Page 9 - Parkview Antimicrobial Stewardship Guidebook_Neat

Alternatives to Restricted Antimicrobials

Alternative options to meropenem:
Drug: Comments:
st
Cefepime + metronidazole 1 choice
nd
Zosyn 2 choice (not meningitis)
Aztreonam + metronidazole + vancomycin Use if PCN allergy

Alternative options to ertapenem:
Drug: Comments:
st
Ceftriaxone + metronidazole 1 choice
Zosyn 2 choice
nd
Levofloxacin + metronidazole Use if PCN allergy

Alternative options to daptomycin:
Indication: Drug:
Cellulitis (purulent) or abscess (cutaneous) Vancomycin
Sepsis with no risk factors Vancomycin + ceftriaxone
Sepsis with risk factors Vancomycin + cefepime +/- flagyl
Necrotizing fasciitis Vancomycin + clindamycin + Unasyn
Febrile neutropenia Cefepime or aztreonam +/- vancomycin
Moderate diabetic foot Vancomycin + Unasyn
Severe diabetic foot (concern for pseudomonas) Vancomycin + Zosyn
Pneumonia (HAP or CAP) or SSTI Linezolid: (600mg BID)
SSTI Tedizolid: (200mg daily)

Alternative options to ceftaroline:
Indication: Drug:
MRSA cellulitis Vancomycin
Doxycycline
Septra DS
Clindamycin
Linezolid
Tedizolid
CAP- per Dr. Patel in non-ICU pt Azithromycin + ceftriaxone
CAP- per Dr. Patel in non-ICU pt with PCN allergy Levofloxacin
CAP- per Dr. Patel for ICU pt Azithromycin + ceftriaxone +/- levofloxacin or
vancomycin