Aerobic Gram Positive Bacteria
30/11/10
CCDHB antibiotic guidelines
PY Mindmaps
Clinical Microbiology made ridiculously simple (Ed 2)
Irwin and Rippe’s ICU
COCCI
Micrococcus
- flucloxacillin
- vancomycin
Staphylococcus aureus
- flucloxaciliin 100mg/kg/day in divided doses
- clindamycin 4mg/kg Q6hrly
- piperacillin-tazobactam
- cephazolin
- co-trimoxazole 10mg/kg of sulphamethoxazole
- erythromycin 20mg/kg/day in divided doses
- fusidic acid 1g Q8hrly
- gentamicin 3-5mg/kg LD -> titrate to trough
- tetracycline 500mg Q12hrly
- vancomycin 10mg/kg LD -> dose as per trough level
- linezolid 600mg Q12hrly (adult)
- meropenem 1g Q8hrly (adult)
- quinpristin-dalfopristin 7.5mg/kg Q8hrly
- rifampicin 20mg/kg /day
- teicoplanin 400mg LD -> 400mg @ 12 hrs -> 400mg Q24hrly
- tigecycline 100mg LD -> 50mg Q12hrly
-> pencillin = waste of time
-> MRSA is resistant to imipenem
Coag Negative Staphylococcus (from blood)
- vancomycin 10mg/kg LD -> dose as per trough level
- linezolid 600mg Q12hrly (adult)
- meropenem 1g Q8hrly (adult)
- quinpristin-dalfopristin 7.5mg/kg Q8hrly
- rifampicin 20mg/kg /day
- teicoplanin 400mg LD -> 400mg @ 12 hrs -> 400mg Q24hrly
- tigecycline 100mg LD -> 50mg Q12hrly
-> penicillin, fluclox and erythromycin = waste of time
-> clindamycin, co-trimoxazole and gentamicin = basically a waste of time
Staphylococcus saprophyticus
- penicillin
Streptococcus + Enterococcus
A – S. pyogenes
- penicillin G
- penicillin V
- erythromycin
-> in invasive infections (toxic shock syndrome or necrotising fasciitis) consider adding clindamycin
B – Streptococcus agalactiae (beta-haemolytic)
- pencillin G
C and G
- penicillin
D
Enterococcus
- penicillin G
- benzylpenicillin 1-5g/day in divided doses
- amoxicillin 1g Q4 hrly
- vancomycin 10mg/kg LD -> dose as per trough level
- nitrofurantoin 100mg QID PO (5-7mg/kg/day)
-> tetracycline and gentamicin = waste of time
-> facecalis: amoxicillin, imipenem
-> faceium: vancomycin (resistant to imipenem)
-> VRE: linezolid
Streptococcus bovis
- ampicillin
- penicillin
- vancomycin
Streptococcus pneumoniae
- moxifloxacin - 400mg Q24 hrly (drug of choice)
- penicillin – becomes less sensitive with decreasing age
- amoxicillin 1g Q4 hrly
- benzylpenicillin 1-5g/day in divided doses
- ceftriaxone (good cover for all age groups) 1-4g Q24hrs
- cefotaxime
- vancomycin
- linezolid
Viridans Group
- Streptococcus mutans, mitis, sanguinis, salavarius, constellatus
- penicillin G
- gentamicin + either: ampicillin, penicillin or vancomycin
- vancomycin
RODS/BACILLI
Bacillus
- anthracis: penicillin G, erythromycin
- cereus: vancomycin, clindamycin
Corynebacterium
- antitoxin, penicillin or erythromycin, vaccination (DPT)
Erysipelothrix
- amoxycillin
- penicillin
Lactobacillus
- penicillin
Listeria
- ampicillin
- co-trimoxazole 10mg/kg of sulphamethoxazole
Nocardia
- co-trimoxazole 10mg/kg of sulphamethoxazole
- ceftriaxone
Jeremy Fernando (2011)