tailieunhanh - Mayo Clinic Antimicrobial Therapy quick guide - part 7

Truyền nhiễm hội chứng điều trị mầm bệnh đạo đầu TRỊ nafcillin oxacillin 1,5-2,0 g IV q4h từ 4-6 tuần, hoặc 1-2 g cefazolin IV q8h cho 4-6 tuần vancomycin 15 mg / kg IV q12h từ 4-6 tuầnvancomycin 15 mg / kg IV q12h từ 4-6 tuần linezolid 600 mg uống hoặc IV q12h từ 4-6 tuần, | Infectious Syndromes Clinical feature First-line treatment Alternate treatment PATHOGEN-DIRECTED THERAPY Staphylococcus sp oxacillin-sensitive oxacillin-resistant nafcillin or oxacillin g IV q4h for 4-6 weeks or cefazolin 1-2 g IV q8h for 4-6 weeks vancomycin 15 mg kg IV ql2h for 4-6 weeks vancomycin 15 mg kg IV ql2h for 4-6 weeks linezolid 600 mg oral or IV ql2h for 4-6 weeks or daptom ycin 6 mg kg IV q24h for 4-6 weeks P-Hemolytic Streptococcus sp or penicillin-sensitive s pneumoniae penicillin G 20 X IO6 units per day IV either continuously or in 6 equally divided doses for 4-6 weeks or ceftriaxone 2 g IV or IM q24h for 4-6 weeks or cefazolin 1-2 g IV q8h for 4-6 weeks vancomycin 15 mg kg IV ql2h for 4-6 weeks Enterobacteriaceae ceftriaxone 2 g IV q24h for 4-6 weeks or ciprofloxacin 500-750 mg oral ql2h for 4-6 weeks imipenem 500 mg IV q6h for 4-6 weeks or meropenem 1 g IV q8h for 4-6 weeks or ertapenem 1 g IV q24h for 4-6 weeks or aztreonam 1 g IV q8h for 4-6 weeks Clinical feature First-line treatment Alternate treatment Pseudomonas sp Enterobacter sp meropenem 1 g IV q8h for 4-6 weeks or cefepime 2 g IV ql2h for 4-6 weeks ciprofloxacin 750 mg oral ql2h for 4-6 weeks or ceftazidime 2 g IV q8h for 4-6 weeksc or aztreonam 1-2 g IV q8h for 4-6 weeks Polymicrobial infection eg diabetic foot infection Treatment depends on type and severity refer to published guidelines in Lipsky et al a Consider using vancomycin in clinical situations with a high risk of methicillin-resistant s aureus. b Consider addition of gram-negative coverage in ill-appearing hemodynamically unstable patients. c Avoid use for organisms that produce extended-spectrum p-lactamases or for organisms that may have inducible p-lactamases. Lipsky et al. Clin Infect Dis. 2004 Oct l 39 885-910. Epub 2004 Sep 10. Other Considerations Therapy for Specific Scenarios Hardware retained Consider chronic suppression until fusion Vertebral osteomyelitis Medical management alone is often sufficient .