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Outpatient pneumonia without comorbity and 60 years of age or younger. Macrolide Tetracycline
Outpatient pneumonia with comorbity and/or 60 years of age or older Second generation Cephalosporin + Macrolide TMP/SMX 4- Macrolide -lactam-B-lactamase inhibitor + Macrolide Community-Acquired Pneumonia, pnumonia, pumonia, pulmonia
Hospitalized Patients with Community-Acquired Pneumonia Second or third generation Cephalosporin + Macrolide B-1actam-B-1actamase inhibitor + Macrolide
Severe Community-Acquired Pneumonia Requiring Hospitalization Second or third generation Cephalosporin + Macrolide B-lactam-B-lactamase inhibitor + Macrolide
Hospital-Acquired Pneumonia
Antistaphylococcal Penicillin + Aminoglycoside First generation Cephalosporin plus Aminoglycoside Ticarcillin clavulanate and/or piperacillin/tazobactam Imipenem or meropenem
Cefepime
Urinary Tract Infections
Community Acquired
TMP/SMX
Amoxicillin (if susceptibility is known)
Fluoroquinolone
Hospital Acquired UTI
Ampicillin + Gentamicin
Piperacillin/tazobactam or Ticarcillin clavulanate Imipenem Fluoroquinolone
Gonorrhea
Parenteral Ceftriaxone (single 125 mg dose ira)
Single-Dose Oral Therapy with Cefixime, Cefpodoxime, Ciprofloxacin, Enoxacin or Ofloxacin
Genital Chlamydial Infection
Recommended Regimens
Doxycycline 100 mg po bid x 7d
or Azithromycin 1 g po (single dose)
Alternative Regimens
Ofloxacin 300 mg po bid x 7d or Erythromycin base 500 mg po 4id x 7d or Erythromycin ethyl succinate 800 mg po 4id x 7d or Sulfisoxazole 500 mg po 4id x 10d (inferior to other regimens)
Pelvic Inflammatory Disease
Inpatient Therapy
Cefoxitin (or Cefotetan) IV plus Doxycycline IV or PO or Clindamycin plus gentamicin Outpatient Therapy
Cefoxitin 2g irn plus Probenecid lg po (single dose) or Ceftriaxone 250 mg irn (or other parenteral third generation cephalosporin, e.g., ceftizoxime or cefotaxime) plus doxycycline x 14d
Ofloxacin 400 mg po bid x 14d plus either clindamycin or metronidazole for 14d
Diarrhea (Travelers)
New Fluoroquinolones
(Doxycycline, Trimethoprim/Sulfamethoxazole inferior because of the emergence of resistance)
Intraabdominal Infections
Clindamycin plus Gentamicin
Metronidazole plus Gentamicin
Cefoxitin or Cefotetan or Cefmetazole + gentamicin
Ticarcillin clavulanate
Ampicillin/sulbactam
Piperacillin/tazobactam
Imipenem, Meropenem or Moxalactam
Bacterial Meningitis
Neonate: Ampicillin plus Gentamicin (or Cefotaxime or Ceftriaxone)
Child: Cefotaxime or Ceftriaxone (+ Vancomycin or Rifampin in areas of high
prevalence of Penicillin-resistance pneumococci)
Adult: Cefotaxime or Ceftriaxone (± Vancomycin)
Compromised Host: Ampicillin plus Cefotaxime or Ceftriaxone
Post Neurosurgery: Nafcillin, Oxacillin or Vancomycin plus Cefotaxime, Ceftriaxone or
Ceftazidime