Harbor:Empiric antibiotics - Revision history

Danbot: Strip excess bold

2026-03-22T09:11:22Z

Strip excess bold

Gtchakalian: /* IMMUNOCOMPROMISED INFECTIONS */

2022-07-25T05:47:34Z

IMMUNOCOMPROMISED INFECTIONS

← Revisión anterior		Revisión del 05:47 25 jul 2022
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	==IMMUNOCOMPROMISED INFECTIONS==		==IMMUNOCOMPROMISED INFECTIONS==
	*[[~~Immunocompromised_antibiotics~~#~~Neutropenic_Fever~~\|Neutropenic Fever]]		*[[Neutropenic_fever#Management\|Neutropenic Fever]]
	**Inpatient		**Inpatient
	***Cefepime 2g IV q8h		***Cefepime 2g IV q8h

Gtchakalian: /* NEURO INFECTIONS */

2022-07-25T05:46:53Z

NEURO INFECTIONS

← Revisión anterior		Revisión del 05:46 25 jul 2022
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	==NEURO INFECTIONS==		==NEURO INFECTIONS==
	*[[~~Neuro_antibiotics~~#~~Meningitis~~\|Meningitis]]		*[[Meningitis#Antibiotics\|Meningitis]]
	**Inpatient		**Inpatient
	***Ceftriaxone 2g IV q12h [infuse first] + Vancomycin per Pharmacy		***Ceftriaxone 2g IV q12h [infuse first] + Vancomycin per Pharmacy

Gtchakalian: /* CARDIOVASCULAR INFECTIONS */

2022-07-25T05:46:14Z

CARDIOVASCULAR INFECTIONS

← Revisión anterior		Revisión del 05:46 25 jul 2022
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	==CARDIOVASCULAR INFECTIONS==		==CARDIOVASCULAR INFECTIONS==
	*[[~~Cardiovascular_antibiotics~~#~~Endocarditis~~\|Endocarditis]]		*[[Endocarditis#Management\|Endocarditis]]
	**Inpatient		**Inpatient
	***Ceftriaxone 2g IV q24h [infuse first] + Vancomycin per Pharmacy		***Ceftriaxone 2g IV q24h [infuse first] + Vancomycin per Pharmacy

Gtchakalian: /* INTRA-ABDOMINAL INFECTIONS */

2022-07-25T05:45:45Z

INTRA-ABDOMINAL INFECTIONS

← Revisión anterior		Revisión del 05:45 25 jul 2022
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	**Inpatient		**Inpatient
	***Ceftriaxone 2g IV q24h		***Ceftriaxone 2g IV q24h
	*[[~~GI_antibiotics~~#~~Clostridium_Difficile~~\|C. difficile Infection (x 10-14 days)]]		*[[Clostridium_difficile#Management\|C. difficile Infection (x 10-14 days)]]
	**Inpatient		**Inpatient
	***Vancomycin 125mg PO QID		***Vancomycin 125mg PO QID

Gtchakalian: /* URINARY INFECTIONS */

2022-07-25T05:44:32Z

URINARY INFECTIONS

← Revisión anterior		Revisión del 05:44 25 jul 2022
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	***If history of ESBL, consider: FosfomycinR 3gm PO x 1 dose		***If history of ESBL, consider: FosfomycinR 3gm PO x 1 dose
	***If pregnant, consider: Amoxicillin/clavulanate 875/125mg PO BID x 7 days OR Cephalexin 500mg PO BID x 7 days		***If pregnant, consider: Amoxicillin/clavulanate 875/125mg PO BID x 7 days OR Cephalexin 500mg PO BID x 7 days
	*[[~~GU_antibiotics~~#~~Pyelonephritis~~\|Pyelonephritis (x 7 days)]]		*[[Pyelonephritis#Management\|Pyelonephritis (x 7 days)]]
	**Outpatient		**Outpatient
	***Ceftriaxone 1g IV x1 can be considered in more severe cases pending cultures.		***Ceftriaxone 1g IV x1 can be considered in more severe cases pending cultures.

Gtchakalian: /* GENITAL INFECTIONS */

2022-07-25T05:31:36Z

GENITAL INFECTIONS

← Revisión anterior		Revisión del 05:31 25 jul 2022
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	==GENITAL INFECTIONS==		==GENITAL INFECTIONS==
	*[[~~OB/GYN_antibiotics~~#~~Cervicitis~~\|Urethritis/Cervicitis]]		*[[Cervicitis#Management\|Urethritis/Cervicitis]]
	**Outpatient		**Outpatient
	***Empiric treatment for both gonorrhea and chlamydia is reasonable in symptomatic high risk patients. Screen for HIV/syphilis, use sexual assault order set if indicated.		***Empiric treatment for both gonorrhea and chlamydia is reasonable in symptomatic high risk patients. Screen for HIV/syphilis, use sexual assault order set if indicated.

Gtchakalian: /* RESPIRATORY INFECTIONS */

2022-07-25T05:27:15Z

RESPIRATORY INFECTIONS

← Revisión anterior		Revisión del 05:27 25 jul 2022
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	==RESPIRATORY INFECTIONS==		==RESPIRATORY INFECTIONS==
	*[[Acute_bronchitis\|Acute Bronchitis]]		*[[Acute_bronchitis#Management\|Acute Bronchitis]]
	**Outpatient		**Outpatient
	***'''No antibiotics are indicated'''; offer symptomatic management and realistic time frame for cough resolution (2-4 wk). To help reframe patient’s reference point, consider terminology such as “viral chest cold.”		***'''No antibiotics are indicated'''; offer symptomatic management and realistic time frame for cough resolution (2-4 wk). To help reframe patient’s reference point, consider terminology such as “viral chest cold.”
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	***Antibiotics help reduce risk of recurrence for moderate to severe symptoms defined as '''purulent sputum''' and either '''dyspnea''' and/or '''increased sputum volume'''		***Antibiotics help reduce risk of recurrence for moderate to severe symptoms defined as '''purulent sputum''' and either '''dyspnea''' and/or '''increased sputum volume'''
	***Azithromycin 500mg PO Daily x 3 days OR Doxycycline 100mg PO BID x 5 days		***Azithromycin 500mg PO Daily x 3 days OR Doxycycline 100mg PO BID x 5 days
	*[[~~Pulmonary_antibiotics~~#~~Pneumonia~~\|Community-acquired Pneumonia]] (x 5 days)		*[[Pneumonia_(main)#Management\|Community-acquired Pneumonia (x 5 days)]]
	**Inpatient		**Inpatient
	***Ceftriaxone 1g IV q24h [infuse first] + Azithromycin 500mg IV q24h		***Ceftriaxone 1g IV q24h [infuse first] + Azithromycin 500mg IV q24h
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	***Healthy adults without comorbidities: Amoxicillin 1g PO TID OR Doxycycline 100mg PO BID		***Healthy adults without comorbidities: Amoxicillin 1g PO TID OR Doxycycline 100mg PO BID
	***Adults with comorbidities: Amoxicillin/clavulanate 875/125mg PO BID AND Azithromycin 500mg PO x 1 day then 250mg PO x 4 days OR Levofloxacin 750mg PO daily monotherapy		***Adults with comorbidities: Amoxicillin/clavulanate 875/125mg PO BID AND Azithromycin 500mg PO x 1 day then 250mg PO x 4 days OR Levofloxacin 750mg PO daily monotherapy
	*[[~~Pulmonary_antibiotics~~#~~Pneumonia~~\|Hospital-acquired Pneumonia in non-ICU (x 7 days)]]		*[[Pneumonia_(main)#Management\|Hospital-acquired Pneumonia in non-ICU (x 7 days)]]
	**Inpatient		**Inpatient
	***Ceftriaxone 1g IV q24h		***Ceftriaxone 1g IV q24h
	*[[~~Pulmonary_antibiotics~~#~~Pneumonia~~\|Hospital-acquired Pneumonia in ICU or Ventilator-associated Pneumonia (x 7 days)]]		*[[Pneumonia_(main)#Management\|Hospital-acquired Pneumonia in ICU or Ventilator-associated Pneumonia (x 7 days)]]
	**Inpatient		**Inpatient
	***Cefepime 2g IV q8h [infuse first] + Vancomycin per Pharmacy		***Cefepime 2g IV q8h [infuse first] + Vancomycin per Pharmacy
	*[[~~Pulmonary_antibiotics~~#~~Pneumonia~~\|Aspiration Pneumonia (x 5-7 days)]]		*[[Pneumonia_(main)#Management\|Aspiration Pneumonia (x 5-7 days)]]
	**Inpatient		**Inpatient
	***Ceftriaxone 1g IV q24h [infuse first]		***Ceftriaxone 1g IV q24h [infuse first]

Gtchakalian: /* EAR, NOSE, & THROAT INFECTIONS */

2022-07-25T05:11:09Z

EAR, NOSE, & THROAT INFECTIONS

← Revisión anterior		Revisión del 05:11 25 jul 2022
Línea 29:		Línea 29:

	==EAR, NOSE, & THROAT INFECTIONS==		==EAR, NOSE, & THROAT INFECTIONS==
	*[[~~ENT_antibiotics~~#~~Otitis_Externa~~\|Otitis Externa (x 7 days)]]		*[[Otitis_externa#Management\|Otitis Externa (x 7 days)]]
	**Outpatient		**Outpatient
	***Oral therapy is NOT recommended unless extension beyond the external ear canal or severely immunocompromised.		***Oral therapy is NOT recommended unless extension beyond the external ear canal or severely immunocompromised.
	***Use antibiotic ear drops (Cortisporin Otic 4 drops in affected ear TID OR Ciprodex 4 drops in affected ear BID). If perforated, use Ciprodex.		***Use antibiotic ear drops (Cortisporin Otic 4 drops in affected ear TID OR Ciprodex 4 drops in affected ear BID). If perforated, use Ciprodex.
	*[[Sinusitis\|Acute Sinusitis (x 5 days)]]		*[[Sinusitis#Management\|Acute Sinusitis (x 5 days)]]
	**Outpatient		**Outpatient
	***'''Mainly viral''', consider watchful waiting with supportive measures. Consider antibiotics for failure to improve ≥10 d after onset of URI, or biphasic illness <10 d with worsening after initial improvement.		***'''Mainly viral''', consider watchful waiting with supportive measures. Consider antibiotics for failure to improve ≥10 d after onset of URI, or biphasic illness <10 d with worsening after initial improvement.
	***Amoxicillin/clavulanate 875/125mg PO BID OR Doxycycline 100mg PO BID		***Amoxicillin/clavulanate 875/125mg PO BID OR Doxycycline 100mg PO BID
	*[[~~ENT_antibiotics~~#~~Streptococcal_Pharyngitis~~\|Group A Strep (GAS) Pharyngitis]]		*[[Streptococcal_pharyngitis#Management\|Group A Strep (GAS) Pharyngitis]]
	**Outpatient		**Outpatient
	***Antibacterial therapy should only be used when POC PCR testing shows the presence of GAS. '''Do not rely on Centor criteria to diagnose GAS.'''		***Antibacterial therapy should only be used when POC PCR testing shows the presence of GAS. '''Do not rely on Centor criteria to diagnose GAS.'''

Gtchakalian: /* SKIN & SOFT TISSUE INFECTIONS (SSTI) */

2022-07-25T05:04:17Z

SKIN & SOFT TISSUE INFECTIONS (SSTI)

← Revisión anterior		Revisión del 05:04 25 jul 2022
Línea 8:		Línea 8:

	==SKIN & SOFT TISSUE INFECTIONS (SSTI)==		==SKIN & SOFT TISSUE INFECTIONS (SSTI)==
	*[[~~Skin_and_soft_tissue_antibiotics~~#~~Cellulitis.2FSuperficial_Abscess_with_Cellulitis~~\|Cellulitis (no purulence) (x 5-7 days)]]		*[[Cellulitis#Management\|Cellulitis (no purulence) (x 5-7 days)]]
	**Inpatient		**Inpatient
	***[No to Minimal Systemic Signs/Symptoms] Cefazolin 1-2g IV q8h (If documented severe ß-lactam allergy: Clindamycin 600mg IV q8h)		***[No to Minimal Systemic Signs/Symptoms] Cefazolin 1-2g IV q8h (If documented severe ß-lactam allergy: Clindamycin 600mg IV q8h)
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	**Inpatient		**Inpatient
	***Ceftriaxone 1g IV q24h [infuse first] + Vancomycin per Pharmacy Metronidazole 500mg IV q8h (+ Clindamycin 900mg IV q8h if suspect streptococcal toxic shock)		***Ceftriaxone 1g IV q24h [infuse first] + Vancomycin per Pharmacy Metronidazole 500mg IV q8h (+ Clindamycin 900mg IV q8h if suspect streptococcal toxic shock)
	*[[~~Bone_and_joint_antibiotics~~#~~Diabetic_foot_infection~~\|Diabetic Foot Ulcer]]		*[[Diabetic_foot_infection#Management\|Diabetic Foot Ulcer]]
	**Inpatient		**Inpatient
	***Refer to Anti-Infective Management Program (https://lacounty.sharepoint.com/sites/dhs-harbor-amp) > Documents > Diabetic Foot Infection Pathway (DFIP)		***Refer to Anti-Infective Management Program (https://lacounty.sharepoint.com/sites/dhs-harbor-amp) > Documents > Diabetic Foot Infection Pathway (DFIP)

← Revisión anterior		Revisión del 09:11 22 mar 2026
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	***[Presence of Systemic Signs/Symptoms] Vancomycin per Pharmacy		***[Presence of Systemic Signs/Symptoms] Vancomycin per Pharmacy
	**Outpatient		**Outpatient
	***~~'''~~Dual antibiotic treatment is not indicated.~~'''~~		***Dual antibiotic treatment is not indicated.
	***Cephalexin 500mg PO QID OR Clindamycin 450mg PO TID OR TMP-SMX DS 1-2 tabs PO BID (2 tabs if >100kg)		***Cephalexin 500mg PO QID OR Clindamycin 450mg PO TID OR TMP-SMX DS 1-2 tabs PO BID (2 tabs if >100kg)
	*[[Skin_abscess#Management\|Purulent SSTI (x 5-7 days)]]		*[[Skin_abscess#Management\|Purulent SSTI (x 5-7 days)]]
Línea 19:		Línea 19:
	***Vancomycin per Pharmacy		***Vancomycin per Pharmacy
	**Outpatient		**Outpatient
	***~~'''~~Dual antibiotic treatment is not indicated.~~'''~~		***Dual antibiotic treatment is not indicated.
	***Incision & Drainage first and then TMP-SMX DS 1-2 tabs PO BID (2 tabs if >100kg) OR Doxycycline 100mg PO BID		***Incision & Drainage first and then TMP-SMX DS 1-2 tabs PO BID (2 tabs if >100kg) OR Doxycycline 100mg PO BID
	*Necrotizing Soft Tissue Infection		*Necrotizing Soft Tissue Infection
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	*[[Sinusitis#Management\|Acute Sinusitis (x 5 days)]]		*[[Sinusitis#Management\|Acute Sinusitis (x 5 days)]]
	**Outpatient		**Outpatient
	***~~'''~~Mainly viral~~'''~~, consider watchful waiting with supportive measures. Consider antibiotics for failure to improve ≥10 d after onset of URI, or biphasic illness <10 d with worsening after initial improvement.		***Mainly viral, consider watchful waiting with supportive measures. Consider antibiotics for failure to improve ≥10 d after onset of URI, or biphasic illness <10 d with worsening after initial improvement.
	***Amoxicillin/clavulanate 875/125mg PO BID OR Doxycycline 100mg PO BID		***Amoxicillin/clavulanate 875/125mg PO BID OR Doxycycline 100mg PO BID
	*[[Streptococcal_pharyngitis#Management\|Group A Strep (GAS) Pharyngitis]]		*[[Streptococcal_pharyngitis#Management\|Group A Strep (GAS) Pharyngitis]]
Línea 45:		Línea 45:
	*[[Acute_bronchitis#Management\|Acute Bronchitis]]		*[[Acute_bronchitis#Management\|Acute Bronchitis]]
	**Outpatient		**Outpatient
	***~~'''~~No antibiotics are indicated~~'''~~; offer symptomatic management and realistic time frame for cough resolution (2-4 wk). To help reframe patient’s reference point, consider terminology such as “viral chest cold.”		***No antibiotics are indicated; offer symptomatic management and realistic time frame for cough resolution (2-4 wk). To help reframe patient’s reference point, consider terminology such as “viral chest cold.”
	*[[COPD_exacerbation#Management\|Acute Exacerbation of Chronic Bronchitis (x 3-5d)]]		*[[COPD_exacerbation#Management\|Acute Exacerbation of Chronic Bronchitis (x 3-5d)]]
	**Outpatient		**Outpatient
	***In patients with emphysema, COPD, or significant tobacco abuse, consider prescriptions for steroids and bronchodilators.		***In patients with emphysema, COPD, or significant tobacco abuse, consider prescriptions for steroids and bronchodilators.
	***Antibiotics help reduce risk of recurrence for moderate to severe symptoms defined as ~~'''~~purulent sputum~~'''~~ and either ~~'''~~dyspnea~~'''~~ and/or ~~'''~~increased sputum volume~~'''~~		***Antibiotics help reduce risk of recurrence for moderate to severe symptoms defined as purulent sputum and either dyspnea and/or increased sputum volume
	***Azithromycin 500mg PO Daily x 3 days OR Doxycycline 100mg PO BID x 5 days		***Azithromycin 500mg PO Daily x 3 days OR Doxycycline 100mg PO BID x 5 days
	*[[Pneumonia_(main)#Management\|Community-acquired Pneumonia (x 5 days)]]		*[[Pneumonia_(main)#Management\|Community-acquired Pneumonia (x 5 days)]]
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	*Asymptomatic Bacteriuria (x 5-7 days)		*Asymptomatic Bacteriuria (x 5-7 days)
	**Outpatient		**Outpatient
	***Diagnosed by urine culture (>10<sup>5</sup> CFU), ~~'''~~NOT urinalysis~~'''~~. No treatment indicated unless pregnant, received renal transplant in past 30 days, or undergoing GU procedure.		***Diagnosed by urine culture (>10<sup>5</sup> CFU), NOT urinalysis. No treatment indicated unless pregnant, received renal transplant in past 30 days, or undergoing GU procedure.
	***Nitrofurantoin (Macrobid)† 100mg PO BID x 5d		***Nitrofurantoin (Macrobid)† 100mg PO BID x 5d
	***If pregnant, consider: Amoxicillin/clavulanate 875/125mg PO BID x 7 days OR Cephalexin 500mg PO BID x 7 days		***If pregnant, consider: Amoxicillin/clavulanate 875/125mg PO BID x 7 days OR Cephalexin 500mg PO BID x 7 days