Amphotericin B lipid complex
Acute bacterial meningitis
Area under the curve
Clostridium difficile infection
Clinical Laboratory Standards Institute
Central nervous system
Catheter-related bloodstream infections
European Committee on Antimicrobial Susceptibility Testing
Ideal body weight
Liposomal amphotericin B
Minimum inhibitory concentration
Methicillin-resistant Staphylococcus aureus
Methicillin-susceptible Staphylococcus aureus
Skin and soft tissue infections
Total body weight
Urinary tract infections
White blood cell
Table 2.1.1 General Approach to Infectious Diseases |Favorite Table|Download (.pdf)
Table 2.1.1 General Approach to Infectious Diseases
Step One: Confirm Infection
General signs and symptoms of infection include:
- Temperature >101°F (>100.4°F in some instances)
- WBC >10 with bands >10%
- Assess for infection-specific signs/symptoms according to algorithms
Step Two: Perform Diagnostic Tests/Workup
- Ensure that cultures are obtained from the site of the infection BEFORE antimicrobial administration
- Gram stain and morphology from culture results may further guide empiric selection
- Assess for severity of infection according to algorithms
Step Three: Start Empiric Therapy
- Review list of likely infectious etiologies according to the algorithms that are largely based on infection site
- Start empiric therapy according to algorithms (base decision on local susceptibility patterns where possible, that is, antibiograms)
- Empiric antimicrobial dosing recommendations can be found in Tables 2.1.2, 2.1.3 and 2.1.4
Step Four: Reevaluate/Monitor Response to Therapy
- Check for resolution of signs and symptoms
- Follow-up culture results/susceptibilities and note MIC when available
- Use Table 2.1.5 to monitor for adverse effects associated with selected empiric therapy and serum concentrations where necessary
Step Five: Streamline/Narrow Antimicrobial Therapy
- Use the most narrow spectrum antimicrobial that is susceptible from culture results
- If MIC results are available, consider selecting an antimicrobial with an MIC well below susceptibility breakpoints found in Table 2.1.6 (NOTE: MICs should NOT be compared across different antimicrobials)
Blood Culture Results: Escherichia coli
Compare MIC = 2 to breakpoint ≤8 (“very susceptible”)
Compare MIC = 1 to breakpoint ≤1 (“susceptible”)
Table 2.1.2 Dosing Regimens for Commonly Selected Intravenous Antimicrobials |Favorite Table|Download (.pdf)
Table 2.1.2 Dosing Regimens for Commonly Selected Intravenous Antimicrobials
Recommended Dosing for Susceptible Organisms
Normal Dose (Infusion Time)...
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