| Risk Factor
|
Likely Organism
|
Initial Empiric Antibiotic Therapy'
|
| Elderly, hematogenous spread
|
MRSA, MSSA, gram neg
|
Vancomycin 1g IV q12h + (Piperacillin/Tazobactam 3.375g IV q6h OR Imipenem 500mg IV q6h)
|
| Sickle Cell Disease
|
Salmonella, gram-negative bacteria
|
Ceftriaxone 50mg/kg IV once daily OR Cefotaxime 50mg/kg IV three times daily, PLUS
- Vancomycin 15mg/kg IV four times daily OR
- Clindamycin 10mg/kg IV PO four times daily OR
- Nafcillin 50 mg/kg IV four times daily to cover K. Kingae (common in daycare population)
|
| DM or vascular insufficiency
|
Polymicrobial: Staph, strep, coliforms, anaerobes
|
Vancomycin 1g IV q12h + (Piperacillin/Tazobactam 3.375g IV q6h OR Imipenem 500mg IV q6h)
|
| IV drug user
|
MRSA, MSSA, pseudomonas
|
Vancomycin 1g IV q12h
|
| Newborn
|
MRSA, MSSA, GBS, Gram Negative
|
Vancomycin 15mg/kg load, then reduce dose, AND Ceftazidime 30mg/kg IV q12 h
|
| Children
|
MRSA, MSSA
|
Vancomycin 10mg/kg q6 h AND Ceftazidime 50mg/kg q8hr
|
| Postoperative (ortho)
|
MRSA, MSSA
|
Vancomycin 1g IV q12h
|
| Human bite
|
Strep, anaerobes, HACEK organism
|
Piperacillin/Tazobactam 3.375gm OR Imipenem 500mg IV q6h
|
| Animal bites
|
Pasteurella, Eikenella, HACEK organism
|
Piperacillin/Tazobactam 3.375gm OR Imipenem 500mg IV q6h
|
| Foot puncture wound
|
Pseudomonas
|
Anti-pseudomonal, staph coverage
|
