EMPIRIC ANTIBIOTIC THERAPY

FOR SELECTED INFECTIOUS SYNDROMES

INDICATION FOR Organisms

DRUG OF CHOICE ALTERNATIVE
THERAPY
Sepsis MSSA/MRSA VANCO VANCO PLUS
 Bacteremia Coag neg Staph Plus Cipro +
 UTI Enterococus Pip-TAZ Carbipenam
 Intra-abdominal S viridans
 Pneumonia S pneumoniae
 Necrotizing fasciitis S pyogenes
 Meningitis N. meningiditis
ENTEROBACTERIACEAE
 (Malaria)
Pseudomonas
 (Enteric Fever)
ANAEROBES (Bacteriodes)
 (Dengue) (Candida)
 (RMSF)
 Toxic shock syndrome

UTI-upper ENTEROBACTERIACEAE CTX GENT

Enterococus or or
(CVA tenderness) Pseudomonas PIP-TAZ Cipro
Candida or
GENTAMCIN
UTI-lower As with upper Cipro same
(dysuria) AND or
S saprophyticus Bactrim
or
Nitrofurantoin
Skin & Soft tissue MSSA/MRSA Vancomycin Vancomycin
 Cellulitis S pyogenes or or
 Carbuncle/Furuncle Vibrio (non-cholera) Clindamycin Clindamycin
 Diabetic foot infection (Mixed gram neg and or
 Necrotizing fasciitis anaerobes with diabetes) AMP-salbactam
(purulent vs non purulent)
Intra-abdominal ENTEROBACTERIACEAE AMP-SAL or Carbipenam
infections Bacteroids PIP-TAZ OR
Clostridium Cipro
(guarding, rebound, RUQ Pseudomonas +/- Gentamycin
tenderness and jaundice) Enterococcus Plus
(S. milleri/intermed/constallatis) Metronidazole
OR
Tigecycline

Acute Meningitis S. pneumonia CTX Chloramphenicol

N meningiditis VANCO Plus
(nuccal rigidity, H influenza AMPICILLIN VANCO
photophobia, altered Listeria + Dexamethasone Plus
MS) BACTRIM
Pneumonia-Community S pneumoniae Azithro + CTX Azithro + Vanco
H influenza or MOXI/LEVO
K pneumoniae MOXI/LEVOFLOX Doxycycline
Chest pain-pleursy Mycoplasma or
Legionella Doxycycline
Chlamydia
Influenza

Pneumonia-Health Care MSSA/MRSA PIP-TAZ (or Cipro + Vanco

ENTEROBACTERIACEAE carbipenam) PLUS +/- Aminogly
Pseudomonas VANCO +/- CIPRO
Acinetobacter

Endocarditis MSSA/MRSA VANCO + gent same

Enterococcus
(Host predisposition- S viridans
valvular heart disease) (Coag neg Staph)*
(Candida)*
HACEK

Neutropenic fever

*PVE