list of recommended antibiotics

8/12/2019 List of Recommended Antibiotics

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Edited by CSMU HOW Medical Team Page 1

General List of Recommended Antibiotics

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Antibiotics Recommendations Medical Department

Acute B acterial Meningit is

Organism(s) First line Alternative notes

Empirical

N. meningitidisH. influnenzaeS. pneumoniae

IV Ceftriaxone 2g bd

for 2 weeks(elderly/ malignancy,to add IV Ampicilin,2g bd to cover for L.monocytogenes)

IV Cefotaxime 2g tds

or IV Meropenem 2gtds for 2 weeks

Acute Dysentary


E. histolyticaShigella

IV/PO Metronidazolefor 10daysIV/PO Ciprofloxacinfor 3days

Aspiration pneumonia


S. pneumoniaeOral anaerobesH. influnenzaeM. catarrhalis

IV Augmentin 1.2g tds IV cefotaxime 1g tdsPlusIV Metronidazole500mg tds

Community acquired pneumonia

Organism(s) First line Alternative notesS. pneumoniae

Oral anaerobesH. influnenzaeM. catarrhalis

IV Augmentin 1.2g tds

orIV Cefotaxime 1g tdsorIV Unasyn 1.5g tdsFor 1-2 weeksPlus eitherErythromycin ES800mg bdordoxycycline 100mg bdor

Azithromycin 500mg

od for 2 weeks

IV Cefuroxime 1.5g

tds for 1-2 weeks


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Diabetic related ulcer


P. aeruginosaE. coli

IV Ampiciln +Sulbactam (Unasyn)1.5g tds

OrIV Amoxicillin +Clavulanic acid(Augmentin) 1-2gtdsFor 1-2 weeks.

Double lumen catheter related sepsis

Organism(s) 1stline Alternative Notes

IV Ceftazidime 1g odplus IV Cloxacillin 500

mg qid for 2 weeks

Gastrointestinal tract


E.coliCamphylobacterSalmonellaVibrioYersinia

Clostridium difficilecolitis

Salmonella thypi

IV / PO Ciprofloxacin500 mg bd for 5 days

IV Metronidazole 500bd or 1g od till

diarrhea cured

IV Ceftriaxone 2g odfor 5 days

Cap Doxycycline100 bd for 5 days

Gonorrhea


N. Gonorrhea IM Ceftrixone 125 mg* 1 dose

IM 3rdgenerationCephalosporin250 500 mg * 1dose

Hospital acquired pneumoniaOrganism(s) 1stline Alternative Notes

P.auruginosaE.coliK. pneumonia

IV Cefotaxime 1g tdsor IV Sulperezone 1gbd for 1-2 weeks

IV Vancomycin 1 g

IV Meropenem 1 gtds orIV Tazosin 4.5 gtds


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Intravenous drug abuserOrganism (s) First line Alternative Notes

S. pneumoniae IV Cloxacillin2g 4hrly plusIV Gentamicin

3.5-5mg in3 divided doses

Liver abscessOrganism (s) First line Alternative Notes

EnterobacteriaceaEnterococcusB. flagilis

Burkholderiapseudomallei

IV CiprofloxacinplusIV Metronidazole500mg tds till

Abscess reduce insize

IV Ceftazidime2g tds for 2 weeksplusCap Doxycycline100mg bd andCo-trimoxazole2 tad bd for18 weeks

Miscellaneous

Organism (s) First line Alternative Notes

Leptospira spp IV C Penicillin

2MU qid plusDoxycycline100mg bdfor 1 week

IV Ceftriaxone 1g

od for 1 week

Staph aureus(MRSA)

tds for 1 week

Infective Endocarditis


Strep viridan

Gp B,C, GStreptococci

IV C Penincillin 2 MU

4 hourly plus IVGentamycin 3.5 5mg per kg in 3 divideddoses 4 minimum of 2weeks.


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SyphilisOrganism (s) First line Alternative Notes

Primary/secondary(1 year)

IM Benzathinepenicillin 2.4MUsingle dose or

Doxycycline100mg bdfor 2 weeks

IM Benzathinepenicillin2.4MU weeklyfor 2 weeks orDoxycycline 100mgbd for 3 weeks

Urinary tracta) Pyelonephritis

Organism(s) 1st

line Alternative Notes

Empiricalenterobacteriacea

IV Ceftriaxone 1g odfor 1 to 2 weeksOrIV / PO Ciprofloxacin500 mg bd for 1 to 2weeks

IV Cefuroxime 1.5 gtds

b) Renal AbscessOrganism(s) 1

stline Alternative Notes

EmpiricalS. pneumonia

IV Ceftriaxone 1g ODor ( till abscessresolved)

C) UrosepsisOrganism(s) 1

stline Alternative Notes

Gram (-ve) IV Ceftriaxone 1g odOrIV Ciprofloxacin 500mg bd for 1 to 2weeks

Gram (+ve) IV Augmentin 1.2g tdsfor 1-2 weeks


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MALARIA

Diagnosis Suggested treatment Notes1stline Altenative

Plasmodium vivax Chloroquine(base)600 mg ( 4 tabs

immediately, then300 mg (2tabs) 6hours later and ondays 2 & 3.+Primaquine 15 mgdaily for 14 days+Pyrimethamine +Sulfadoxine (Fansidar) 3tabs

G6PD deficiency shouldbe excluded prior to the

use of PrimaquineIf fails to respond tostandard Chloroquinetreatment Quinine orMefloquine arealternative therapies.Chloroquine resistant iswidespread alongMalaysia,Thai border,Sabah and in someareas with illegalimmigrant village.

Fansidar iscontraindicated inpregnancy and infant.


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Antibiotics Recommendations Surgery Department

Breast AbscessOrganism(s) 1stline Alternatives Notes

Staphylococciaureus and

epidermidisStreptococci

Cloxacillin1stgeneration

Cephalosporins

Erythromycin Recommendedduration: 1week

Proper I&D anddressings arenecessary

Burns (burn wound sepsis)Organism(s) 1stline Alternatives Notes

StaphylococciStreptococciPseudomonas

CloxacillinGentamicin

Metronidazole Recommendedduration: dependson response

Diverticulitis Perirectal Abscess

Organism(s) 1stline Alternatives NotesE.coliKlebsiellaEnterococciProteus

2nd/ 3rdgenerationof CephalosporinsMetronidazole

GentamicinAmikacin

Recommendedduration: 1week

Duodenal / Gastric Ulcer

Organism(s) 1stline Alternatives Notes

H.pylori PO ClarithromycinPO AmoxycillinPO Lansoprazole

PO TetracyclinPO MetronidazolePO Omiprazole


Urease test positive

Gastrointestinal(Gallbladder, Cholecystitis, Cholangitis Biliary Sepsis,Appendicitis)


E.coliKleabsiellaProteusEnterococci

Anaerobes

Amoxycillin2nd/ 3rdgenerationof CephalosporinsMetronidazole

GentamicinAmikacin


Kidney(Perinephric abscess, UTI, Pyelonephritis)


ColiformsanaerobesStaphylococci

Bactrim 2nd/ 3rdgenerationof CephalosporinsMetronidazole

GentamicinAmikacin



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Liver(Hepatic Abscess)


Coliforms

anaerobes

2nd/ 3rdgeneration

of CephalosporinsMetronidazole

Gentamicin

Amikacin

Recommended

duration: 1 week

Muscle(Gas gangrene)


Clostridiumperfringens

BenzylpenicillinCephalosporins

Metronidazole Recommendedduration: 1week

Muscle

(Pyomyocitis)Organism(s) 1stline Alternatives Notes

StaphylococciClostridium

Beta-lactamsCloxacillin

Cephalosporins Recommendedduration: 1week

Necrotizing fascilitis


StaphylococciStreptococciPseudomonas

CloxacillinGentamiciUnasyn

Metronidazole Recommendedduration: 1week

PancreasNecrotizing pancreatitis



GentamicinAmikacin


Pancreatic abcess, Infected pseudocyst


Coliformsanaerobs



Pancreatitis, Acute alcoholic pancreatitis





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PeritoniumPrimary Peritonitis

Organism(s) 1stline Alternatives NotesColiformsanaerobs


GentamicinAmikacin

Recommendedduration:dependant onrespond

Prevention of SPB (cirrhosis & ascites)


Coliformsanaerobs


GentamicinAmikacin


Secondary peritonitis(bowel perforation, ruptured appendix/diverticula)


Coliformsanaerobs


GentamicinAmikacin

Recommendedduration:dependant onrespond

ANTIBIOTIC PROPHYLAXIS FOR SURGERY

Type Of Surgery Prophylaxis

Agent/Dose/Route/Duration

Notes

AAA repair and

vascular bypass

surgery

IV Ampicillin/Sulbactam 1.5gm TDS x

1week

IV Cloxacillin 1gm on induction and

500mg QID x 1 week

May continue with oral

antibiotics

Biliary

Laparoscopic

cholecyctectomy

(high risk)

IV Cefoperazone 1g BD x 1 week

IV Metronidazole 500mg TDS x 1 week


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Breast IV Cefuroxime 1.5g on induction May be extended in presence

of skin infection

Colorectal

Elective

Emergency



IV Gentamicin Or Amikacin

may be used if indicated

Gastrointestinal

tract

Appendicitis



Herniorraphy IV Cefuroxime 1.5g on induction May be extended in presence

of skin infection

Vascular access IV Ampicillin/Sulbactam 1.5gm

IV Cloxacilin 1g

May continue with oral

antibiotics

list of recommended antibiotics

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