Aerobic Gram Negative Bacteria
1/12/10
CCDHB antibiotic guidelines
PY Mindmaps
Examinations Book
Clinical Microbiology made ridiculously simple (Ed 2)
Irwin and Rippe’s ICU
COCCI
Neiserria
- meningitides: vaccination, penicillin G or ceftriaxone, rifampicin (prophylaxis)
- gonorrhoea: piperacillin-tazobactam 4.5g Q8hrly, ceftriaxone
Moroxella
-
azithromycin
clarithromycin
amoxicillin + clavulanate
second or third generation cephalosporin
co-trimoxazole 10mg/kg of sulphamethoxazole
RODS/BACILLI
-> aminoglycosides are good agents (gentamicin, tobramycin, amikacin, streptomycin)
Campylobacter
- fluoroquinolones
- erythromycin
Citerobacter
E. coli (from blood)
-
cefuroxime 1.5g Q8 hrly
ceftriaxone 1-4g Q24hrs
ciprofloxacin 300mg Q12 hourly
meropenem 2g Q8hrly
gentamicin 3-5mg/kg LD -> titrate to trough
tobramycin 3-5mg/kg/day in 3 divided doses -> monitor
piperacillin-tazobactam 4.5g Q8hrly
nitrofurantoin 100mg QID PO (5-7mg/kg/day)
-> amoxicillin and penicillin = waste of time
Jeremy Fernando (2010)
E. coli (from urine)
-
cefuroxime 1.5g Q8 hrly
ceftriaxone 1-4g Q24hrs
ciprofloxacin 300mg Q12 hourly
meropenem 2g Q8hrly
gentamicin 3-5mg/kg LD -> titrate to trough
tobramycin 3-5mg/kg/day in 3 divided doses -> monitor
piperacillin-tazobactam 4.5g Q8hrly
nitrofurantoin 100mg QID PO (5-7mg/kg/day)
-> not as much cover with amoxicillin-clavulnate, trimethoprim and co-trimoxazole
Enterobacter species
-
ceftriaxone
ciprofloxacin 300mg Q12 hourly
imipenem 500mg Q6 hrly
meropenem 2g Q8hrly
gentamicin 3-5mg/kg LD -> titrate to trough
tobramycin 3-5mg/kg/day in 3 divided doses -> monitor
co-trimoxazole 10mg/kg of sulphamethoxazole
Helicobacter
- clarithromycin + omeprazole
Klebsiella
- piperacillin-tazobactam 4.5g Q8hrly
- ceftriaxone
- ciprofloxacin
Morganella morganii
-
piperacillin-tazobactam 4.5g Q8hrly
meropenem 2g Q8hrly
imipenem 500mg Q6 hrly
tobramycin 3-5mg/kg/day in 3 divided doses -> monitor
gentamicin 3-5mg/kg LD -> titrate to trough
Proteus mirabilis
-
cefuroxime 1.5g Q8 hrly
ceftriaxone 1-4g Q24hrs
amoxicillin-clavulate 1.2g Q6 hrly
meropenem 2g Q8hrly
imipenem 500mg Q6 hrly
gentamicin 3-5mg/kg LD -> titrate to trough
tobramycin 3-5mg/kg/day in 3 divided doses -> monitor
Jeremy Fernando (2010)
- piperacillin-tazobactam 4.5g Q8hrly
- ciprofloxacin 300mg Q12 hourly
- co-trimoxazole 10mg/kg of sulphamethoxazole
-> only 90% coverage with penicillin & amoxicillin
Salmonella
-
fluroquinolones: ciprofloxacin, moxifloxacin
ceftriaxone
co-trimoxazole 10mg/kg of sulphamethoxazole
azithromycin
Serratia species
-
ciprofloxacin 300mg Q12 hourly
meropenem 2g Q8hrly
imipenem 500mg Q6 hrly
gentamicin 3-5mg/kg LD -> titrate to trough
tobramycin 3-5mg/kg/day in 3 divided doses -> monitor
co-trimoxazole 10mg/kg of sulphamethoxazole
Shigella
- fluroquinolones: ciprofloxacin, moxifloxacin
- co-trimoxazole 10mg/kg of sulphamethoxazole
Vibrio
- doxycycline
- fluoroquinolone
Yersinia
- pestis: streptomycin, gentamycin, doxycycline
- enterocolitica: fluoroquinolone, co-trimoxazole 10mg/kg of sulphamethoxazole
PSEUDOMONAS + RELATIONS
Acinetobacter
- fluroquinolones: ciprofloxacin, moxifloxacin
Burkholderia
Jeremy Fernando (2010)
-> resistant to imipenem
Flavobacterium
-> resistant to imipenem
Pseudomonas
- aeruginosa:
(1)
(2)
(3)
(4)
(5)
(5)
piperacillin-tazobactam + gentamicin
imipenem or meropenem
ceftazidime + gentamicin
cefepime + gentamicin
tobramycin
fluroquinolones: ciprofloxacin, moxifloxacin
-> resistance to imipenem can develop during treatment
- cepacea: co-trimoxazole 10mg/kg of sulphamethoxazole, ciprofloxacin
Stenothophomonas
- maltophilia: resistant to imipenem
COLLOBACILLI
Brucella
- doxycycline + gentamycin
Bartonella
- doxycycline
- chloramphenicol
Bordetella
- erythromycin, DPT vaccine
Haemophilus
- influenzae: piperacillin-tazobactam 4.5g Q8hrly, second or third generation cephalosporins,
fluroquinolones (ciprofloxacin, moxifloxacin)
Hib vaccination
- ducreyl: azithromycin or erythromycin, ceftriaxone, ciprofloxacin
Jeremy Fernando (2010)
Legionella
- erythromycin
- rifampicin
- fluroquinolones: ciprofloxacin, moxifloxacin
Pasturella
- penicillin G
- doxycycline
- third generation cephalosporin
Jeremy Fernando (2010)