Journal Article

Initial Empirical Antimicrobial Therapy: Duration and Subsequent Modifications

K. Tamura

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 39, issue Supplement_1, pages S59-S64
Published in print July 2004 | ISSN: 1058-4838
Published online July 2004 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/383057
Initial Empirical Antimicrobial Therapy: Duration and Subsequent Modifications

More Like This

Show all results sharing these subjects:

  • Infectious Diseases
  • Immunology
  • Public Health and Epidemiology
  • Microbiology

GO

Show Summary Details

Preview

Neutropenic patients at low risk of complications can receive oral ciprofloxacin or levofloxacin as outpatients. These agents plus amoxicillin/clavulanate or other penicillins, cephalosporins, or penem compounds are indicated to treat infections with gram-positive organisms in patients with oral mucositis or skin lesions. Parenteral fourth-generation cephalosporins or carbapenems can be given. For high-risk patients, monotherapy with cefepime or the carbapenems can be used. Methicillin-resistant Staphylococcus aureus should be treated with vancomycin or teicoplanin. For combination therapy, a third- or fourth-generation cephalosporin or carbapenem plus an aminoglycoside is desirable. Defervescence in 3–5 days for at least 7 days is suggested for subsequent management. Initial antibiotic(s) can be continued for patients who remain in good condition. For persistent fever after 3–5 days, the patient should be thoroughly reassessed. An aminoglycoside should be added for those initially treated with monotherapy. The initial cephalosporin can be changed to another cephalosporin or a carbapenem, or the initial carbapenem can be changed to a broad-spectrum cephalosporin. For patients initially receiving dual therapy, the cephalosporin or carbapenem can be changed as with monotherapy, whereas the initial aminoglycoside should be changed to another aminoglycoside or intravenous ciprofloxacin.

Journal Article.  3144 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

Full text: subscription required

How to subscribe Recommend to my Librarian

Users without a subscription are not able to see the full content. Please, subscribe or login to access all content.