List of Recommendations Arranged According To System and Diseases

12/19/2015
AntibioticGuideline
Listofrecommendationsarrangedaccordingtosystemanddiseases
(Accordingtoalphabeticalorder)
CentralNervoussystem
CommunityacquiredMeningitis(CAM)
Likelycausativeagent
Antimicrobialofchoice
Preferreddrug
Streptococcus
Pneumonia
Inj.Meropenem(2
gm)
8hourlyfor14
daysplus/or
Neisseriameningitides
Haemophilusinfluenza
Staphylococcusaureus
Inj.Linezolid(600
mg)
12hourly
Herpessimplex
Inj.Acyclovir(500
mg)
6hourlyfor14
daysifviral
infection
Alternativedrug
Tab.Teicoplanin
(400mg)statand
(200mg)
12hourlyfor14
daysplus/or
Inj.Acyclovir(5000
mg)
6hourlyfor14days
Name:S.IAvoidImipenem
PyogenicMeningitis
Preferreddrug
Streptococcus
Pneumonia
Listeriamonocytogenes
Streptococcus
agalactiae
Escherichiacoli
Inj.Vancomycin
(3045mg/kg/day)
412hourly
interval+
Inj.Ceftriaxone(2
gm)
12hourly714
days
Alternativedrug
Inj.PenicillinG
Inj.Meropenem
Inj.Gentamicin
Inj.Amikacin
Name:MostofthepatientcamefromdifferentICUwithmultipledrugs
includingtwoormoreantibioticswithculturalandsensitivityreport,so
antibioticschoicemostlydependsonc/sreport
http://exam.bsmmu.edu.bd/antibiotic_guideline/list.html
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AntibioticGuideline
Dentistry
Acutevaricealhaemorrhage
Preferreddrug
PortalHypertension
duetoCirrhosisofliver
ornoncirrhoticportal
hypertension
Inj.Somatostatin
(250gmor500
gm)Abolusofis
givenfollowedby
aninfusionof6
mg/24hourfor120
hrs
Inj.Octreotide(5
gm)Abolus
followedby(50
gm/hour)
forupto5days
Alternativedrug
Inj.Terlipressin(2
mg)6hourlyfor48
hour.Itmaybe
continuedfora
further3daysat1
mgevery46
hourly
Cleftlippalate,facialcleft,facialdeformitycorrectionsurgery
Preferreddrug
Inj.Ceftriaxone(1
gm)
12hourly
Tab.
Metronidazole(500
mg)
8hourlyfor57
daysfollowedbyor
Cap.
Cephalosporins
Tab.
Metronidazole
Alternativedrug
Inj.Meropenem(1
gm)
8hourlyI/Vfor7
days,followedby
Cap.Cephalosporins
Tab.Metronidazole
Dentalabscess
Preferreddrug
Obligateanaerobes:
Prevotellaintermedia
Prevotellanigresub
Cap.Flucloxacillin
Tab.
Metronidazole
Alternativedrug
Cap.Cepholosporins
Cap.Cefixime
Cap.Cefuroxime
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AntibioticGuideline
Fusobacterium
periodontices
Phyromonas
endodontics
Porphyromonas
gingivalis
Tab.metronidazole
Name:Forrapidlyspreadinginfectionsinjectablefrommaybeadvised
Denturesoremouth
Preferreddrug
Candidaalbicans
Antifungalagents
eg,Nystatin
powderorcream
Alternativedrug
Antifungalagents
eg,Nystatinpowder
orcream
Denturestomatitis
Preferreddrug
Candidaalbicans
Alternativedrug
1antifungalagents
(eg,Nystatin
powderorcream)
Extractionoftoothsurgical/nonsurgical
Preferreddrug
Cap.Amoxicillin
(500mg)
8hourlyfor7days
or
Alternativedrug
2oftheother3rd
lineantibiotic*
Cap.Cefixime(200
mg)
12hourlyfor7
days+
Tab.
Metronidazole(400
mg)
8hourlyfor5
days.
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AntibioticGuideline
FungalinfectionsinmaxillofacialregionlikeCandidiasis,mucormicosisetc
Preferreddrug
Fungus
Alternativedrug
Nystatinoral
suspension(510
ml)ofsuspension
foratleast14days
Nystatinoral
suspension(510
ml)ofsuspension
foratleast14days.
Cap.Fluconazole
(100mg)
dailyfor714
days.
Cap.Itraconazole
(400mg)
24hourlyfor714
days
Inj.Amikacin
Cap.Itraconazole
(400mg)
24hourlyfor714
days
Gingivitis
Preferreddrug
Campylobacterrectus
Actinomycesspecies
Prevotellainginosus
Streptococcus
Tab.PenicillinV
(250500mg)
postoperative6
hourlyfor57days
Tab.
Metronidazole
(200400mg)
8hourlyfor35
days
Alternativedrug
Cap.Doxycycline
Initial:(200
mg/day)divided
twicedailypost
operativefirstday
then.Maintenance:
(100200mg/day)
divided12hrly
Cap.Doxycycline
Initial:(200
mg/day)
dividedtwicedaily
postoperativefirst
daythen.
Maintenance:
(100200mg/day)
divided12hourly
Name:AvoidanceofDoxycycline,Metronidazoleingrowingpatientsand
pregnantwomen.
Avoidanceofantimicrobialdrugsinpatientshavingthehistoryofthatspecific
drugallergy.
Hepatorenalsyndrome
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AntibioticGuideline
Preferreddrug
Cirrhosisofliverwith
asciteswithrenal
impairment
Inj.Human
albumin(1
g/kg/day)boluson
presentation
(maximumDose,
100gmdaily)
Inj.Noradrenaline
(0.53.0mg/hour)
continuousI/V
infusion[Sherlock]
Alternativedrug
Inj.Terlipressin
(0.52.0mg)
every46hourly
Inj.Octreotide(100
200gm)
subcutaneously8
hourly
Inj.Midodrine(7.5
12.5mg)
8hourly
Incaseofmaxillofacialfracturemanagementlikeopenreductionand
fixation
Preferreddrug
3rdgeneration
Ceftriaxone(1mg
)I/V
12hourly
Metronidazole(500
mg)I/V
8hourlyfor57
daysfollowedby
oral
Cephalosporins
Tab.
Metronidazole
Alternativedrug
Inj.Meropenem(1
gm)
8hourlyI/Vfor7
days,followingby
Cap.Cephalosporins
Tab.Metronidazole
Incaseoforalandmaxillofaciallesionwithorwithoutreconstruction,like
mendibulectomy,maxillectomy,neckdissection,etc
Preferreddrug
Inj.Ceftriaxone(1
mg)12hourly
Tab.
Metronidazole(500
mg)
8hourlyfor57
daysfollowedby
Cap.
Alternativedrug
Inj.Meropenem(1
gm)8hourlyfor7
days,followingby
Cap.Cephalosporins
Tab.Metronidazole
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AntibioticGuideline
Cephalosporins
Tab.
Metronidazole
Jawosteomyelitis
Preferreddrug
Mixedanaerobic
infection.Commonlyby
staphylococciand
entericmicroorganism
Alternativedrug
Cap.Clindamycin
(600mg)
individeddosefor
6daysto8weeks
Flucloxacillin(500
mg)
6hourlyfor68
weeks+
Tab.
Metronidazole(500
mg)
8hourlyfor7days
Tab.Secnidazole(2
gm)
singledose
Minororalsurgerylikebiopsy,excisionofmucoceleetc
Preferreddrug
Cap.Amoxicillin
(500mg)
8hourlyfor7days
or
Cap.Cefixime(200
mg)
12hourlyfor7
days+
Tab.
Metronidazole(400
mg)
8hourlyfor5days
Alternativedrug
Cap.Amoxicillin
(500mg)+
Clavulanicacid(125
mg)
8hourlyor
Cap.Cefuroxime
(500mg)+
Clavulanicacid(125
mg)
12hourlyfor7days
+
Tab.Metronidazole
(400mg)
8hourlyfor57
days
OralCandidiasis
Preferreddrug
Streptococcus
Peptostreptococcus
Antifungalagents
eg,Nystatin
powderorcream
Alternativedrug
Clotrimazoleor
Nystatinlozenges
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Bacteroides
Orofacialspaceinfections
Preferreddrug
Polymicrobialsofboth
anaerobicandaerobic
Cap.Amoxicillin
orCap.
Cephalosporins
(Cephradine,
Cefixime,
Cefuroxime)(500
mg1gm)in
differentdose
for714days+
Tab.
Metronidazole(500
mg)
8hourly7days.
Alternativedrug
Cap.Amoxicillinor
Cap.Cephalosporins
withClavulanicacid
+Tab.Secnidazole
(2gm)singledose.
Cefuroxime(500
mgto1gm)
indifferentdosefor
714days
Periimplantitis
Preferreddrug
Pseudomonas
aeruginosa
Staphylococcusspp.
Peptostreptococcus
micros
Porphyromonas
ednodontalis
Alternativedrug
Cap.
Cephalosporins
(200400mg)
612hourlyfor7
days
Metronidazole(400
mg)
57days
Name:Safeinpregnancy
PeriapicalPathosis
Preferreddrug
Prevotella
melaninogenica
Streptococcus
anginosus
Cap.
Cephalosporins
(200400mg)
612hourlyfor7
days.
Alternativedrug
Tab.Metronidazole
(400mg)
6hourlyfor7days
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AntibioticGuideline
Porphyromonas
gingivalis
Peptospreptococus
Microbes
Pericoronitis
Preferreddrug
Porphyromonas
gingivalis
Fusobacteriumspecies
Peptostreptococcus
micros
Fusobacterium
nucleatum
Alternativedrug
Tab.PenicillinV
(250500mg)
postoperative6
hourlyfor57days
Tab.PenicillinV
(250500mg)
postoperative6
hourlyfor57days
Cap.Doxycycline
Initial:(200
mg/day)
dividedtwicedaily
postoperativefirst
daythen
Tab.Metronidazole
(200400mg)
orally8hourlyfor
35days
Cap.
Cephalosporins
Periodontitis
Preferreddrug
Prohyromonas
gingivalis
Bacteroidesforsythus
Antinobacillus
actinomycente
Fusobacterium
nucleatum
Peptostreptococcus
micros
Alternativedrug
Tab.
Metronidazole
(200400mg)
8hourlyfor35
days
Cap.Cephalosporins
(2004000mg)
612hourlyfor7
days
Metronidazole
Cap.Amoxicillin
(500mg)
6hourly57days
Cap.Doxycycline
(200mg)
24hourly
Amoxicillin
Prevotellaoralis
Primary&secondaryprophylaxisforvaricealhaemorrhage
Preferreddrug
Alternativedrug
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AntibioticGuideline
PortalHypertension
duetoCirrhosisofliver
ornoncirrhoticportal
hypertension
Tab.Propranolol
(20mg)
Startat12hourly
twiceadayand
titrateupto
maximumdoseof
320mg/day.
Tab.Carvedilol
(6.25mg)
24hourlystartwith
thisdosethen
increasefor
maintenanceup
to12.5mg
Prophylaxis
Preferreddrug
Cap.Amoxicillin
(3gm)priorto
surgery.
Alternativedrug
Cap.Clindamycin3
gmpriortosurgery
Cap.Amoxicillin3
gmpriortosurgery
Pulpits
Preferreddrug
Obligateanaerobes:
Peptostreptococcus
anaerobius
Veillonellaparvula
Lactobacilus
cateraforme
Porphylaomonas
endodontic
Cap.Amoxicillin
(500mg)
(preferablywith
clavulanicacid)or
Alternativedrug
Cap.Cefixime
Cap.Cefuroxime
Cap.Cephradine
Tab.
Metronidazole
Facultativeanaerobes:
Streptococcusmitis
Streptococcusoralis
Enterococcusfaucal
Neisseria
Viralinfectioninlip/oralcavitylikeherpessimplexinfection
Preferreddrug
Herpesviruses
Acyclovir(400mg)
orally8hourlyfor
710days
Alternativedrug
Tab.Valacyclovir(1
gm)
12hourlyfor710
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Acyclovirointment
fortopical
application
days
Acyclovirointment
fortopical
application
Dermatology
AcneVulgaris
Preferreddrug
Propionibacterium
Acan
Tab.Azithromycin
(500mg)
24hourly3daysin
aweekfor12
weeks
Cap.Doxycycline
(100mg)
12hourlyfor12
weeksor
Alternativedrug
Cap.Amoxicillin
(250500mg)
8hourly
Tab.Trimethoprim
Sulfamethoxazolein
doublestrength
12hourly
Cap.Clindamycin
(150mg)
8hourlyand
reducedgradually
ascontrolis
achieved
Cap.Minocycline
(50100mg)
12or24hourlyfor
3months
Cap.Tetracycline
(250500mg)
6hourlyfor3
months
Erythromycin
(250500mg)
6hourlyfor3
months
Cellulitis
Preferreddrug
Staphylococcal
Streptococcalor
Alternativedrug
Coamoxiclav(625
mg)
8hourly
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Combined
Cap.Flucloxacillin
plus
Phenoxymethyl
penicillin(500mg)
6hourlyor
Tab.Gatifloxacin
(400mg)
24hourlyfor7
daysor
Inj.Ceftriaxone(2
gm)I/V
singleordivided
dose
Chancroid
Preferreddrug
Haemophilusducreyi
Alternativedrug
Tab.Azithromycin
(1gm)
Oralsingledose
Inj.Ceftriaxone(1
gm)statdosewith
Tab.Ciprofloxacin
Inj.Ceftriaxone
(250mg)
I/Msingledose
Tab.Levofloxacin
(750mg)
24hourly7days
Tab.Ciprofloxacin
(500mg)
12hourlyfor2
days
Erythromycin(500
mg)
8hourlyfor7days
CutaneousAnthrax
Preferreddrug
Bacillusantharacis
Alternativedrug
Tab.Ciprofloxacin
(500mg)
12hourlyfor14
days
Cap.Doxycycline
(100mg)
12hourlyfor14
days
CutaneousTuberculosis
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Preferreddrug
Mycobacterium
Tuberculosis
Alternativedrug
Cap.Rifampicin
(400600mg)
singledose
Inj.Clarithromycin
or
Tab.Ofloxacinor
Tab.Isoniazid(300
mg)
singledose
Tab.Ciprofloxacin
or
Tab.Ethambutol
(1525mg/kg/day)
or
Inj.Capreomycinor
Inj.Streptomycin
(75mg1gm)
singledose
Inj.Cycloserineor
Tab.
Paraaminosalicyclic
acid
Tab.Ethionamide.
Tab.Pyrazinamide
(2535mg/kg/day)
for2months
Tab.Rifampicin
(400600mg)
singledose
Tab.Isoniazid(300
mg)
singledosefornext
4months
Gonorrhoeae
Preferreddrug
Neisseriagonorrhea
Alternativedrug
Singledosesofany
ofthefollowing
orally:
Cap.Cefixime(300
mg)
Tab.Ciprofloxacin
(500mg)
Tab.Ofloxacin
(400mg)
Tab.Levofloxacin
(250mg)
Impetigocontagiosa
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Preferreddrug
Staphylococcal
Streptococcalor
Cap.Dicloxacillin
(250500mg)
Combined
Tab.Coamoxiclav
(625mg)
8hourly
Cap.Cephalexin
(250500mg)
6hourlyfor7days
Alternativedrug
Tab.Clindamycin
(30mg)
8hourly
Cap.Erythromycin
(250500mg)
6hourlyfor7days
Leprosy
Preferreddrug
Mycobacteriumleprae
Forpaucibacillary:
Tab.Dapsone(100
mg)
singledoseplus
Cap.Rifampicin
(600mg)
monthlyfor6
months
Formultibacillary:
Tab.Dapsone(100
mg)
singledoseplus
Alternativedrug
Inj.Clarithromycin
(500mg)
singledose
Tab.Minocycline
(100mg)
singledose
Tab.Ofloxacin(400
mg)
singledose
Tab.Levofloxacin
(500mg)
singledose
Tab.Clofazimine
(50mg)
singledoseplus
Cap.Rifampicin
(600mg)
monthlyfor1year
Syphilis
Preferreddrug
Treponemapallidum
Inj.Benzathin
penicillin12lac
unitI/Mineach
buttockdayone
dayeightandday
fifteenthaccording
tostages
Alternativedrug
Cap.Doxycycline
(100mg)
12hourlyfor2
weeks
Cap.Erythromycin
(500mg)
6hourlyfor14days
Inj.Ceftriaxone
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AntibioticGuideline
(250mg)
24hourlyI/Mor
I/Vfor810days
Inj.Azithromycin(2
gm)
singledose
Cap.Tetracycline
(500mg)
6hourlyfor14days
EndocrineSystem
Sepsis/Septicemia
Preferreddrug
Escherichiacoli
Klebsiella
Streptococcuspyogens
Pseudomonas
aeruginosa
Alternativedrug
Inj.Ceftriaxone(2
gm)
12hourlyatleast
for710days
Inj.Piperacillin+
Inj.Tazobactam
Inj.Meropenem
Inj.AmphotericinB
Skinandsofttissueinfectione.g.diabeticfootlesion
Preferreddrug
Staphylococcus
Streptococcus
Anaerobes
Alternativedrug
Tab.CoAmoxiclav
(625mg)
8hourlyfor710
days
Fluoroquinolones
Ceftibuten
Inj.Ceftriaxone+
Inj.Clindamycin
Name:Woundcarelikedebridement,regulardreningoffloadingofpresure
areaaremuchimportant
SupportiveParotitis(SalivaryGlandInfection)
Preferreddrug
Inj.CoAmoxiclav
(1.2gm)
Alternativedrug
Inj.Clindamycin
(900mg)
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8hourlyOral
then:
Tab.CoAmoxiclav
(625mg)
8hourly1014
days
8hourlyOralthen:
Tab.Clindamycin
(450mg)
8hourly
GastroIntestinalSystem
Acutegastroenteritis
Preferreddrug
Escherichiacoli
Alternativedrug
Tab.Azithromycin
(500mg)
2tabstatthen1
tabfor4days
Campylobacter
Shigella
Salmonella
Tab.Ciprofloxacin
(500mg)
12hourlyfor7days
Tab.Metronidazole
(400mg)
8hourlyfor57days
Clostridiumdifficile
Name:Pseudomembrenouscolitiesbyclostridiumdifficileisanimportant
causeofgastroenteritisfollowinguseofotherantibiotics
AbdominalSepsis
Likelycausative
agent
Preferreddrug
Acinatobacter
Enterococci
faecalis
Bacteroides
fragilis
Alternativedrug
Inj.
Piperacillin/Tazobactam(4.5
gm)
68hourlyfor714days
Plus
Inj.Amikacin(500mg)
12hourlyfor7daysPlus
Tab.Metronidazole(500
mg)
8hourly7days
Inj.Meropenem
(1gm)
8hourlyfor7
14daysplus
Inj.Amikacin
(500mg)
12hourlyfor7
days.
Cholangitis
Preferreddrug
Gramnegative
Alternativedrug
Inj.Meropenem
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anaerobes
(500mg)
8hourly
Gastroenteritis,Typhlitis
Likelycausative
agent
Preferreddrug
Candida
Alternativedrug
Enterococcusfaecalis
Inj.Cefepime(500mg)
8hourly
Aspergillus
Piperacillin/Tazobactam
Anaerobes
Vancomycin
Itraconazole
Name:Liverfunctiontestnecessary
NecrotizingPancreatitis(infected)
Likelycausative
agent
Preferreddrug
Alternativedrug
Inj.
(4.5gm)
68hourlyfor714days
Inj.Meropenem(1
gm)
8hourlyfor714
daysplus
PlusInj.Amikacin(500
mg)
12hourlyfor7days
Plus
Inj.Amikacin(500
mg)
12hourlyfor7
daysplus
Tab.Metronidazole
(500mg)
8hourly7days
Inj.Clindamycin
(600mg)
8hourlyfor714
days
Pepticulcerdisease
Preferreddrug
Helicobacterpylori
Tab.Levofloxacin
(500mg)
12hourlyfor14to
30days
Alternativedrug
Cap.Tetracycline
(500mg)
6hourlyfor14to
30days
Tab.
Metronidazole
(400500mg)
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8hourlyfor1430
days
Name:Durationdependingonthenatureandseverityoftheinfection
Secondarybacterialperitonitis
Preferreddrug
Escherichiacoli
Othergutpathogens
Alternativedrug
Inj.Meropenem
(500mg)
8hourly
Spontaneousbacterialperitonitis
Preferreddrug
Escherichiacoli
Klebsiella
Proteus
Tab.Levofloxacin
(500mg)
12hourlyfor14to
30days
Alternativedrug
Inj.Coamoxiclav
(1gm/0.2gm)
8hourlyfor5days
Tab.
Metronidazole
(400500mg)
8hourlyfor1430
days
Inj.Cefotaxime(2
gm)
12hourlyfor5
days
Name:Asciticfluidshouldbeculturedforbothaerobicandaraerobic
organism.
Asciticfluidshouldbeinculatedofbloodculturebottlecontaining100ml
mediaofbloodculturebottlecontaining100mlmediaatbedside.
Hepatobiliarysystem
Amoebicliverabscess
Preferreddrug
Entamoebahistolytica
Inj.Metronidazole
(750mg)
Alternativedrug
Nitazoxanide(500
mg)
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8hourlyfor510
days
12hourlyfor3days
Tinidazole,
Orrnidazole(2gm)
24hourlyfor3days
AntiviralusedinHepatitisBinfection(ChronicHepatitisB)
Preferreddrug
HepatitisBViris
Treatmentisindicated:
HBVDNA>2000
IU/mlALT>Upper
limitofnormal
Histology=moderateto
severe
necroinflammation&
significantfibrosis
Alternativedrug
Tab.Tenofovir
(300mg)
24hourly
Tab.Lamivudine
(100mg)
24hourly
Tab.Entecavir(0.5
mg)
oncedaily
Tab.Adefovir(10
mg)
24hourly
Tab.Telbivudine
(600mg)
24hourly
Inj.PEGIFN2a
(180g)
subcutaneously
weeklyfor12
months
AntiviralusedinHepatitisCinfection(ChronicHepatitisC)
Preferreddrug
HCVGenotype1
Alternativedrug
Inj.PEGIFN+
Tab.Simeprevir+
Cap.Ribavirin
for12weeks
Inj.PEGIFN+Tab.
Sofosbuvir+Cap.
Ribavirin
for12weeksand
Tab.Sofosbuvir+
Cap.Ledipasvir
for12weeks
Inj.PEGIFN+Cap.
Ribavirin
fornext12weeks
Tab.Sofosbuvir+
Tab.Simeprevir
for12weeks
Tab.Sofosbuvir+
Tab.Daclatasvir
for12weeks
HCVGenotype2
Tab.Sofosbuvir+
Cap.Ledipasvir
for12weeks
Inj.PEGIFN+Tab.
Sofosbuvir+Cap.
Ribavirin
for12weeksand
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Tab.Sofosbuvir+
Cap.Daclatasvir
for12weeks
HCVGenotype3
HCVGenotype4
Inj.PEGIFN+
Tab.Sofosbuvir+
Cap.Ribavirin
for12weeks
Tab.Sofosbuvir+
Cap.Ribavirin
for24weeks
Inj.PEGIFN+
Tab.Simeprevir+
Cap.Ribavirin
for12weeks
Inj.PEGIFN+Tab.
Sofosbuvir+Cap.
Ribavirin
for12weeksand
Tab.Sofosbuvir+
Tab.Ledipasvir
for12weeks
Inj.PEGIFN+Cap.
Ribavirin
fornext1236
weeks
Tab.Sofosbuvir+
Tab.Daclatasvir
for12weeks
Tab.Sofosbuvir+
Tab.Simeprevir
for12weeks
Tab.Sofosbuvir+
Tab.Daclatasvir
for12weeks
HCVGenotype5&6
Inj.PEGIFN+
Tab.Sofosbuvir+
Cap.Ribavirin
for12weeks
Tab.Sofosbuvir+
Tab.Ledipasvir
for12weeks
Tab.Sofosbuvir+
Tab.Daclatasvir
for12weeks
Cholangitis
Preferreddrug
Escherichiacoli
KlebsiellaPneumoniae
Pseudomonas
Proteus
Inj.Piperacillin
Tazobactam(3.375
gm)
6hourly
Alternativedrug
Inj.Meropenem(1
gm)
8hourly
Hepaticactinomycosis
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Preferreddrug
Actinomycesisraelii
Benzy1Penicillin
Alternativedrug
Doxycyclineand
Clindamycin
Name:Percutaneousliverbiopsyrelvealssuphaurgranuleswithtypical
organism
Hydatiddiseaseofliver
Preferreddrug
Echinococcus
granulosus
Surgeryfollowed
byTab.
Albendazole(400
mg)
12hourlyfor1
month
Alternativedrug
PAIRfollowedby
Tab.Albendazole
(400mg)
12hourlyfor1
month
Tab.Albendazole
(400mg)
for1monththen
14daysinterval,
total36cycles
Name:PAIRisaseffectiveassurgery.(WHOguideline1996)
Leptospirosis
Preferreddrug
Leptospira
icterohaemorrhagiae
Inj.Benzyl
Penicillin(900mg)
1.5millionunit6
hourlyfor1week
Alternativedrug
Inj.Ceftriaxone(1
gm)
24hourlyfor1
week
Name:Bloodcultureduringlimit10daysorurinecultureduring2ndweek
Melioidosis
Preferreddrug
Burkholderia
pseudomallei
Inj.Ceftazidime(2
gm)
8hourlyfor23
weeksfollowedby
Alternativedrug
Inj.Meropenem
(0.51gm)
8hourlyfor23
weeksfollowedby
20/66
12/19/2015
AntibioticGuideline
Cap.Doxycycline
(200mg)
24hourlyplus
Cap.Doxycycline
(200mg)
24hourlyplus
Tab.Co
trimoxazole
(80/400mg)
Cotrimoxazole
Pyogenicliverabscess
Preferreddrug
Escherichiacoli
Viridansstreptococci
Streptococcus
Pneumoniae
Alternativedrug
Inj.Ciprofloxacin
(500mg)
12hourly
Piperacillin/
Tazobactam
Inj.Ceftriaxone(1
gm)
plus12hourly
Meropenem
Imipenem/Cilastatin
Coamoxiclav
Inj.Metronidazole
for2weeksand
thenoralfor4
weeks.
InfectiousDisease
Bacterialvaginosis
Preferreddrug
Anaerobes
Tab.
Metronidazole(500
mg)
8hourly
Tab.Clindamycin
(80mg)
8hourly
Alternativedrug
Tab.Metronidazole
(500mg)
8hourly
Tab.Clindamycin
(80mg)
8hourly
FebrileNeutropenia
Preferreddrug
Staphylococcus
Pseudomonas
Inj.Meropenem(1
gm)
8hourlyfor710
Alternativedrug
Inj.Meropenem(1
gm)
8hourlyfor710
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12/19/2015
AntibioticGuideline
Streptococcus
days
days
Escherichiacoli
Klebsiella
Name:Culturesensitivitypreferedprecededbyempericaltreatment
GenitalHerpes
Preferreddrug
HerpessimplextypeI
ortypeII
Tab.Acyclovir
(400mg)
8hourlyfor710
days
Alternativedrug
Tab.Famcyclovir
(250mg)
orally8hourlyfor
710days
Tab.Valacyclovir(1
gm)
12hourlyfor710
days
Kalaazar
Preferreddrug
Leishmania
Inj.Liposomal
AmphotericinB
(10mg/kg)
notlessthanin2
hourssingledose.
Alternativedrug
Miltefosine
(2.5mg/kg/day)
in2divideddoses
for28days
Paromomycin
(15mg/kg/day)
alternatebuttock
oncedailyfor21
days
AmphotericinB
Deoxycholate
(1mg/kg/day)
alternatedaytotal
15doses
Malaria
Preferreddrug
Plasmodiumsepsis
Tab.Artemether
Lumefantrine
Alternativedrug
Chloroquine
22/66
12/19/2015
AntibioticGuideline
Quinine(10
mg/kg)8hourly
for7days
Doxycycline
Tetracycline
Neutropenicfever,Cellulitis
Preferreddrug
MostlyUnknown
Gramnegative
Escherichiacoli
Inj.Meropenem
(500mg)
8hourlyplusInj
Alternativedrug
Ceftazidime
Cefepime
Amikacin(500mg)
I/V12hourlyfor7
days
Name:ANC<500X10L,Hyperemtivity
Pelvicinflammatorydisease
Preferreddrug
Alternativedrug
Tab.Azithromycin
(1gm)
postoperativestat
followedby
Tab.Ofloxacin
(400mg)
postoperative12
hourlyplus
Tab.
Metronidazole(400
mg)
postoperative12
hourly14days
Tab.Azithromycin
(1gm)
postoperativestat
followedby
Inj.Clindamycin
(900mg)
8hourlyplus
Inj.Gentamicin(as
perlocalprotocol)
Tab.Clindamycin
(450mg)
postoperative6
hourlyPlus
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AntibioticGuideline
Tab.Ofloxacin
(400mg)
postoperative12
hourlytocomplete
14days
PostofInfection
Preferreddrug
Pseudomonas
Inj.Amikacin(500
mg)
12hourly
Alternativedrug
Netlimicin
PostofInfection
Preferreddrug
Escherichiacoli
Ceftriaxone(1gm)
24hourly
Alternativedrug
Meropenem
Secondaryfungalinfectione.g.oralthrush
Preferreddrug
Candidaspecies
Alternativedrug
Fluconazoleplus
LocallyNystatin/
Miconazole
Secondaryinfectioninmalignantlesion
Preferreddrug
Pseudomonas
Staphylococcus
Streptococcus
3rdgeneration
Cephalosporins
plusMetronidazole
Alternativedrug
2ndGeneration
Cephalosporinsor
Quinolone
derivatives
Sepsis/AcutePID
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12/19/2015
AntibioticGuideline
Preferreddrug
Gmnegative
Alternativedrug
Inj.Cephazolin
(1gm)(if>80kg
2gm)
8hourly+
Inj.Metronidazole
(500mg)
8hourly
Inj.Clindamycin
(600mg)
8hourly+
Inj.Gentamicin
(2mg/kg)
8hourly
Sepsis/Septicemia
Preferreddrug
Escherichiacoli,
Klebsiella
Inj.Ceftriaxone(2
gm)
12hourlyatleast
for710days
Pseudomonas
aeruginosa
Alternativedrug
Inj.Piperacillin+
Inj.Tazobactam
Inj.Meropenem
Inj.AmphotericinB
Sepsisuncertainfocus
Preferreddrug
Alternativedrug
Inj.Cefepime(1
gm)
812hourlyfor7
14days
Inj.Meropenem
(1gm)
8hourlyfor714
daysplus
Inj.Vancomycin(1
gm)
12hourly
Inj.Metronidazole
(500mg)
8hourlyfor7days
Inj.Amikacin(500
mg)
12hourlyfor7
daysPlus
Inj.Metronidazole
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12/19/2015
AntibioticGuideline
(500mg)
8hourlyfor7days
Septicemia
Preferreddrug
Accordingtosourceof
infection
Inj.Meropenem(1
gm)
6hourly
Alternativedrug
Inj.Piperacillin/
Tazobactam(4.5
gm)
8hourly
SickImmunocompromised(febrileneutropenia)
Likelycausative
agent
Preferreddrug
Inj.Meropenem
(1gm)
8hourlyfor714
daysor/plus
Inj.Meropenem
(1gm)
8hourlyfor714
daysor/plus
Alternativedrug
Inj.Linezolid(600mg)
12hourlyor/plus
Inj.
(4.5gm)
68hourlyfor714
days
Quinolone
714days
Trichomoniasis
Preferreddrug
Trichomoniasis
vaginalis
Metronidazole(2
gm)asasingleoral
doseor(400mg)
12hourlyfor7
days.Or
Tinidazole(2gm)
asasingleoral
doseOr
Secnidazole(2gm)
singledoseforboth
partners
Alternativedrug
Tab.Metronidazole
(2gm)asasingle
oraldoseor(400
mg)
12hourlyfor7
days.Or
Tab.Tinidazole(2
gm)
asasingleoraldose
Or
Tab.Secnidazole(2
gm)
singledoseforboth
26/66
12/19/2015
AntibioticGuideline
partners
UncomplicatedChlamydialInfection
Preferreddrug
Ifpoorcompliance:
Tab.Azithromycin
(1gm)
postoperativestat
dose
IfPregnant:
Alternativedrug
Inj.Clarithromycin
or
Tab.Ofloxacinor
Tab.Erythromycin
(500mg)
postoperative6
hourlyfor7days
or
Tab.Erythromycin
(500mg)
postoperative12
hourlyfor14days
ValvovaginalCandidiasis(nonregnant)
Preferreddrug
CandidaAlbicans
Tab.Clotrimazole
(500mg)aginal
tabonceOrTwo
(100mg)vaginal
tablettopically
for3nightsOr
Vaginal1%cream
topicallyfor6
nights
Cap.Fluconazole
(150mg)
asasingledose
Alternativedrug
Tab.Clotrimazole
(500mg)vaginal
tabletonceOrTwo
(100mg)vaginal
tablettopically
for3nightsOr
Vaginal1%cream
topicallyfor6
nights
Cap.Fluconazole
(150mg)
oralasasingledose
Name:Contraindicatedinpregnancy
Venousasepticsiteofinfection
Preferreddrug
Alternativedrug
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12/19/2015
AntibioticGuideline
Staphylococcus
epidermises
Pseudomonas
<
Inj.Cephalosporins
Inj.Ceftriaxone(1
2gm)
12hourly
Inj.Amikacin
Tab.Linezolid
Cap.Flucloxacillin
Inj.Amikacin(500
mg)
12hourly
Tab.Ciprofloxacin
Name:Sterelityshouldbestrictlymaintained.Personalhygineofthepatientas
wellashospitalstuffshouldbemaintained
Venousharvestingsitewoundinfectionofleg
Preferreddrug
Streptococcusaureus
Pseudomonas
Escherichiacoli
Inj.Ceftriaxone(1
2gm)
12hourly
Inj.Amikacin(500
mg)
12hourly
Alternativedrug
Inj.Cephalosporins
Inj.Amikacin
Tab.Linezolid
Cap.Flucloxacillin
Tab.Ciprofloxacin
Name:Sterelityshouldbestrictlymaintained.Personalhygineofthepatientas
wellashospitalstuffshouldbemaintained
VTI,Septicemia
Preferreddrug
Grampositive
Pseudomonas
Alternativedrug
Inj.Ceftriaxone(1
gm)
24hourly
Inj.Imipenem(500
mg1gm)
8hourly
Name:Steroidcoveragewithantimicrobialtherapymayberequired
Woundinfection
Preferreddrug
Escherichiacoli
Alternativedrug
CreamGentamicin
applylocally23
28/66
12/19/2015
AntibioticGuideline
Pseudomonas
Klebsiella
timesdailyOr
Cream/ointment
Fusidicacidapply
locally23times
dailyOr
Cream/ointment
Mupirocinapply
locally23times
dailyOr
Combinationof
Bacitracinand
neomycinapply
thecreamlocally
23timesdaily
Fusidicacidisa
steroid
antimicrobial
agentwhichisused
almostexclusively
againstlactamase
producing
staphylococci
KidneyandUrinarySystem
AcutePyelonephritis
Preferreddrug
Escherichiacoli
Streptococcus
saprophyticus
Klebsiella
Pseudomonas
aeruginosa
Enterococci
Tab.Ciprofloxacin
(500mg)
12hourlyfor7
days
Tab.
Trimethoprim
Sulfamethoxazole1
doublestrength
tablet(160/800mg)
12hourlyfor3
days
Alternativedrug
Inj.Ceftriaxone(1
gm)
statdosewithoral
Ciprofloxacin
Inj.Levofloxacin
(750mg)
24hourlyfor7days
Name:Complicatedpyelorephritisarecommonindiabeticpatientrequire
prolongtherapy
ESWL
Preferreddrug
Alternativedrug
29/66
12/19/2015
AntibioticGuideline
Fluoroquinolones
TMP/SMX
Inj.
Aminoglycosides
Tab.Amoxicillin
1st/2ndgeneration
Cephalosporins
Lowerurinarytractinfection(cystitis)inpregnancyUTI
Preferreddrug
Escherichiacoli
Klebsiella
Pseudomonas
Enterococcus
Cap.
Nitrofurantoin
(100mg)
6hourlyfor7days
Alternativedrug
Cap.Cephalexin
(500mg)
8hourlyfor7days
Tab.
Pivmecillinam(400
mg)stat&(200
mg)
8hourlyfor7days
NonGonococcalUrethritis
Preferreddrug
Chlamydiatrachomatis
Ureplasmaurealyticum
Mycoplasma
Genetalium
Cap.Doxycycline
(100mg)
12hourlyfor7
days
Tab.Azithromycin
(1gm)
singledose
Alternativedrug
Cap.Erythromycin
(500mg)
6hourlyfor7days
or12hourlyfor2
weeksor
Tab.Ofloxacin(200
mg)
12hourlyfor7days
PCNL
Preferreddrug
1st/2ndgeneration
Cephalosporinsor
Alternativedrug
Aminoglycosides
Fluoroquinolones
Inj.
Aminoglycosides
Tab.
30/66
12/19/2015
AntibioticGuideline
Metronidazoleor
Clindamycin
Prostatitis
Preferreddrug
Escherichiacoli
TMP/SMXfor4
weeks
Enterobacteriaceae
Pseudomonas
Alternativedrug
Fluoroquinolones
Enterococci
Enterococcus
Prostaticbiopsy
Preferreddrug
Alternativedrug
Fluoroquinolones
TMP/SMX
1st/2ndgeneration
Cephalosporins
Aminoglycosides
Surgicalprophylaxix:Urethrocystoscopy,Urodynamicstudy,Ureteroscopy,
TURP,TURBT
Preferreddrug
Fluoroquinolones
TMP/SMX
Alternativedrug
Inj.
Aminoglycosides
Inj.Ampicillin
1st/2ndgeneration
Cephalosporins
CoAmoxiclav
UrinaryTractInfection
Likelycausative
agent
Escherichiacoli
Preferreddrug
Tab.
Alternativedrug
Coamoxiclav
31/66
12/19/2015
AntibioticGuideline
Klebsiella
Pseudomonas
Staphylococcus
aureus
Candidaalbicans
Ciprofloxacin
(500mg)
12hourlyfor7
10days
Cefuroxime+Clindamycin
UrinaryTractInfection(acuteuncomplicatedcystitis)
Preferreddrug
Escherichiacoli
Streptococcus
saprophyticus
Klebsiella
Pseudomonas
aeruginosa
Tab.
Nitrofurantoin
(100mg)
12hourlyfor5
days
Tab.
Trimethoprim
Sulfamethoxazole1
doublestrength
tablet(160/800mg)
12hourlyfor3
days
Fosfomycin
trometamol(3gm)
Asachetorallya
singledose
Pivmecillinam(400
mg)
12hourlyfor37
days
Alternativedrug
Fluoroquinolones
Tab.Ofloxacin(400
mg)
12hourlyfor3days
Tab.Ciprofloxacin
(250mg)
12hourlyfor3days
Tab.Levofloxacin
(500mg)
24hourlyfor3days
Lactams
Coamoxiclav
Cefdinir
Cefaclor
Cefpodoxime
Proxetil(100mg)
12hourly3days
Urosepsis
Preferreddrug
Escherichiacoli
Proteus
Klebsiella
Enterococci
Candia
Inj.Amikacin(500
mg)
12hourlyfor7
days
Inj.Meropenem(1
gm)
8hourlyfor714
daysplus
Cap.Fluconazole
(500100mg/day)
iffungalinfection
Alternativedrug
Inj.Cefepime(1
gm)
812hourlyfor714
days
Inj.Meropenem(1
gm)
8hourlyfor714
daysorplus
Cap.Fluconazole
(500100mg/day)
32/66
12/19/2015
AntibioticGuideline
UrologicalSurgeryinvolvingintestinee.g.:GItract,Skin+intestine
Preferreddrug
2nd/3rdgeneration
Cephalosporins
Inj.
Aminoglycosides
Tab.
Metronidazoleor
Alternativedrug
Inj.Ampicillin
Inj.Ticarcillin/Co
Amoxiclav
Inj.Piperacillin/
Tazobactam
Fluoroquinolones
Clindamycin
Musculoskeletalsystem
AcuteandchronicpyogenicOsteomyelitis
Preferreddrug
Staphylococcus
pyogens
Inj.Ceftriaxone(1
gm)
12hourly
Inj.Flucloxacillin
(250mg1gm)
6hourly
Alternativedrug
Inj.Cefuroxime
(750mg)
12hourly
Deepsternalwoundinfection
Preferreddrug
Streptococcusaureus
Pseudomonas
Escherichiacoli
Fungal
Inj.Meropenem
(500mg1gm)
18hourly
Inj.Amikacin(500
mg)
12hourly
Alternativedrug
Inj.Ceftriaxone
Inj.Amikacin
Inj.Flucloxacillin
Inj.Linezolid
Inj.Ciprofloxacin
Name:Sterctityshouldbestrictlymaintained.Personalhygineofthepatientas
wellashospitalstuffshouldbemaintainedsuperficialanddeep
ElectiveSurgery
33/66
12/19/2015
AntibioticGuideline
Preferreddrug
Prophylacticpurpose
Alternativedrug
Inj.Ceftriaxone(1
gm)
12hourly
Inj.Cefuroxime
(750mg)
12hourly
Inj.Cefepime(500
mg1000mg)
8hourly
Inj.Flucloxacillin
(250mg1000mg)
6hourly
Inj.Amikacin(500
mg)
12hourlyanyone
ortwoin
combination
Septicarthritis
Preferreddrug
EnterobacterSpecies
Alternativedrug
Inj.Ceftriaxone(1
gm)
12hourly
Inj.Flucloxacillin
(250mg1gm)
12hourly
Name:Preferredculturesensitivityreport
Skin&Softtissueinfection
Preferreddrug
Cap.Flucloxacillin
(500mg)6hourly
Alternativedrug
Tab.Clarithromycin
(500mg)12hourly
andCap.
Clindamycin(450
60mg)6hourly
Superficialsternalwoundinfection
34/66
12/19/2015
AntibioticGuideline
Preferreddrug
Escherichiacoli
Pseudomonas
Inj.Ceftriaxone(1
2gm)
12hourly
Inj.Amikacin(500
mg)
12hourly
Alternativedrug
Inj.Cephalosporins
Inj.Amikacin
Inj.Flucloxacillin
Inj.Linezolid
Inj.Ciprofloxacin
Name:Sterctityshouldbestrictlymaintained.Personalhygineofthepatientas
wellashospitalstuffshouldbemaintainedsuperficialanddeep
TubercularOsteomyelitis
Preferreddrug
Mycobacteriumaureus
Alternativedrug
1stlineanti
tuberculardrugs
Woundinfections
Preferreddrug
Streptococcusaureus
Pseudomonas
pyogenosa
Klebsiella
Enterobacteriaceae
Alternativedrug
Inj.Ceftriaxone(1
gm)
12hourly
Inj.Meropenem
(500mg)
8hourly
Inj.Amikacin(500
mg)
2hourly
Inj.Flucloxacillin
Name:Accordingtoculturesensitivityreport
ObstetricsandGynaecologicalProcedure
D&C,endoscopicorotherminorprocedure
Preferreddrug
Alternativedrug
35/66
12/19/2015
AntibioticGuideline
Anaerobes
Notneeded
Caesareansection
Preferreddrug
Prophylaxis
Inj.Amoxiclav(1.2
gm)
8hourly
Alternativedrug
Inj.Clindamycin
(900mg)
8hourly
Name:Reviewculturereports
InfectedwoundCaesar/Perinealtearandepisiotomy
Preferreddrug
Gramnegative
Staphylococcus
Escherichiacoli
Pseudomonas
Alternativedrug
Inj.Flucloxacillin
(900mg)
8hourly+
Inj.Metronidazole
(500gm)
8hourlyfollowed
byoralfor7days
Intrapartumpyrexia
Preferreddrug
Prophylaxis
Inj.Amoxicillin(2
gm)+Inj.
Metronidazole(500
mg)initially
followedby
Alternativedrug
Inj.Clindamycinin
penicillinallergy
group
Inj.Amoxicillin
(500mg)
8hourly+
Inj.Metronidazole
(500mg)
8hourlytill
delivery
Inj.Gentamicinif
severesepsis5days
fororalantibiotics
36/66
12/19/2015
AntibioticGuideline
afterdelivery
PlacentaRemoval,4DegreeTear,MajorSurgery,ExtensiveOncological
Surgery
Preferreddrug
Alternativedrug
IVsingledoseonly
atinduction
PostoperativeGynaecologicalSepsis
Preferreddrug
Alternativedrug
Inj.Gentamicin(as
perlocalprotocol)
plusInj.
Clindamycin(1.2
gm)
6hourly
Stopandreviewif
patientdevelops
diarrhoeaorif
Gentamicinis
contraindicated(
seeGHNHSFT
protocol)consult
microbiologist
Duration:57days
andthenreview
Nonseverepenicillin
Allergy:
Inj.Meropenem(1
gm)
8hourly
Severepenicillin
Allergy:
Inj.Gentamicin(as
perlocalprotocol)
plus
Inj.Clindamycin
(1.2gm)
6hourly
Stopandreviewif
patientdevelops
37/66
12/19/2015
AntibioticGuideline
diarrhoeaorif
Gentamicinis
contraindicated(
GHNHSFTprotocol
)consult
microbiologist.
Duration:57days
andthenreview.
Consult
Microbiologist
ProphylaxisHysterectomyLaparotomyVaginalRepair
Preferreddrug
Inj.Ceftriaxone(2
gm)
12hourlyatleast
for710days
Alternativedrug
Inj.Cephazolin
(1gm)(if>80kg2
gm)+
Inj.Metronidazole
(500mg)
8hourly
Inj.Clindamycin
(600mg)+Inj.
Gentamicin(2mg
/kg)
8hourly
Name:IfnopenicillinorBlactuseallergy
SurgicalProphylaxisObstetric&GynaecologicalSurgeryHysterectomy
Preferreddrug
Alternativedrug
IVsingledoseonly
atinduction
Opthalmology
Antibioticsusedinsurgicalprophylaxis:Cataractsurgery,Glaucoma
surgery,Dacryocystitis(Chronic)
Preferreddrug
Alternativedrug
38/66
12/19/2015
AntibioticGuideline
Moxifloxacin0.3%
Gatifloxacin0.3%
1dropg.i.d.
Levofloxacin0.3%
BacterialUveitis
Preferreddrug
Mycobacterium
tuberculosis
MycobacteriumBovis
Treponema.pallidum
Alternativedrug
Accordingtocause
AntiTB
AntiSyphilis
(systemicregimen
tobefollowed)
Name:Aquausandvitreoussampleforculturesensitivity
Conjunctivitis
Preferreddrug
Streptococcus
Pneumonia
Haemophilus
influenzae
Moraxellacatarrhalis
Neisseriagonorrhea
Chloramphenicol
Aminoglycosides
(Gentamicin,
Neomycin)
Quinolones
(Ciprofloxacin
Ofloxacin)
Alternativedrug
Tetracycline
Fusidicacid
Doxycycline
Erythromycin
Bacitracin
Levofloxacin
Lomefloxacin
Gatifloxacin
Moxifloxacin
PolymyxinB
Fusidicaciddose
(g.i.d.for1week)
Name:Conjunctivalculturesensitivityneeded
CornealUlcer
Preferreddrug
Alternativedrug
39/66
12/19/2015
AntibioticGuideline
Pseudomonas
Ciprofloxacin
0.3%
Moxifloxacin
Gatifloxacin
Streptococcus
NeisseriaGonorrhoeae
Ofloxacin03.%
Fortified
Gentamicin
Doxycycline
Tetracycline
Meningitis
Coronibacterium
diphtheria
Haemophilus
influenzae
Treponemapallidum
Fortified
Cephalosporins
ProcainePenicillin
(g.i.d.for1week
oraccordingto
severityofthe
disease)
Erythromycin
Subconjunctival
antibiotics
Name:Dependsonculturesensitivity.Conjunctivalsweabandcorneal
serapping
Dacryocystitis
Preferreddrug
Epidermidis
Streptococcusviridians
Pneumoniaepyogens
Escherichiacoli
Flucloxacillin
(oral)
for1week
Cephradine
Alternativedrug
Coamoxiclav
Cephalosporins
Cefixime
Name:Dependingonculturesensitivity
Endophthalmitis
Preferreddrug
Staphylococcusspecies.
Bacillusspecies
Alternativedrug
Ceftazidime(2mg
in0.1ml)
Amikacin(0.4mg
in0.1ml)
Vancomycin(2mg
in0.1ml)
Gentamicin(0.2mg
in0.1ml)
Tab.Ciprofloxacin
(750mg)
12hourlyor
Moxifloxacin(400
mg)
24hourly
Name:Aquausvitreoussampleforculturesensitivity
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12/19/2015
AntibioticGuideline
Lidinfection
Preferreddrug
Alternativedrug
Ciprofloxacin
0.3%1dropg.i.d
for7days(dose
canbereadjusted
accordingto
severity)
Pyogenes
Epidermidis
Streptococcusviridans
Pneumonia
Moxifloxacin
Flucloxacillin
Pyogenes
Name:Tomaintainlidhygine
Neonatalconjunctivitis(OpthalmiaNeonatorum)
Preferreddrug
Alternativedrug
PenicillinG
Topical1,00,000
3,33,000units/ml
Paediatric10,000
to20,000IU
Silvernitrate1%
solution
OrbitalCellulitis
Preferreddrug
Streptococcus
Pneumoniae
Streptococcusviridans
Haemophilusinfluenzas
Alternativedrug
CeftazidimeI/V
(2mgin0.1ml)
Oral
Metronidazole
(antibiotic
continued)tillthe
patientfreefrom
fever
for4days.
Vancomycin(if
penicillinallergy)1
mgin0.1ml
Name:Pusforculturesensitivityiforbitalobsessprerent
Syphiliticeyedisease,SyphiliticUveitis,Opticneuritis,Neuroretinitis
41/66
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AntibioticGuideline
Preferreddrug
Treponemapallidum
3to4millionunit
PenicillinGis
administeredevery
4hourlyfor10to
14days.
Alternativedrug
Alternativeprocaine
PenicillinGIM2.4
millionIUdaily
plusProbenecid
(500mg)
oralg.i.dfor10to
14days.
PaediatricCentralNervousSystem
CentralvenouscathetertipMicroorganismisolated:75%
Preferreddrug
Pseudomonas66.66%
33.33%
Alternativedrug
Imipenem(20
mg/kg/dose)
8hourly
Tazobactam+
Piperacillin
8hourly
MeningitisinChildren(Bacteria),Younginfant
Preferreddrug
Streptococcus
pneumonia
Haemophilusinfluenjae
Inj.Ceftriaxone
(100mg/kg/day)
12hourly+
Inj.
Dexamethasone
(0.15mg/kg/day)
every6hourlyfor
48hoursstartedat
least20minutes
beforeantibiotic
therapy
Inj.Cefotaxime
(200mg/kg/day)
8hourlyfor10
days+
Inj.Vancomycin
(4560mg/kg/day)
8hourlyfor10
days+
Alternativedrug
Meropenem(40
mg/kg/day)
8hourly+
Aminoglycosides
(ifpseudomonas)
42/66
12/19/2015
AntibioticGuideline
Ampicillin(200
400mg/kg/day)
6hourlyfor10
days
SepticemiaCNSinfection
Preferreddrug
Organismofunknown
susceptibility
Inj.Vancomycin
(4560mg/kg/day)
12hourlyfor1014
days+
Inj.Meropenem
(3040mg/kg/day)
8hourlyfor1014
days
Alternativedrug
Inj.Vancomycin
(4560mg/kg/day)
12hourlyfor1014
days+
Inj.Meropenem
(3040mg/kg/day)
8hourly
PaediatricGastrointestinalSystem
Bacillarydysentery
Preferreddrug
Shigellaspecies,
Shigelladysentery,
Shigellaflexnari
Cap.Cefixime(8
10mg/kg/day)
12hourlyfor5
days
Alternativedrug
Cefixime12hourly
Ceftriaxone(5075
mg/kg/day)
12hourly
Pivmecillinam(50
mg/kg/day)
6hourlyfor5days
Cholangitis
Preferreddrug
Escherichiacoli
Ceftazidime(150
mg/kg/day)
Alternativedrug
Meropenem(3040
mg/kg/day)
Amikacin(1520
mg/kg/day)
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12/19/2015
AntibioticGuideline
Diarrhoea
Preferreddrug
Escherichiacoli
Shigella
Vibriocholerae
Azithromycin(10
mg/kg/day)
Alternativedrug
Ceftriaxone(50200
mg/kg/day)
Ciprofloxacin(15
30mg/kg/day)
Pivrnecillinam
EntericFever&SevereEntericFever
Preferreddrug
Salmonellatyphi
Salmonellaparaphyphi
A
SalmonellaparatyphiB
Cap.Cefixime(20
mg/kg/day)
12hourlyfor10to
14days
Inj.Ceftriaxone
(5075mg/kg/day)
12hourlyatleast5
daysafterafebrile
period
Alternativedrug
Azithromycin(20
mg/kg/day)
24hourly7days
Ciprofloxacin(20
30mg/kg/day)
12hourly710days
Inj.Ceftriaxone
(5075mg/kg/day)
Inj.
Dexamethasone
(3mg/kg)initial
flowedby(1
mg/kg)
6hourlyfor48
hours
Giardiasis
Preferreddrug
Giardia
Metronidazole(15
mg/kg/day)
8hourlyfor57
days
Alternativedrug
Secnidazole
Hydatidcyst
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AntibioticGuideline
Preferreddrug
Echinococcus
Granulosus
Alternativedrug
Albendazole(15
mg/kg/day)
12hourly
IntestinalAmoebiasis
Preferreddrug
Entamoeba
Histolytica
Metronidazole(15
mg/kg/day)
8hourlyfor57
days
Alternativedrug
Secnidazole
LiverAbscess
Preferreddrug
Streptococcusaureus
Gramnegative
Anaerobicorganism
Alternativedrug
Ceftriaxone(50
200mg/kg/day)
Flucloxacillin(50
100mg/kg/day)
Metronidazole
Peritonitis(AsciticFluidC/S)Microorganismisolated:4%
Preferreddrug
Streptococcus
Pneumoniae
Acinetobactor
Escherichiacoli
Alternativedrug
Ceftazidime(50
mg/kg/dose)
8hourly
Ceftriaxone(100
mg/kg/day)
1224hourly
Amikacin(7.5
mg/kg/dose)
12hourly
45/66
12/19/2015
AntibioticGuideline
SBP
Preferreddrug
Escherichiacoli
Cefotaxime(50200
mg/kg/day)
Flucloxacillin(50
100mg/kg/day)
Alternativedrug
Meropenem(3040
mg/kg/day)
PaediatricInfectiousDisease
Abscess2%
Preferreddrug
EnterobacterSpesis
Flucloxacillin(25
250mg)
6hourly
Vancomycin(4560
mg/kg/day)
Tazobactam
Meropenem(3040
mg/kg/day)
Alternativedrug
Inj.Vancomycin
(4560mg/kg/day)
12hourlyfor1014
days+
Inj.Meropenem
(3040mg/kg/day)
8hourly
Oralthrush
Preferreddrug
Candidaalbicans
Nystatin(46
lakhs)
unitfor6hourly
Miconazole2%
apply
12hourly
Alternativedrug
Inj.Vancomycin
(4560)
8hourlyfor24
weeks
Septicemia(BloodC/S)10%
Preferreddrug
Alternativedrug
46/66
12/19/2015
AntibioticGuideline
Klebsiella
Acinatobacter
Coagulasenegative
staph
Escherichiacoli
Inj.Amikacin(15
20mg/kg/day)
Inj.Meropenem
(3040mg/kg/day)
Inj.Ceftazidime
(150mg/kg/day)
Gentamicin
Amikacin
Imipenem
Colistin
Ciprofloxacin
Cotrimoxazole
Vancomycin
Netlimicin
Name:FebrileNeutropeniainPaediatricHaematologyandOncologyis
consideredasanentitywhichistobeaddressedifferently.Herethepractised
protocolis
1stline3rdgenerationofCephalosporin+Amikacin
2ndline4thgenerationofCephalosporinorCarbapenem+Vancomycin
Iffebrileneutropeniapersists57daysormorewestartintravenous
AmphotericinB
Septicemia(BloodC/S)Microorganismisolated:6%
Preferreddrug
Escherichiacoli
Salmonella
Enterococcus
Pseudomonas
Klebsiella
Alternativedrug
Cefotaxime(50
mg/kg/dose)
812hourly
Ampicillin(25
mg/kg/dose)
6hourly
Vancomycin
(15mg/kg/dose)
8hourly
Ceftazidime(50
mg/kg/dose)
8hourly
Amikacin(7.5
mg/kg/dose)
12hourly
SepticArthritis
Preferreddrug
Streptococcusaureus
Streptococcus
pneumoniae
Inj.Ceftriaxone
(5075mg/kg/day)
12hourlyfor4
weeks
Alternativedrug
Inj.Clindarnycin
(1040g/kg/day)
8hourly
Vancomycin(4560
47/66
12/19/2015
AntibioticGuideline
Cefotaxime(20
mg/kg/day)
8hourlyfor4
weeks+
Clindamycin(10
40mg/kg/day)
8hourlyfor4
weeks
mg/kg/day)
8hourly
Meropenem(40
mg/kg/day)
8hourly
SkininfectionCellulitisOsteomyelitis
Preferreddrug
Organismofunknown
susceptibility
Cloxacillin(50100
mg/kg)
6hourlyfor710
days
Inj.Clindamycin
(1040mg/kg/day)
8hourlyfor24
weeks
Alternativedrug
Inj.Vancomycin
(4560)
8hourlyfor24
weeks
ThroatSwabMicroorganismisolated:12%
Preferreddrug
82%
18%
Alternativedrug
Penicillin(2550
mg/kg/dose)
6hourly
Erythromycin(10
mg/kg/dose)
6hourly
Amoxicillin(25
mg/kg/dose)
8hourly
Clindamycin(36
mg/kg/dose)
6hourly
WoundSwab2%
Preferreddrug
Alternativedrug
48/66
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AntibioticGuideline
Pseudomonas
Flucloxacillin(125
250mg)
6hourly
Amikacin(1520
mg/kg/day)
Meropenem(3040
mg/kg/day)
Vancomycin(4560
mg/kg/day)
Imipenem
Amikacin
Colistin
Ticarcillin
PaediatricSurgery
Amnioticbandofbothleg:releaseofbankandZplastyinrightleg
Preferreddrug
Staphylococci
Micrococci
Grampositiverods
Alternativedrug
Inj.Ceftriaxone
(5075mg/kg/day)
Inj.
Flucloxacillin(50
100mg/kg/day)
followedby
Flucloxacillin
AVMattherootofnose:Excised
Preferreddrug
Alternativedrug
Inj.Ceftriaxone
(5075mg/kg)
AVMofleftthigh(Aspirated)(Aspiratedfluid:nogrowth)
Preferreddrug
Staphylococci
Micrococci
Grampositiverods
Alternativedrug
Inj.Cephradine
(50100mg/kg/day)
CysticHygroma(withintheabdomen)withslidinghernia:ExcisionofCystic
hygromawithherniotomy
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AntibioticGuideline
Preferreddrug
Escherichiacoli
Klebsiella
Pseudomonas
aeruginosa
Enterococci
Alternativedrug
Inj.Ceftriaxone
(5075mg/kg/day)
Inj.Flucloxacillin
(50100mg/kg/day)
followedby
Cefixime(20
mg/kg/day)
Dischargingsinusatpenoscrotalregion:Excision(PusforC/S:Pseudomonas
spp.)
Preferreddrug
Escherichiacoli
Klebsiella
Pseudomonas
aeruginosa
Proteus
Alternativedrug
Inj.Ceftriaxone
(5075mg/kg/day)
Tab/Inj.
Ciprofloxacin(10
mg/kg/day)
Inj.Amikacin(15
20mg/kg/day)
followedby
Inj.Imipenem(60
100mg/kg/day)
Name:Duringchangetoothergroupofantibioticrequirefurtherurineculture
sensitivity
Eventrationofleftdomeofdiaphragmwithumbilicalhernia:Plicationofthe
defectandrepairofhernia
Preferreddrug
Escherichiacoli
Streptococci
Pseudomonas
Enterococci
Alternativedrug
Inj.Ceftriaxone
(5075mg/kg/day)
Inj.Gentamicin(5
mg/kg/day)
GrowthinlowerEsophagus:feedinggastrostomywithbiopsyfromgrowth
50/66
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AntibioticGuideline
Preferreddrug
Escherichiacoli
Klebsiellapneumonia
Streptococcus
pneumonia
Enterococci
Alternativedrug
Cephradine(50
100mg/kg/day)
Inj.Gentamicin(5
mg/kg/day)
HydrocephalusandMeningomyelocelewithurinaryandfecalincontinence
IntroductionofVPshuntwithexcisionofmeningomyelocele
Preferreddrug
Encapsulated
organism:
Streptococcus
Pneumoniae,Nigeria
meningitides,
Haemophilusinfluenza.
Noncapsulated
organism:Listeria
monocytogenes
Alternativedrug
Inj.Ceftazidime
(1520mg/kg/day)
Inj.Amikacin(15
20mg/kg/day)
Hypospaediaswithrotationaldeformityofpenis:Urethroplastyand
correctionofrotation
Preferreddrug
Escherichiacoli
Klebsiella
Pseudomonas
aeruginosa
Proteus
Alternativedrug
Inj.Ceftriaxone
(5075mg/kg/day)
followedby
Inj.Meropenem
(3040mg/kg/day)
Inj.Flucloxacillin
(50100mg/kg/day)
Inj.Amikacin
Name:Multidruguseofantibioticalsorequirespecificindication
Hypospaedias:Urethroplasty
51/66
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AntibioticGuideline
Preferreddrug
Escherichiacoli,
Klebsiella,
Pseudomonas
aeruginosa,Proteus
Alternativedrug
Inj.Ceftriaxone
(5075mg/kg/day)
Inj.Flucloxacillin
(50100mg/kg/day)
followedby
Cefixime(20mg/
kg/day)
Streptococcus
pyogens82%
Staphylococcus
aureus18%
LongsegmentHirschsprungsDiseasewithIleostomy:Totalcolectomywith
ileoanalanaestomosis.On7thPODpatientdevelopedincompletewound
dehiscencewhichclosedbysecondarysuture
Preferreddrug
Escherichiacoli
BactericidesFragilis
group
Alternativedrug
Inj.Ceftriaxone
(5075mg/kg/day)
Inj.Metronidazole
(1530
mg/kg/day)On3rd
PODadded
Inj.Ciprofloxacin
(10mg/kg/day)due
todevelopmentof
loosediarrhoea.
On26thPOD:
Changedto
Inj.Meropenem
(3040mg/kg/day)
Inj.Amikacin(15
20mg/kg/day)
Name:Frequentchangesofantibioticsorequirewoundsweab.Specific
indicationshouldmentioned
Massinrightglutealregion:Incisionalbiopsy
Preferreddrug
Staphylococci,
Micrococci,Gram
positiverods
Inj.Ceftriaxone
(5075mg/kg/day)
followedbyoral
Cefixime
Alternativedrug
Streptococcus
pyogens82%
Staphylococcus
aureus18%
MeconiumileuswithIleostomy:Ileostomyclosure(Stoolculture:no
52/66
12/19/2015
AntibioticGuideline
organism)
Preferreddrug
Escherichiacoli,
group
Alternativedrug
Inj.Ceftriaxone
(5075mg/kg/day)
Inj.Metronidazole
Inj.Amikacin
NonoperativecaseofCholedochalcyst
Inj.Ceftriaxone
(5075mg/kg)
Penoscrotalhypospaedias:Urethroplasty(Urinec/s:nogrowth)
Preferreddrug
Escherichiacoli
Klebsiellapneumonia
Pseudomonas
aeruginosa
Proteus
Alternativedrug
Inj.Ceftriaxone
(5075mg/kg/day)
Inj.Flucloxacillin
(125250
mg/kg/day)
followedbyoral
Cefixime
Perinealhypospaediaswithbilateralundescendedtestes:Urethroplastywith
bilateralorchiopexy(Urinec/s:nogrowth)
Preferreddrug
Escherichiacoli,
Klebsiella,
Pseudomonas
aeruginosa,Proteus
Alternativedrug
Inj.Ceftriaxone
(5075mg/kg/day)
for7days,Then
Inj.
Meropenem(3040
mg/kg/day),Inj.
Flucloxacillin(50
100mg/kg/day)
andInj.Amikacin
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AntibioticGuideline
(1520mg/kg/day)
for8daysfollowed
bySyrupCefixime
(20mg/kg/day)
for16days.
Rectourethralfistula:Perinealholetechniqueanoplasty(UrineC/S:No.
growth)
Preferreddrug
Escherichiacoli
group
Alternativedrug
Inj.Ceftriaxone
(5075mg/kg/day)
Inj.Metronidazole
(1530mg/kg/day)
Inj.Ceftazidime
(150mg/kg/day)
Inj.Gentamicin(5
mg/kg/day)
ResidualPUVwithLeftsidedVUR:Fulgarationwithleftsideduretericre
reimplantationRuineR/M/E:Normalfinding(UrineC/S:noorganism)
Preferreddrug
Escherichiacoli
Klebsiella
Pseudomonas
aeruginosa
Proteus
Alternativedrug
Inj.Ceftriaxone
(5075mg/kg/day)
followedby
Inj.Meropenem
(3040mg/kg/day)
Inj.Amikacin
ThalasseaemiawithHypersplensim:Splenectomy
Preferreddrug
Escherichiacoli
Streptococci
Pseudomonas
Enterococci
Alternativedrug
Inj.Ceftriaxone
(5075mg/kg/day)
Inj.Phylopen
Inj.Amikacin(15
20mg/kg/day)
54/66
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AntibioticGuideline
PaediatricUrinarySystem
UrinarytractinfectionAcutecystitisAcutepyelonephrities
Preferreddrug
Escherichiacoli
Klebsiella
Proteus
Cap.Cefixime(8
10mg/kg/day)
12hourlyfor710
days
Tab.Ciprofloxacin
(830mg/kg/day)
12hourlyfor710
days
Alternativedrug
Inj.Amikacin(15
20mg/kg/day)
Inj.Gentamicin(5
mg/kg/day)
Cap.Nitrofurantoin
(57mg/kg/day)
Tab.Cotrimoxazole
Inj.Amikacin(15
20mg/kg/day)
Inj.Gentamicin(5
mg/kg/day)
Ceftazidime(150
mg/kg/day)
Urinarytractinfection(UTI)Microorganismisolated:6%
Preferreddrug
Escherichiacoli
Enterococci
Acinatobacter
Pseudomonas
Alternativedrug
Cefotaxime(50
mg/kg/dose)
812hourly
Ceftazidime(50
mg/kgdose)
8hourly
Ceftriaxone(100
mg/kgdays)
1224hourly
Nitrofurantoin
(1.75mg/kgdose)6
hourly
Amikacin(15
mg/kgdose)
12hourly
Gentamicin(2.5
mg/kg/day)
8hourly
RecurrentUTIprophylaxis
55/66
12/19/2015
AntibioticGuideline
Preferreddrug
Alternativedrug
Cap.
Nitrofurantoin(12
mg/kg/day)
Singledoseatbed
time
Tab.Co
trimoxazole(620
mg/kg/day)
singledoseatbed
time
PaediatricsRespiratorySystem
OtitisMedia2%
Preferreddrug
Pseudomonas
Ceftriaxone(5075
mg/kg/day)
Cefuroxime
Ceftazidime(150
mg/kg/day)
Alternativedrug
Ceftazidime
Ciprofloxacin
Imipenem
Meropenem
Netlimicin
Pneumonia
Preferreddrug
Nosocomial:
Escherichiacoli
Streptococcus
Pneumoniae
Pseudomonas
Klebsiella
Communityacquired:
Inj.Ceftriaxone
(5075mg/kg/day)
710days
accordingto
clinicalresponse
Cap.Flucloxacillin
(125250mg)
6hourly.(in
staphylococcus
aureus)
Inj.Azithromycin
(10mg/kg/day)
Inj.Erythromycin
Alternativedrug
Inj.Ceftriaxone(50
75mg/kg/day)
12hourly
Inj.Gentamicin(5
mg/kg/day)
3hourly
Inj.Clarithromycin
(15mg/kg/day)
8hourly
Inj.Clindamycin
(1040g/kg/day)
8hourlyfor14days
56/66
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AntibioticGuideline
5years:Mycoplasma
Chlarnydia
(3050g/kg/day)
Inj.Vancomycin
(4560g/kg/day)
8hourly
Inj.Imipenem(15
25mg/kg/day)
8hourly
Inj.Clarithromycin
(15mg/kg/day)
RTI4%
Preferreddrug
Klebsiella
Acinatobacter
Penicillin(125250
mg)
orallyevery68
hourly
Erythromycin(30
50mg/kg/day)
Clarithromycin(15
mg/kg/day)
Meropenem(3040
mg/kg/day)
Alternativedrug
Imipenem
Ciprofloxacin
Colistin
Tazobactam
Piperacillin
RespiratorySystem
AcuteBacterialRhinosinusitis(severeorpersistentsymptoms)
Preferreddrug
Grampositive:
Streptococcus
Pneumoniae
Haemophilus
influenzae
Pseudomonas
aeruginosa
Moraxellacatarrhalis
Gramnegative:
Alternativedrug
1stline:
1stline:
Tab.CoAmoxiclav
(625mg)
8hourlyorally
2ndline:
Doxycycline
oral(100mg)
12hourly10days
Inj.Clarithromycin
(500mg)
12hourly
2ndline:
Cap.Doxycycline(100
mg)
12hourly
Pseudomonas
aeruginosa
Escherichiacoli
Proteasemirabilis
57/66
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AntibioticGuideline
Enterobacter
AcuteDiffusedOtitisExterna(Swimmer'sear)
Preferreddrug
Staphylococusaureus
Pseudomonaspyogens
Escherichiacoli
Oftenmixedflora
Alternativedrug
Milemoderate:
Cap.Flucloxacillin
Topical
Antimicrobial
Severe(e.g.Cellulitis
orblockedear
canal):
Inj.Ceftriaxone(1
mg)
Tab.Ciprofloxacin
(500mg)
12hourlyfor710
day
Name:TopicaldropstobeprescribedatthediscretionoftheENTconsultant
AcuteLaryngitis
Preferreddrug
Alternativedrug
Antibioticsare
NOTIndicated
AcuteLocalisedOtitisExterna(furuncle)
Preferreddrug
Staphylococcal
Cap.Flucloxacillin
(1gm)
6hourlyfor7days
plus
Topicalsteroids
Alternativedrug
Clarithromycin(500
mg)
12hourly
AcuteOtitisMedia
58/66
12/19/2015
AntibioticGuideline
Preferreddrug
Streptococcus
Pneumoniae
Haemophilus
influenzae
Micrococcus
Catarrhalis
(Necrotizing)
BHaemolytic
streptococcus
Alternativedrug
Antibioticsshould
notberoutinely
prescribedfor
uncomplicated
AOM.Forsevere
diseaseorwhenrisk
ofcomplications:
Antibioticsshould
notberoutinely
prescribedfor
uncomplicated
AOM.Forsevere
diseaseorwhenrisk
ofcomplications:
1stLine
1stLine
Cap.Amoxicillin
(500mg)
8hourly
Clarithromycin(500
mg)
12hourly
2ndline
2ndline
Tab.CoAmoxiclav
(625mg)
8hourly10days
Cap.Doxycycline
(100mg)
12hourlyand
Tab.Metronidazole
(400mg)
8hourly
Name:Mostcasesareviralandselflimiting.Antibioticsshouldbedelayedfor
23daysandpatientresponse
AcuteRhinoSinusitis
Preferreddrug
Alternativedrug
Antibioticsshould
beOnlyprescribed
inSEVERE
infection.Mostly
thiscondition
causedbyviral
Aspirationpneumonia
Likelycausative
agent
Pseudomonas
Acinatobacter
Enterococci
faecalis
Preferreddrug
Alternativedrug
Inj.
Piperacillin/Tazobactam(4.5
gm)
68hourlyfor714days
plus
Inj.Meropenem
(1gm)
8hourlyfor7
14days
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12/19/2015
AntibioticGuideline
Bacteroides
fragilis
Inj.Amikacin(500mg)
12hourlyfor7daysPlus
Tab.Metronidazole(500
mg)
8hourlyfor7days
Inj.Amikacin
(500mg)
12hourlyfor7
daysplus
Tab.
Clindamycin
(600mg)
8hourlyfor7
14days
ChronicOtitisMedia
Preferreddrug
Aerobic:
Pseudomonas
aeruginosa
Escherichiacoli
Streptococcusaureus
Streptococcus
Pyogenes
Proteusmirabilis
Klebsiellaspecies
Anaerobic:
Alternativedrug
Oralantimicrobial
maybeaddedifa
susceptible
organismis
cultured710days
Bacteroides
Peptostreptococcus
Propionibacterium
CommunityAcquiredPneumonia(CAP)
Preferreddrug
Streptococcus
Pneumoniae
Candia
Inj.Azithromycin
(500mg)I/VOD
5days,or
Inj.
Clarithromycin
(500mg)
12hourlyfor714
days
Inj.Quinolone
714daysor
Inj.Linezolid(600
mg)
12hourly714
Alternativedrug
Inj.Ceftazidine(1
gm)
8hourlyfor714
days,plus/or
Inj.Clindamycin
(600mg)I/V
8hourlyfor714
days
Inj.Piperacillin/
Tazobactam(4.5
gm)
68hourlyfor714
days
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AntibioticGuideline
days(ifgram
positiveinfection),
or
Inj.Ticoplzmin
(400mg)statand
(200mg)
12hourlyfor714
days,or
Inj.Vancomycin(1
gm)I/V
12hourly714days
(ifgrampositive
infection)
Inj.AmphotericinB
iffungalinfection
Cap.Fluclonazole
(50100mg/day)if
fungalinfection
Epiglottises
Preferreddrug
Haemophilusinfluenzae
(25%),followedby
Haemophilus
parainfluenzae,
Streptococcus
Pneumoniae,andgroup
Astreptococci
Inj.Ceftriaxone(2
gm)
24hourly.Oral
then:
Tab.Coamoxiclav
(625mg)
8hourlyfor710
days
Alternativedrug
Inj.Clarithromycin
(900mg)
8hourlyand
Tab.Ciprofloxacin
(500gm)
12hourly.Oral
then:
Tab.Clindamycin
(450mg)
6hourlyand
Tab.Ciprofloxacin
(500gm)
12hourly
LungAbscess
Preferreddrug
Staphylococus
Coamoxiclav
Metronidazole
Alternativedrug
Clindamycin,
Vancomycin,
Daptomycin,
Linezolid
MalignantOtitisExterna
Preferreddrug
Alternativedrug
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AntibioticGuideline
Pseudomonas
3rdGeneration
Cepholosporins
Piperacillinhourly
plusTopical
TreatmentoralStop
down:
Tab.Ciprofloxacin
(500mg750mg)
12hourlyfor46
weeks
Inj.Clindamycin
(900mg)and(750
mg)
8hourlyand12
hourly
Name:Ensuresueabsaretakenpriortotherapy.Switchtooralsbasedon
clinicalassesmentandmicrobiologicalresults.
Assessforanyboneandintracranialextension
Allcasestobediscumedwithmicrobiology
Perichondritis
Preferreddrug
Pseudomonas
Mixedflora
Alternativedrug
1stline
Tab.Ciprofloxacin
(500mg750mg)for
12hourly
2ndline:
Cap.Clindamycin
(450mg)6hourly
for46weeks
Pharyngitis/Tonsillitis
Preferreddrug
GABHS(common)
Arcanobacterium
hemolytic(7%or
adolescentsandadults
withpharyngitis)
GroupCStreptococci
(uncommon)
GroupGStreptococci
(uncommon))
(uncommon)
Mild:
Tab.
Phenoxymethy1
penicillin(500mg)
6hourly
Severe:
Inj.Benzy1
penicillin(1.2gm)
6hourlyand
Inj.Metronidazole
(500mg)
8hourly.Oralthen
Alternativedrug
Mild:
Tab.Clarithromycin
(500mg)
12hourly
Severe:
Inj.Clarithromycin
(900mg)
8hourly.Oralthen
Tab.Clindamycin
(450mg)
8hourly
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AntibioticGuideline
Coronibacterium
diphtheria(rare)
Tab.Coamoxiclav
(625mg)
8hourlyfor710
days.
Pneumonia
Preferreddrug
Mostlyunknown
GramveEscherichia
coli
Inj.Meropenem
(500mg)
8hourlyplus
Inj.Amikacin(500
mg)I/V
12hourlyfor7
days
Alternativedrug
Ceftazidime
Cefepime
Quinsy(peritonsillarabscess)
Preferreddrug
Aerobicbacteriaare
StreptococcusgroupA
(GAS),Bhemolytic
StreptococcigroupCand
G,andStaphylococcus
aureusAnaerobic
bacteriaisolatedform
PTAaspiratesis
Fusobacterium
necrophorum
Inj.
Benzy1penicillin
(1.2gm)
6hourlyand
Inj.Metronidazole
(500mg)
8hourly.Oralthen
Tab.Coamoxiclav
(625mg)
8hourlyfor710
days
Alternativedrug
Inj.Clarithromycin
(900mg)
8hourly.Oralthen
Tab.Clindamycin
(450mg)
8hourly
Respiratorytractinfectione.g.bronchitisPneumonia
Preferreddrug
Streptococcus
Pneumoniae
Legionella
pneumophetin
3rd/4th
generation
Cephalosporins
Macrolide
Alternativedrug
Fluoroquinolones
Macrolide
Mycoplasma
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AntibioticGuideline
Name:NosocomialRTIiscommonindiabeticpatient.Earlyandagresive
treatmentisrequired
RetropharyngealAbscessLateralpharyngealAbscess
Preferreddrug
Inj.Ceftriaxone(2
gm)
24hourlyand
Inj.Metronidazole
(500mg)
4hourly.Oral
then:
Tab.Coamoxiclav
(625mg)
8hourlyor
accordingtoC/S
for1014days
Alternativedrug
Inj.Clarithromycin
(900mg)
8hourlyand
Tab.Ciprofloxacin
(500gm)
12hourly.Oral
then:
Tab.Clindamycin
(450mg)
6hourlyand
Tab.Ciprofloxacin
(500gm)
12hourly
SoreThroat
Preferreddrug
Alternativedrug
Pleasenotethatsore
throatcanbeviral
innature.Thesedo
NOTrequire
antimicrobial
therapy.Antibiotic
treatmentofadult
pharyngitisbenefits
onlythosepatients
withGABHS
infectionFour
clinicalcriteria
(Centorcriteria**)
thatpredict
infectionwith
GABHSinclude:(a)
historyoffever(b)
tonsillarexudates(c)
absenceofcough(d)
tenderanterior
cervical
lymphadenopathy
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AntibioticGuideline
(lymphadenitis)
Antibiotictherapyis
recommendedonly
forpatientswho
fulfillTHREEor
FOURcriteria.See
belowforantibiotic
recommendations
for
pharyngitis.Throat
culturesarenot
recommendedfor
theroutineprimary
evaluationofadults
withpharyngitisor
forconfirmationof
negativeresultson
rapidantigentests.
Upperorlowerrespiratorytractinfection(Oncology)
Preferreddrug
Pneumococcus
Streptococcus
Staphylococcus
Alternativedrug
Inj.Azithromycin
(500mg1gm)
24or12hourlyfor
3daysor
3rdgeneration
Cephalosporinsor
Quinolone
derivatives
Tab.Azithromycin
(500mg)
orally24or12
hourlyfor3days
or
Tab.Coamoxiclav
(625mg)
orally8hourlyfor
7days
Ventilatorassociatedpneumonia(EarlyVAP)
Likelycausative
agent
Pseudomonas
Acinatobacter
Proteus
Klebsiella
Staphylococcus
aureus
Preferreddrug
Alternativedrug
Inj.
(4.5gm)
68hourlyfor714days
plus
Inj.Amikacin(500mg)
12hourlyfor7days
Inj.Meropenem
(1gm)
8hourlyfor714
daysor
Inj.Vancomycin
(1gm)
12hourlyor
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AntibioticGuideline
Quinolone
for714days
Inj.Colistin
Sulphate(12
MU)
8hourlyfor714
days
Ventilatorassociatedpneumonia(LateVAP)
Preferreddrug
Pseudomonas
Acinatobacter
Proteus
Klebsiella
Inj.Meropenem(1
gm)
8hourlyplus
Inj.Cefepime(1
gm)
812hourly
Inj.Amikacin(500
mg)
12hourlyfor7
days
Inj.Vancomycin(1
gm)
12hourly
Inj.Colistin
Sulphate(12MU)
8hourlyfor714
days
Inj.Colistin
Sulphate(12MU)
8hourlyfor714
days
Alternativedrug
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