Antimicrobial Use Guidelines (AMUG) version 21 - UW Health

More documents

Recommendations

Info

VascularLIKELYPATHOGENS• ANTIMICROBIALREGIMEN (Adult)ANTIMICROBIAL REGIMEN(Pediatric)OR REDOSINGCOMMENTS• Abdominalaorticaneurysm:elective orruptured• Thoracoabdominalaneurysm• Aortobifem/iliac bypass• Renal orcarotidendarterectomyStaph aureus(predominant), alsoGram--negative bacilli,coagulase-negativestaphylococci andenterococci• Cefuroxime 4,5 1.5 g IV preop• AND/OR vancomycin 1 gIV (single dose) ifimplantation ofprosthetic/valvular graft(Staphylococcusepidermidis), or if patient isMRSA-positive----- or• Vancomycin 1 g IV, ifpenicillin allergic• Cefuroxime 30mg/kg IV(Maximum of 1.5g) pre-op• AND/OR vancomycin15mg/kg IV (Maximum of1g) if patient is MRSApositiveor pencillin allergic• Cefuroxime every 4hours• Vancomycin: none;every 6 hours forpediatric patientsAll preoperative antibiotics shouldbe administered within 1 hour ofincision• Below/abovekneeamputations• Lowerextremitybypass (nowarfarin)• Transmetatarsalamputation• Toeamputation• 1st ribresection
NeurosurgicalLIKELYPATHOGENS• ANTIMICROBIALREGIMEN (Adult)ANTIMICROBIAL REGIMEN(Pediatric)OR REDOSINGCOMMENTSCraniotomyCerebrospinalfluidshuntStaphylococcus aureus,coagulase-negativestaphylococciStaphylococci accountfor 75-80% of woundinfections following shuntprocedures; Gram--negative bacteria 1-20%.• Cefazolin 4 1 g IV pre-op(2 g if > 80 kg)• Cefuroxime 4,5 1.5 g IV preop----- or• Vancomycin 1 g IV as asingle dose• Cefazolin 25mg/kg IV preop(Maximum of 1 g)• Cefuroxime 30mg/kg IV(Maximum of 1.5g) pre-op---- Or• Vancomycin 15mg/kg IV(Maximum of 1 g) pre-op• Cefazolin every 4hours• Cefuroxime every 4hours• Vancomycin none;every 6 hours forpediatric patientsOrganisms listed represent >85%of post-op infectionsIF incidence of infections withMRSA >10% in an institution,vancomycin is recommended,otherwise it is optional(IF incidence of infections with MRSA>10% in an institution, vancomycin isrecommended, otherwise it isoptional)OrthopedicsLIKELYPATHOGENSANTIMICROBIAL REGIMEN(Adult)ANTIMICROBIAL REGIMEN(Pediatric)OR REDOSINGCOMMENTSTotal jointreplacementStaphylococcus aureusand Staphylococcusepidermidis and variousstreptococci cause>66% of woundinfections.• Cefazolin 1,4 1 g IV preop(2 g if > 80 kg)----- or• Cefuroxime 5 1.5 g IV preop----- or• Vancomycin (15 mg/kg), upto 1 g IVpre-op if MRSA+• Cefazolin 25mg/kg IV preop(Maximum of 1 g)---- Or• Cefuroxime 30mg/kg IVpreop (Maximum of 1.5 g)---- Or• Vancomycin 15mg/kg IV(Maximum of 1 g) preop ifMRSA+• Cefazolin every 4hours• Cefuroxime every 4hours• Vancomycin none;every 6 hours forpediatric patientsCefuroxime has enhanced activityagainst coagulase-negativestaphylococci<strong>Use</strong> vancomycin only for severepenicillin allergy or if MRSA+.Some clinicians use clindamycinin penicillin-allergic patientsHip fracturerepairStaphylococci• Cefazolin 1,4 1 g IV pre-op(2 g if > 80 kg)----- or• Cefuroxime 5 1.5 g IV preop----- or• Vancomycin (15 mg/kg) upto 1 g IV if MRSA+• Cefazolin 25mg/kg IV preop(Maximum of 1 g)---- Or• Cefuroxime 30mg/kg IVpreop (Maximum of 1.5 g)---- Or• Vancomycin 15mg/kg IV(Maximum of 1 g) preop ifMRSA+• Cefazolin every 4hours• Cefuroxime every 4hours• Vancomycin none;every 6 hours forpediatric patients<strong>Use</strong> vancomycin only for severepenicillin allergy or MRSA+.Some clinicians use clindamycinin penicillin-allergic patients
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 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 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
show all

Antimicrobial Use Guidelines (AMUG) version 21 - UW Health

Create successful ePaper yourself

Delete template?

Save as template?