol |
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community-acquired sepsis
|
3rd gen cephalosporin
aminoglycoside |
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asplenic patients
|
risk for fulminant sepsis w/ encapsulated organisms such as strep pneumoniae, haemophilus influenzae, and N. meningitidis
---------------------------- Penicillin G 2 mill units IV q2-4h OR vancomycin 1g IV q12h PLUS 3rd gen cephalosporin (ceftriaxone 2g IV q12h) |
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neutropenic hosts
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pseudomonas aeruginosa sepsis may be likely
---------------------------- antipseudomonal beta-lactam PLUS aminoglycoside |
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Erysipelas
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GABHS
------------------------- penicillin V 250-1000mg PO qid OR procaine pencillin G 600,000 units IM bid OR penicillin G 0.6-2 million units IV q6h ----------------------------- erythromycin 500mg PO qid OR macrolides in penicillin allergic patients |
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Cellulitis
|
GABHS, S.aureus
----------------------------- oxacillin 1-2g IV q4h OR cefazolin 1-2g IV q8h OR vancomycin 1g IV q12h --------------------------- clindamycin OR macrolides for penicillin-allergic patients |
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Cellulitis in diabetic patients
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beta-lactam/beta-lactamase inhibitor PLUS
3rd gen cephalosporin OR carbapenem |
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Cellulits from water-borne pathogens
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fresh water (Aeromonas hydrophila) or salt water (Vibrio vulnificus)
-------------------------- ceftazidime 2g IV q8h OR cefepime 2g IV q8h OR ciprofloxacin 400mg IV q8h or 750mg PO bid Add doxycycline 100mg IV/PO q12 for Vibrio infections |
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Infected decubitus ulcers and limb-threatening diabetic foot ulcers
|
s.aureus, anaerobes, and enteric gram negative organisms
----------------------------- clindamycin 450-900mg IV q8h PLUS 3rd gen cephalosporin OR ciprofloxacin 500-750mg PO bid ----------------------------- OR beta-lactam/beta lactamase inhibitor combination ----------------------------- OR imipenem-cilastatin 500mg IV q6h ------------------------------ less severe diabetic infections due to s.aureus w/ or w/o streptococcus-- cephalexin OR dicloxacillin OR clindamycin |
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Necrotizing fasciitis
|
mixed anaerobic (bacteroides, other anaerobes, aerobic gram negative organisms, and streptococcus species) or GABHS
---------------------------- penicillin G (or ampicillin) PLUS clindamycin PLUS gentamicin or 3rd gen cephalosporin ----------------------------- gram stain/culture show mixed infection-- imipenem or a beta-lactam/beta-lactamase inhibitor combination ------------------------------ if GABHS, penicillin or clinamycin should be continued |
|
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Anaerobic myconecrosis (gas gangrene)
|
Clostridium perfringens, Clostridium septicum, S.aureus, GABHS, or other anaerobes
----------------------------- penicillin PLUS clindamycin PLUS gentamicin, ciprofloxacin, or 3rd gen cephalosporin until gram stain excludes gram-negative organism |
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Acute hematogenous osteomyelitis
|
s.aureus
---------------------------- |
|
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osteomyelitis in the presence of orthopedic devices
|
s.aureus or coagulase-negative staphylococcus species
------------------------------ |
|
|
Rocky Mountain spotted fever
empiric therapy |
Ceftriaxone 2g IV q12h
Doxycycline 100mg IV or PO q12h |
|
|
Neisseria meningitidis septicemia (meningococcemia)
|
3rd gen cephalosporin (ceftriaxone 2g IV q12h
---------------------------- Chloramphenicol 100mg/kg/day IV divided q6h in beta-lactam allergic patient x 10-14d |
|
|
RMSF
|
doxycycline 100mg q12h IV or PO x 7d
---------------------------- chloramphenicol |
|
|
community-acquired sepsis
|
3rd gen cephalosporin
aminoglycoside |
|
|
asplenic patients
|
risk for fulminant sepsis w/ encapsulated organisms such as strep pneumoniae, haemophilus influenzae, and N. meningitidis
---------------------------- Penicillin G 2 mill units IV q2-4h OR vancomycin 1g IV q12h PLUS 3rd gen cephalosporin (ceftriaxone 2g IV q12h) |
|
|
neutropenic hosts
|
pseudomonas aeruginosa sepsis may be likely
---------------------------- antipseudomonal beta-lactam PLUS aminoglycoside |
|
|
Erysipelas
|
GABHS
------------------------- penicillin V 250-1000mg PO qid OR procaine pencillin G 600,000 units IM bid OR penicillin G 0.6-2 million units IV q6h ----------------------------- erythromycin 500mg PO qid OR macrolides in penicillin allergic patients |
|
|
Cellulitis
|
GABHS, S.aureus
----------------------------- oxacillin 1-2g IV q4h OR cefazolin 1-2g IV q8h OR vancomycin 1g IV q12h --------------------------- clindamycin OR macrolides for penicillin-allergic patients |
|
|
Cellulitis in diabetic patients
|
beta-lactam/beta-lactamase inhibitor PLUS
3rd gen cephalosporin OR carbapenem |
|
|
Cellulits from water-borne pathogens
|
fresh water (Aeromonas hydrophila) or salt water (Vibrio vulnificus)
-------------------------- ceftazidime 2g IV q8h OR cefepime 2g IV q8h OR ciprofloxacin 400mg IV q8h or 750mg PO bid Add doxycycline 100mg IV/PO q12 for Vibrio infections |
|
|
Infected decubitus ulcers and limb-threatening diabetic foot ulcers
|
s.aureus, anaerobes, and enteric gram negative organisms
----------------------------- clindamycin 450-900mg IV q8h PLUS 3rd gen cephalosporin OR ciprofloxacin 500-750mg PO bid ----------------------------- OR beta-lactam/beta lactamase inhibitor combination ----------------------------- OR imipenem-cilastatin 500mg IV q6h ------------------------------ less severe diabetic infections due to s.aureus w/ or w/o streptococcus-- cephalexin OR dicloxacillin OR clindamycin |
|
|
Necrotizing fasciitis
|
mixed anaerobic (bacteroides, other anaerobes, aerobic gram negative organisms, and streptococcus species) or GABHS
---------------------------- penicillin G (or ampicillin) PLUS clindamycin PLUS gentamicin or 3rd gen cephalosporin ----------------------------- gram stain/culture show mixed infection-- imipenem or a beta-lactam/beta-lactamase inhibitor combination ------------------------------ if GABHS, penicillin or clinamycin should be continued |
|
|
Anaerobic myconecrosis (gas gangrene)
|
Clostridium perfringens, Clostridium septicum, S.aureus, GABHS, or other anaerobes
----------------------------- penicillin PLUS clindamycin PLUS gentamicin, ciprofloxacin, or 3rd gen cephalosporin until gram stain excludes gram-negative organism |
|
|
Acute hematogenous osteomyelitis
|
s.aureus
---------------------------- |
|
|
osteomyelitis in the presence of orthopedic devices
|
s.aureus or coagulase-negative staphylococcus species
------------------------------ |
|
|
osteomyelitis associated w/ hemoglobinopathies
|
s.aureus or salmonella
------------------------------ salmonella may require surgical treatment and parenteral administration of high-dose ampicillin or chloramphenicol |
|
|
osteomyelitis associated w/ vascular insufficiency
|
polymicrobial, including anaerobes
|
