Version June 2024
| Patient population | Common causative organisms | Antimicrobial regimensΔ |
| Immunocompetent patients | Viridans and other streptococci, Peptostreptococcus spp, Bacteroides spp, and other oral anaerobes | Ampicillin-sulbactam 3 g IV every 6 hours OR |
| Penicillin G 2 to 4 million units IV every 4 to 6 hours PLUS Metronidazole 500 mg IV or PO every 8 hours OR | ||
| Cefoxitin 2 g IV every 6 hours OR | ||
| Cefotetan 2 g IV every 12 hours OR | ||
| Ceftriaxone 2 g IV every 24 hours PLUS Metronidazole 500 mg IV or PO every 8 hours OR | ||
| Metronidazole 500 mg IV or PO every 8 hours◊ PLUS Levofloxacin 750 mg IV or PO every 24 hours | ||
| Immunocompromised patients | Viridans and other streptococci, Peptostreptococcus spp, Bacteroides spp, and other oral anaerobes, facultative gram-negative bacilli (including Pseudomonas aeruginosa) | Piperacillin-tazobactam 4.5 g IV every 6 hours OR |
| Cefepime 2 g IV every 12 hours PLUS Metronidazole 500 mg IV or PO every 8 hours OR | ||
| Meropenem 1 g IV every 8 hours OR | ||
| Levofloxacin 750 mg IV or PO every 24 hours¶ PLUS Metronidazole 500 mg IV or PO every 8 hours |
IV: intravenous; MRSA: methicillin-resistant Staphylococcus aureus; PO: by mouth.
* The doses recommended in this table are intended for patients with normal renal and hepatic function.
¶ Local and institutional rates of antibiotic resistance should be considered before choosing an antibiotic regimen. This is particularly important for immunocompromised patients, since there are substantial rates of fluoroquinolone resistance among Pseudomonas aeruginosa and other gram-negative bacteria in some regions.
Δ For patients with risk factors for MRSA infection, we typically add vancomycin (or other MRSA-active antibiotic) to the initial empiric regimen.
◊ This is an option for immunocompetent patients with penicillin allergy. Meropenem is another option, depending on the type of allergy.آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟
