Page 4 - Parkview Antimicrobial Stewardship Guidebook_Neat

PARKVIEW MEDICAL CENTER

Recommendations for initial empiric antimicrobial
therapy for 2016*

1
SKIN AND SOFT TISSUE INFECTIONS Δ
Clinical setting Antibiotics
NON PURULENT
Mild to moderate Penicillin or cefazolin^
Severe# Vancomycin + pip/tazo or
Vancomycin+cefepime+metronidazole
PURULENT
Mild Incision and drainage alone
Moderate Doxycycline or TMP/SMX
Severe# Vancomycin (or Linezolid or tedizolid#)

2
INTRA ABDOMINAL INFECTIONS IN ADULTS
Clinical setting Antibiotics
Community acquired
Mild to moderate Ceftriaxone plus metronidazole
Severe Cefepime plus flagyl OR Pip/Tazo
Health care associated Vancomycin + cefepime + metronidazole
OR
Vancomycin PLUS Pip/Tazo

PNEUMONIA
Clinical setting Antibiotics
3
Community acquired bacterial pneumonia
Non ICU setting Azithromycin + ceftriaxone
PCN allergic patients: levofloxacin 750 mg
ICU setting# Azithromycin + ceftriaxone +/- Linezolid or
vancomycin
Health care associated bacterial Vancomycin** + Pip/Tazo or
4#
pneumonia Vancomycin + cefepime

5
MENINGITIS #
Clinical setting Antibiotics
Community acquired (Age 18-50, not Vancomycin + ceftriaxone***
immunocompromised)
Community acquired (Age >50, pregnant Vancomycin + Ceftriaxone + Ampicillin
or immunocompromised))
Post neurosurgery Vancomycin + Cefepime***