Antimicrobial Use Guidelines (AMUG) version 21 - UW Health

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superinfection: amoxicillin 1 g PO TIDfor 10 days or amoxicillin/clavulanateextended-release two tablets PO BIDfor 10 days ($)Acute BacterialSinusitis 23 Amoxicillin 500 mg PO TID for 10 days -Antibiotic therapy should bereserved for patients withmoderately severe symptomslasting at least 7-10 days whohave maxillary pain ortenderness in face or teeth(symptomatic treatmentpreferred for patients with mildsymptoms)Skin InfectionsImpetigo 24,25Mild to ModerateInflammatory Acne 26Inflammatory Acne 26Severe PapulonodularAcne 26Topical mupirocin 2% TID for 7 days($)Topical benzoyl peroxide 5% pluserythromycin 2% solution applied BIDfor 8-12 weeksTopical benzoyl peroxide 5% pluserythromycin 2% solution applied BIDfor 8-12 weeks or oral tetracycline 500mg BID for 6-8 weeks (preferred) ordoxycycline 100 mg PO BID for 6-8weeksNo anti-infective strategies suggested-Treatment continued until nonew lesions develop and thenshould be slowly discontinued-Use OTC benzoyl peroxideand generic topicalerythromycin preparationEarly Lyme Disease 27,28 Doxycycline 100 mg PO BID for 10days-Therapeutic choice isappropriate for the treatmentof early localized or earlydisseminated Lyme diseaseassociated with erythemamigrans, in the absence ofneurological involvement orthird-degree atrioventricularheart block
References1. National Institute for Health Care Management Research and Educational Foundation.Prescription Drug Expenditures in 2001: Another Year of Escalating Costs. Revised May6, 2002.2. Davis BR, Cutler JA, Gordon DJ, et al. Rationale and design for the Antihypertensive andLipid Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). Am J Hypertens1996;9(4 pt 1):342-360.3. Hendley JO. Otitis media. N Engl J Med 2002;347:1169-1174.4. Dowell SF, Butler JC, Gibink GS, et al. Acute otitis media: management and surveillancein an era of pneumococcal resistance- a report from the Drug-resistant Streptococcuspneumoniae Therapeutic Working Group. Pediatr Infect Dis J 1999;18:1-9.5. Suerbaum S, Michetti P. Helicobacter pylori infection. N Engl J Med 2002;15:1175-1186.6. Cheng AC, Thielman NM. Update on traveler’s diarrhea. Curr Infect Dis Rep 2002;4:70-77.7. Fihn SD. Acute uncomplicated urinary tract infections in women. N Engl J Med2003;349:259-266.8. Centers for Disease Control and Prevention. Sexually transmitted disease guidelines2002. MMWR Recomm Rep 2002;51(RR-6):1-78.9. Horner PJ, Caul EO. National guidelines for the management of Chlamydia trachomatisgenital tract infection. Sex Transm Infect 1999;75:4S-8S.10. Bigness C. National Guidelines for the management of gonorrhea in adults. Sex TransmInfect 1999;75:13S-15S.11. Barton S, Brown D, Cowan F, et al. National guidelines for the management of genitalherpes. Sex Transm Infect 1999;75:24S-28S.12. Hay P. National guidelines for the management of bacterial vaginosis. Sex Transm Infect1999;75:16S-18S.13. Daniels D, Forster G. National guidelines for the management of vulvovaginalcandidiasis. Sex Transm Infect 1999;75:19S-20S.14. Sherrard J. National guidelines for the management of Trichomonas vaginalis. SexTransm Infect 1999;75:21S-23S.15. Walker P, Wilson J. National guidelines for the management of prostatitis. Sex TransmInfect 1999;75:46S-50S.16. Fowler JE. Antimicrobial therapy for bacterial and nonbacterial prostatitis. Urology2002;20(Supp 6A):24-26.
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PREFACEThe Antimicrobial Use Guidel
Page 4 and 5:
Antimicrobial Cost Table (Cost info
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Summary of Antibiotic Order Form: S
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LUNGS/PULMONARYCommunity-Acquired P
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PART I: BY DRUGABACAVIRFor up-to-da
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constructed systemic-pulmonary shun
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AMPICILLIN/SULBACTAM (Unasyn ® )Us
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ATOVAQUONE/PROGUANIL (Malarone ® )
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CEFAZOLINUsual DoseAdult: Moderate/
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CommentsDose adjustment required fo
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1. Typhoid fever. (NOTE: Third-gene
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-Dutasteride-Eltrombopag-Theophylli
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CLINDAMYCINUsual DoseAdult: 600-900
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DAPTOMYCINInfectious Disease approv
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Concurrent administration with peni
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• Cisapride (contraindicated) •
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• Oral contraceptives/hormones -
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Synergy in infective endocarditis a
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• Colchicine • Indinavir • Ta
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• Donepezil • Pioglitazone• D
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with linezolid should be considered
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4. Life-threatening Gram-negative i
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MOXIFLOXACINLevofloxacin and moxifl
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Indications1. Uncomplicated cystiti
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CommentsDose adjustment required fo
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PIPERACILLIN/TAZOBACTAM (Zosyn ® )
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PRIMAQUINEUsual DoseAdult: Malaria
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RIFABUTINUsual DoseAdult (150 mg ca
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• Chloramphenicol • Leflunomide
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SULFISOXAZOLENo longer available as
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TICARCILLIN/CLAVULANATE (Timentin
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2. Recurrent urinary tract infectio
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VANCOMYCINUsual DoseAdult: 1 g Q12H
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Careful monitoring of patients usin
Page 72 and 73: APPENDIX B: UWHC SURGICAL ANTIMICRO
Page 74 and 75: GI:Appendectomy 3Anaerobic organism
Page 76 and 77: VascularLIKELYPATHOGENS• ANTIMICR
Page 78 and 79: Cleanorthopedicprocedures(other)Sta
Page 80 and 81: APPENDIX C: THERAPY FOR TUBERCULOSI
Page 82 and 83: p-Aminosalicylic acid(PAS)Granules
Page 84 and 85: Appendix D: UNIVERSITY OF WISCONSIN
Page 86 and 87: Appendix E: UWHC Guidelines for the
Page 88 and 89: B. Antifungal Prophylaxis for BMT a
Page 90 and 91: D. Cost ComparisonDrugAmphotericin
Page 92 and 93: 17. Maertens J, Glasmacher A, Herbr
Page 94 and 95: 47. Courtney R, Wexler D, Radwanski
Page 96 and 97: 2.1.7 Patient is without placement
Page 98 and 99: Medications Approved for Parenteral
Page 100 and 101: APPENDIX G: Serum Drug Concentratio
Page 102 and 103: APPENDIX H: Guidelines for Monitori
Page 104 and 105: 1. Patients with large volumes of d
Page 106 and 107: 16. Tsuji B, Rybak MJ. The influenc
Page 108 and 109: APPENDIX I: Infectious Diseases App
Page 110 and 111: APPENDIX J: UWHC Guidelines For the
Page 112 and 113: with aztreonam and other beta-lacta
Page 114 and 115: D. Side Chains1.2.5. The prescriber
Page 116 and 117: 14. Pichichiro ME. Use of selected
Page 118 and 119: Appendix KUWHC Guidelines for Cost-
Page 120 and 121: sulfa and can be prescribed topatie
Page 124 and 125: 17. Smucny J, Fahey T, Becker L, Gl
Page 126 and 127: Appendix M: Guidelines for the Prop
Page 128 and 129: D. CategorizationPatients should be
Page 130 and 131: Empiric coverage for Enterococcus i
Page 132 and 133: H. Necrotizing PancreatitisThe publ
Page 134 and 135: Bone or JointEndocarditis 4Streptoc
Page 136 and 137: Candidemia or candidiasis 11Non-neu
Page 138 and 139: 11. Pappas PG, Kauffman CA, Andes D
Page 140 and 141: piperacillin/tazobactam. There were
Page 142 and 143: D. Dose of Antibiotic1. Piperacilli
Page 144 and 145: TNAVasopressinVoriconazoleMeropenem
Page 146 and 147: pretreatment with an H1-histamine b
Page 148 and 149: formal consult is not required, but
Page 150: K. References1.0 Bliziotis IA, Ples
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