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Community-Acquired Pneumonia

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.

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