Samaritan Infectious Disease - Antibiotic Guidelines Table View

Syndrome	Primary Rx	Alternate Rx	Comments
Diabetic foot infection, inpatient	Ampicillin/sulbactam 3 gm IV q 6h Clindamycin 900 mg IV q8-12h + (Gentamicin or Ciprofloxacin)	Piperacillin/tazobactam	Avoid gentamicin in older diabetics or those with renal insufficiency; use vancomycin if MRSA likely.
Peritonitis; intra-abdominal, intra-pelvic abscess	Zosyn 3.375 gm q 6 hr Gentamicin + metronidazole + ampicillin	Ceftriaxone + metronidazole Ampicillin/sulbactam + gentamicin Aztreonam + metronidazole + vancomycin	Infection is often polymicrobic; GNR's and anaerobes are common etiologies.
Clostridium difficile associated disease	Metronidazole 500 mg po tid x 10 - 14d	Vancomycin 125 mg po qid x 10 - 14d	Vancomcyin is likely more effective for severe disease; epidemic strain causes more relapses, complications.
Arthritis, septic	(Cefazolin 2 gm IV q 8 hr or Nafcillin 2gm IV q 4-6 hr) +/- Gentamicin Ceftriaxone 1 gm q 24 hr if gonorrhea is suspected	(Clindamycin or Vancomycin) +/- (Gentamicin, Aztreonam, or Ciprofloxacin)	Acute, community acquired, non-prosthetic joint. If MRSA is suspected, see MRSA algorithm-severe.
Bite, animal or human, outpatient	Amoxicillin/clavulanate 875 mg po bid	Clindamycin + (TMP/SMX or Doxycycline)	Pasturella multocida is a common cauae of animal (cat or dog) bite infections.
Bite, animal or human, inpatient	Ampicillin/sulbactam 3 gm IV q 6 hr	Ceftriazone Clindamycin + (TMP/SMX or Doxycycline)	Pasturella multocida is a common cauae of animal (cat or dog) bite infections.
MRSA, mild to moderate	TMP/SMX or doxycycline (clindamycin if susceptible)	Linezolid	MRSA is more reliably susceptible to TMP/SMX or doxycycline than clindamycin.
MRSA, severe	Vancomycin IV	Linezolid Daptomycin Ceftaroline Tigecycline	Daptomycin ineffective for pneumonia; Avoid tigecycline for bloodstream infection.
Cutaneous abscess, carbuncles	Doxycycline 100 mg po bid TMP/SMX DS po bid	Clindamycin Linezolid	I&D may be sufficient; obtain cultures

First

Respiratory quinolones--Levofloxacin, Moxifloxacin
2nd generation cephalosporins--Cefuroxime, Cefpodoxime