Santa Monica:Antibiotics in Sepsis
Unknown Source
- Primary Therapy
- piperacillin/tazobactam4.5g IV q6h OR cefepime 1g IV q8h OR meropenem 1g IV q8h
- +/- vancomycin 15mg/kg/dose IV q12h [Maximum dose of 1500mg]
- +/- gentamicin 7mg/kg/dose IV q24h
- +/- fluconazole 400mg IV q24h
- If allergy or prior exposure
- aztreonam 2g IV q8h OR levofloxacin 750mg IV q24h
- +/- vancomycin 15mg/kg/dose IV q12h [Maximum dose of 1500mg]
- +/- gentamicin 7mg/kg/dose IV q24h
- +/- fluconazole 400mg IV q24h
Pneumonia (Community)
- Comm. Acquired
- Ceftriaxone 1g IV q24h
- AND, Azithromycin 500mg IV q24h
- If allergy or prior exposure
- Levofloxacin 750mg IV q24h AND Aztreonam 2g IV q8h
Pneumonia (Healthcare Assoc/Pseudomonas Risk)
- Primary therapy
- cefepime 1g IV q8h OR piperacillin/tazobactam4.5g IV q6h
- +/- azithromycin 500mg IV q24h
- +/- vancomycin 15mg/kg/dose IV q12h [Maximum dose of 1500mg]
- If allergy or prior exposure
- levofloxacin 750mg IV q24h
- +/- azithromycin 500mg IV q24h
- +/- gentamicin extended interval 7mg/kg/dose IV q24h
Abdominal/Pelvic
- Primary therapy
- piperacillin/tazobactam4.5g IV q6h OR ertapenem 1g IV q24h OR ceftriaxone 1g IV q24h
- AND, metronidazole 500mg IV q8h
- vancomycin 15mg/kg/dose IV q12h [Maximum dose of 1500mg]
- If allergy or prior exposure
- aztreonam 2g IV q8h
- AND, metronidazole 500mg IV q8h
- +/- vancomycin 15mg/kg/dose IV q12h [Maximum dose of 1500mg]
Urosepsis
- Primary therapy
- ertapenem 1g IV q24h OR ceftriaxone 1g IV q24h
- If allergy or prior exposure
- ciprofloxacin 400mg IV q12h OR ciprofloxacin 400mg IV q12h
- AND, gentamicin 7mg/kg/dose IV q24h
Heme/Onch
- Primary therapy
- meropenem 1g IV q8h
- +/- vancomycin 15mg/kg/dose IV q12h [Maximum dose of 1500mg]
- If allergy or prior exposure
- aztreonam 2g IV q8h
- +/- vancomycin 15mg/kg/dose IV q12h [Maximum dose of 1500mg]
See Also
References
Santa-Monica UCLA 5/12