Harbor:Sepsis antibiotics: Difference between revisions

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==Unknown Source<ref>Form v2011.09.15</ref>==
==Unknown Source<ref>Form v2011.09.15</ref>==
*'''Severe Sepsis'''
*'''Severe [[Sepsis]]'''
**Comm. Acquired
**Comm. Acquired
***[[Ceftriaxone]] 1 g IV
***[[Ceftriaxone]] 1 g IV
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===Community Acquired Pneumonia (CAP) ===
===Community Acquired Pneumonia (CAP) ===


MCC by S. pneumoniae. In young must cover for mycoplasma and other atypicals. See [[Pneumonia (Pathogens)]]  
MCC by [[S. pneumoniae]]. In young must cover for [[mycoplasma]] and other atypicals. See [[Pneumonia (Pathogens)]]  


Treatment based on [[Pneumonia (Port Score)]]  
Treatment based on [[Pneumonia (Port Score)]]  
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**'''[[Cefepime]] '''2g IV Q8H + '''[[Levofloxacin]] '''750mg IV Qday
**'''[[Cefepime]] '''2g IV Q8H + '''[[Levofloxacin]] '''750mg IV Qday


===Healthcare Associated PNA (HCAP) + Hospital Associated PNA (HAP) ===
===Healthcare Associated [[PNA]] (HCAP) + Hospital Associated [[PNA]] (HAP) ===


HAP occurs if patient develops PNA 2-3 days after hospitalization. HCAP occus in non-hospitalized patient with extensive healthcare contact.  
HAP occurs if patient develops [[PNA]] 2-3 days after hospitalization. HCAP occus in non-hospitalized patient with extensive healthcare contact.  


*Mild HAP/HCAP no recent antibiotic exposure:  
*Mild HAP/HCAP no recent antibiotic exposure:  
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**If shock, recent ABX, or from SNF/ward:  
**If shock, recent ABX, or from SNF/ward:  
***Add '''[[Meropenem]]'''  
***Add '''[[Meropenem]]'''  
*Cephalosporin allergy:  
*[[Cephalosporin]] allergy:  
**[[Clinda]] 600 mg IV  
**[[Clinda]] 600 mg IV  
**[[Cipro]] 400 mg IV  
**[[Cipro]] 400 mg IV  
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**[[Ceftriaxone]] 2 g IV
**[[Ceftriaxone]] 2 g IV
**Add [[Vancomycin]] 1 g IV if [[CSF Results]] suggest pneumococcal [[meningitis]] (for [[ceftriaxone]] resistant [[S. pneumoniae]])
**Add [[Vancomycin]] 1 g IV if [[CSF Results]] suggest pneumococcal [[meningitis]] (for [[ceftriaxone]] resistant [[S. pneumoniae]])
**Add Ampicillin 2g IV Q4H in age >50 years and pregnant
**Add [[Ampicillin]] 2g IV Q4H in age >50 years and pregnant
*Cephalosporin allergy           
*[[Cephalosporin]] allergy           
**[[Chloramphenicol]] 1 g IV
**[[Chloramphenicol]] 1 g IV
**[[Vancomycin]] 1.5g IV
**[[Vancomycin]] 1.5g IV


==Meningitis (Nl/Post neurosurgical)==
==[[Meningitis]] (Nl/Post neurosurgical)==
*Healthcare Assoc.           
*Healthcare Assoc.           
**[[Vancomycin]] 1.5 g IV
**[[Vancomycin]] 1.5 g IV
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**[[Cipro]] 400mg IV
**[[Cipro]] 400mg IV


==Meningitis (Immunocomp)==
==[[Meningitis]] (Immunocomp)==
(Cirrhosis, EtoH, age > 65, steroids, HIV)
(Cirrhosis, EtoH, age > 65, steroids, HIV)


*Comm. Acquired           
*Comm. Acquired           
**Penicillin G 4M Units IV
**[[Penicillin]] G 4M Units IV
**[[Ceftriaxone]] 2 g IV
**[[Ceftriaxone]] 2 g IV
**[[Vancomycin]] 1g IV
**[[Vancomycin]] 1g IV
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**[[Vancomycin]] 1.5g IV
**[[Vancomycin]] 1.5g IV


==Necrotizing Soft-tissue Infection==
==[[Necrotizing Soft-tissue Infection]]==
*Comm. Acquired/Healthcare Assoc.           
*Comm. Acquired/Healthcare Assoc.           
**[[Vancomycin]] 1 gm IV
**[[Vancomycin]] 1 gm IV
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**[[Gentamicin]] 5-7mg/kg
**[[Gentamicin]] 5-7mg/kg


==Neutropenic Fever==
==[[Neutropenic Fever]]==
*'''Severe Sepsis'''
*'''Severe Sepsis'''
**Cefepime 2 g IVPB x 1
**Cefepime 2 g IVPB x 1

Revision as of 15:23, 18 July 2016

Unknown Source[1]

Pneumonia

Community Acquired Pneumonia (CAP)

MCC by S. pneumoniae. In young must cover for mycoplasma and other atypicals. See Pneumonia (Pathogens)

Treatment based on Pneumonia (Port Score)

Healthcare Associated PNA (HCAP) + Hospital Associated PNA (HAP)

HAP occurs if patient develops PNA 2-3 days after hospitalization. HCAP occus in non-hospitalized patient with extensive healthcare contact.

Abdominal/Pelvic

Urosepsis

Meningitis (Nl/Community)

Meningitis (Nl/Post neurosurgical)

Meningitis (Immunocomp)

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

Necrotizing Soft-tissue Infection

Neutropenic Fever

  • Severe Sepsis
    • Cefepime 2 g IVPB x 1
    • Vancomycin 1 g IVPB x 1
  • Septic Shock

See Also

Harbor:Antibiotics by diagnosis

See also Harbor: Sepsis core measures
Initial Antibiotics in Sepsis (Main)

References

  1. Form v2011.09.15