Antimicrobial Use Guidelines (AMUG) version 21 - UW Health

More documents

Recommendations

Info

17. Smucny J, Fahey T, Becker L, Glazier R. Antibiotics for acute bronchitis. The CochraneDatabase of Systematic Review [database online]. Cochrane Acute RespiratoryInfections Group; 2000. Updated December 15, 2003.18. Gonzales R, Bartlett JG, Besser RE, et al. Principles of appropriate antibiotic use for thetreatment of uncomplicated acute bronchitis: Background. Ann Emerg Med 2001;37:720-727.19. Bisno AL, Gerber MA, Gwaltney JM Jr, Kaplan EL, Schwartz RH. Practice guidelines forthe diagnosis and management of group A streptococcal pharyngitis. Clin Infect Dis2002;35:113-125.20. Cooper RJ, Hoffman JR, Bartlett JG, et al. Principles of appropriate antibiotic use foracute pharyngitis in adults: Background. Ann Emerg Med 2001; 37:711-719.21. Mandell LA, Bartlett JG, Dowell SF, Tile TM, Musher DM, Whitney C. Update of practiceguideline for the management of community-acquired pneumonia in immunocompetentadults. Clin Infect Dis 2003;37:1405-1433.22. Wetterneck TB, Fox BC. Community-acquired pneumonia: Evaluation and treatment.University of Wisconsin Hospital and Clinics Guideline. 2004.23. Hickner JM, Bartlett JG, Besser RE, Gonzales R, Hoffman JR, Sande M. Principles ofappropriate antibiotic use for acute rhinosinusitis in adults: Background. Ann Emerg Med2001;37:703-710.24. George A, Rubin G. A systematic review and meta-analysis of treatments for impetigo.Br J Gen Pract 2003;53:480-487.25. Gisby J, Bryant J. Efficacy of a new cream formulation of mupirocin: Comparison withoral and topical agents in experimental skin infections. Antimicrob Agents Chemother2000;44:255-260.26. Haider A, Shaw JC. Treatment of acne vulgaris. JAMA 2004;292:726-735.27. Wormser GP, Nadelman RB, Dattwyler RJ, et al. Practice guidelines for the treatment ofLyme disease. Clin Infect Dis 2000;31(Suppl 1):S1-14.28. Wormser GP, Ramanathan R, Nowakoaski JM et al. Duration of antibiotic therapy forearly Lyme disease. Ann Int Med 2003;138:697-704.29. Vogel T, Verrault MG, Morin M, Grenier-Gosselin L, Rochette L. Can Med Assoc J2004;170:469-173.30. Hoepelman AI. Meiland R. Geerlings SE. Pathogenesis and management of bacterialurinary tract infections in adult patients with diabetes mellitus. Int J Antimicrob Agents2003;22 Suppl 2:35-43.31. Gilbert DN, Moellering RC, Eliopoulos GM, Sande MA, eds. The Sanford Guide toAntimicrobial Therapy. 34th Edition. Hyde Park, VT. Antimicrobial Therapy, Inc. 2004.
Appendix L: Child-Pugh Grading of Liver Disease and Liver Disease DosingNo single lab test can adequately access liver function. A common way to access metabolic ability is todetermine the Child-Pugh score which evaluates lab tests and clinical symptoms to determine the extentof liver dysfunction. A patient with a score of 5 has normal function, while a score of 15 representssevere hepatic failure and dysfunction.Scale for Assessing the Depth of Hepatic EncephalopathyGrade Cognitive/Motor Behavior1 Mild tremor, altered handwriting Anxiety, insomnia, mild confusion2 Dysarthria Lethargy, disorientation3 Seizure, muscle twitching Delirium, bizarre behavior4 Posturing ComaChild-Pugh Grading of Liver DiseaseClinical & BiochemicalPoints Scored for Increasing Abnormality*Measurements 1 2 3Encephalopathy None 1 and 2 3 and 4Ascites Absent Slight ModerateBilirubin (mg/dL) 3Albumin (G/dL) >3.5 2.8-3.5 2.3• INR (International Normalized Ratio) is an expression of prothrombin time (PT), corrected by thesensitivity of the reaction to anticoagulants, and should be validated as an alternative to PT inliver insufficiency.• Each row is given a point value of 1, 2, or 3. The sum of each row’s score provides the overallscore that is converted to a “grade of A, B, or C”• Grade A = 5-6 points Grade B =7-9 points Grade C >10 pointsFor drugs with > 60% hepatic metabolism general initial dosing recommendations can be made andsubsequently titrated as clinically indicated. Close clinical monitoring for efficacy and adverse reactions isimperative.Initial Dosing of Drugs with > 60% Hepatic metabolism(unless otherwise indicated by manufacturer)Child-Pugh Score Liver Dysfunction Dosage Adjustment8-9 Moderate Decrease dose by 25% of initial dose> 10 Severe Decrease dose by 50% of initial doseAn alternative method of measuring severity of liver disease and prognosis is the Model of End-StageLiver Disease (MELD) score, for which an on-line calculator can be found athttp://www.mayoclinic.org/meld/mayomodel7.html. However, no recommendations for dose adjustmentsspecific to MELD scores have been published.Bauer LA. Drug dosing in special populations: renal and hepatic disease, dialysis, heart failure, obesity, and druginteractions. In: Applied Clinical Pharmacokinetics. New York, NY: McGraw-Hill; 2001:57-67.Pugh RNH, Murray-Lyon IM, Dawson JL et al. Transection of the oesophagus for bleeding oesophageal varices. Br JSurg 1973;60: 649-9.Propst A, Propst T, Zangerl G, Ofner D, Judmaier G, Vogel W. Prognosis and life expectancy in chronic liver disease.Dig Dis Sci 1995;40:1805-1815.
Page 2 and 3:
PREFACEThe Antimicrobial Use Guidel
Page 4 and 5:
Antimicrobial Cost Table (Cost info
Page 6 and 7:
Summary of Antibiotic Order Form: S
Page 8:
LUNGS/PULMONARYCommunity-Acquired P
Page 12 and 13:
PART I: BY DRUGABACAVIRFor up-to-da
Page 14 and 15:
constructed systemic-pulmonary shun
Page 16 and 17:
AMPICILLIN/SULBACTAM (Unasyn ® )Us
Page 18 and 19:
ATOVAQUONE/PROGUANIL (Malarone ® )
Page 20 and 21:
CEFAZOLINUsual DoseAdult: Moderate/
Page 22 and 23:
CommentsDose adjustment required fo
Page 24 and 25:
1. Typhoid fever. (NOTE: Third-gene
Page 26 and 27:
-Dutasteride-Eltrombopag-Theophylli
Page 28 and 29:
CLINDAMYCINUsual DoseAdult: 600-900
Page 30 and 31:
DAPTOMYCINInfectious Disease approv
Page 32 and 33:
Concurrent administration with peni
Page 34 and 35:
• Cisapride (contraindicated) •
Page 36 and 37:
• Oral contraceptives/hormones -
Page 38 and 39:
Synergy in infective endocarditis a
Page 40 and 41:
• Colchicine • Indinavir • Ta
Page 42 and 43:
• Donepezil • Pioglitazone• D
Page 44 and 45:
with linezolid should be considered
Page 46 and 47:
4. Life-threatening Gram-negative i
Page 48 and 49:
MOXIFLOXACINLevofloxacin and moxifl
Page 50 and 51:
Indications1. Uncomplicated cystiti
Page 52 and 53:
CommentsDose adjustment required fo
Page 54 and 55:
PIPERACILLIN/TAZOBACTAM (Zosyn ® )
Page 56 and 57:
PRIMAQUINEUsual DoseAdult: Malaria
Page 58 and 59:
RIFABUTINUsual DoseAdult (150 mg ca
Page 60 and 61:
• Chloramphenicol • Leflunomide
Page 62 and 63:
SULFISOXAZOLENo longer available as
Page 64 and 65:
TICARCILLIN/CLAVULANATE (Timentin
Page 66 and 67:
2. Recurrent urinary tract infectio
Page 68 and 69:
VANCOMYCINUsual DoseAdult: 1 g Q12H
Page 70 and 71:
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 122 and 123: superinfection: amoxicillin 1 g PO
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
show all

Antimicrobial Use Guidelines (AMUG) version 21 - UW Health

Create successful ePaper yourself

Delete template?

Save as template?