Harbor:Sepsis antibiotics

Unknown Source

1. Comm. Acquired
   1. Vanco 1 g IV
   2. Ceftriaxone 1 g IV
   3. Metronidazole 1.5 g IV
   4. Gentamicin 5mg/kg
2. Healthcare Assoc.
   1. Vanco 1 gm IV
   2. Cefepime 2g gm IV
   3. Metronidazole 1.5 g IV
   4. Gentamicin 5-7 mg/kg
3. Cephalosporin allergy
   1. Vanco 1 gm IV
   2. Metronidazole 1.5 g IV
   3. Gentamicin 5-7 mg/kg IV
   4. Levofloxacin 750mg IV or (Meropenem or Imipenem 1gm IV outside HGH)

Pneumonia (Community)

1. Comm. Acquired
   1. Ceftriaxone 1 gm IV
   2. Azithromycin 500 mg IV OR Doxycycline 100mg IV
2. Cephalosporin allergy
   1. Moxifloxacin 400 mg IV OR Levofloxacin 750mg IV

Pneumonia (Healthcare Assoc/Pseudomonas Risk)

1. Healthcare Assoc.
   1. Cefipime 2 g IV
   2. Cipro 400 mg IV
   3. Clinda 600 mg IV
2. Cephalosporin allergy
   1. Clinda 600 mg IV
   2. Cipro 400 mg IV
   3. Gentamicin 5-7 mg/kg IV

Abdominal/Pelvic

1. Comm. Acquired
   1. Ceftriaxone 1 g IV
   2. Metronidazole 1.5 g IV
   3. Gentamicin 5-7 mg/kg IV
2. Healthcare Assoc.
   1. Ceftazidime 2 g IV
   2. Gentamicin 5 mg/kg IV
   3. Metronidazole 1.5 mg IV
3. Cephalosporin allergy
   1. Cipro 400 mg IV
   2. Metronidazole 1.5 g IV
   3. Gentamicin 5-7 mg/kg IV

Urosepsis

1. Comm. Acquired
   1. Ceftriaxone 1 g IV
   2. Gentamicin 5-7 mg/kg IV
2. Healthcare Assoc.
   1. Vancomycin 1 g IV
   2. Ceftazidime 1g IV
   3. Gentamicin 5-7 mg/kg IV
3. Cephalosporin allergy
   1. Vancomycin 1g IV
   2. Cipro 400 mg IV
   3. Gentamicin 5 mg/kg IV

Meningitis (Nl/Community)

1. Comm. Acquired
   1. Ceftriaxone 2 g IV
   2. Vancomycin 1.5 g IV
2. Cephalosporin allergy
   1. Chloramphenicol 1 g IV
   2. Vancomycin 1.5g IV

Meningitis (Nl/Post neurosurgical)

1. Healthcare Assoc.
   1. Vanco 1.5 g IV
   2. Cefepime 2 g IV
2. Cephalosporin allergy
   1. Vanco 1.5g IV
   2. Cipro 400mg IV

Meningitis (Immunocomp)

(Cirrhosis, EtoH, age > 65, steroids, HIV)

1. Comm. Acquired
   1. Penicillin G 4M Units IV
   2. Ceftriaxone 2 g IV
   3. Vancomycin 1g IV
2. Cephalosporin allergy
   1. Chloramphenicol 1g IV
   2. Trim/sulfa 10mg/kg IV
   3. Vancomycin 1.5g IV

Necrotizing Soft-tissue Infection

1. Comm. Acquired/Healthcare Assoc.
   1. Vanco 1 gm IV
   2. Ceftriaxone 1 gm IV
   3. Clinda 600 mg IV
   4. Consider: Gent 5-7mg/k IV
2. Healthcare Assoc.
   1. Vancomycin 1g IV
   2. Piperacillin/Tazobactam 3.375g IV
   3. Clindamycin 600mg IV
3. Cephalosporin allergy
   1. Vanco 1 gm IV
   2. Clinda 600 mg IV
   3. Cipro 400 mg IV
   4. Gentamicin 5-7mg/kg

See Also

Sepsis

Source

Harbor-UCLA Antibiotics Review Committee (Rev. 07/27/06)