Aidan at 18:01, 9 February 2023

2023-02-09T18:01:03Z

← Older revision		Revision as of 18:01, 9 February 2023
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			Anne H Norris, Nabin K Shrestha, Genève M Allison, Sara C Keller, Kavita P Bhavan, John J Zurlo, Adam L Hersh, Lisa A Gorski, John A Bosso, Mobeen H Rathore, Antonio Arrieta, Russell M Petrak, Akshay Shah, Richard B Brown, Shandra L Knight, Craig A Umscheid, 2018 Infectious Diseases Society of America Clinical Practice Guideline for the Management of Outpatient Parenteral Antimicrobial Therapy, ''Clinical Infectious Diseases'', Volume 68, Issue 1, 1 January 2019, Pages e1–e35, <nowiki>https://doi.org/10.1093/cid/ciy745</nowiki>
	{\| class="wikitable sortable"		{\| class="wikitable sortable"
	! rowspan="2" \|Antiinfective		! rowspan="2" \|Antiinfective

Aidan: Created page with "{| class="wikitable sortable" ! rowspan="2" |Antiinfective ! rowspan="2" |Oral Bioavailability, %a ! rowspan="2" |Doses per dayb ! rowspan="2" |Infusion Time ! rowspan="2" |Delivery Devicec ! colspan="3" |Monitoring Frequency (Weekly) ! rowspan="2" |Most Common Potentially Serious ADRs ! rowspan="2" |Torsades de Pointes Riske ! rowspan="2" |Other Comments |- !CBC-diff !BMP: including K, Cr, BUN !Liver profile: ALT, AST, ALK, Tbil |- ! colspan="11" |Antibiotics |- |Amikac..."

2023-02-09T17:59:57Z

Created page with "{| class="wikitable sortable" ! rowspan="2" |Antiinfective ! rowspan="2" |Oral Bioavailability, %a ! rowspan="2" |Doses per dayb ! rowspan="2" |Infusion Time ! rowspan="2" |Delivery Devicec ! colspan="3" |Monitoring Frequency (Weekly) ! rowspan="2" |Most Common Potentially Serious ADRs ! rowspan="2" |Torsades de Pointes Riske ! rowspan="2" |Other Comments |- !CBC-diff !BMP: including K, Cr, BUN !Liver profile: ALT, AST, ALK, Tbil |- ! colspan="11" |Antibiotics |- |Amikac..."

New page

{| class="wikitable sortable"
! rowspan="2" |Antiinfective
! rowspan="2" |Oral Bioavailability, %a
! rowspan="2" |Doses per dayb
! rowspan="2" |Infusion Time
! rowspan="2" |Delivery Devicec
! colspan="3" |Monitoring Frequency (Weekly)
! rowspan="2" |Most Common Potentially Serious ADRs
! rowspan="2" |Torsades de Pointes Riske
! rowspan="2" |Other Comments
|-
!CBC-diff
!BMP: including K, Cr, BUN
!Liver profile:
ALT, AST, ALK, Tbil
|-
! colspan="11" |Antibiotics
|-
|Amikacin
|NA
|1–3
|30–60 min depending on dose
|Grav, Elas
|1
|2
|…
|Nephrotoxicity; ototoxicity
|
|See aminoglycoside monitoringf
|-
|Ampicillin
|50
|4–6
|3–5 min push or 10–15 min infusion
|Grav, EID, IVP
|1
|1
|1
|Hypersensitivity including anaphylaxis
|
|Stable once reconstituted for only 3 days; see stability footnoteg
|-
|Ampicillin-sulbactam
|NA
|3–4
|10–15 min push or 15–30 min infusion
|Grav, EID, Elas, IVP
|1
|1
|1
|Hypersensitivity including anaphylaxis
|
|Stable once reconstituted for only 3 days; see stability footnoteg
|-
|Azithromycin
|28–52
|1
|60 min
|Grav
|1
|…
|…
|
|Known
|Consider change to po
|-
|Aztreonam
|NA
|2–4
|3–5 min push or 20–60 min infusion
|Grav, EID, Elas, IVP
|1
|1
|1
|
|
|Rare cross-allergenicity with other beta-lactams
|-
|Cefazolin
|NA
|3–4
|3–5 min push or 30–60 min infusion
|Grav, Elas, IVP
|1
|1
|…
|Hypersensitivity including anaphylaxis
|
|Dialysis-only dosing possible
|-
|Cefepime
|NA
|2–3
|5 min push or 30 min infusion
|Grav, Elas, IVP
|1
|1
|…
|Hypersensitivity including anaphylaxis
|
|Dialysis-only dosing possible
|-
|Cefoxitin
|NA
|3–4
|3–5 min push or 20–30 min infusion
|Grav, Elas, IVP
|1
|1
|…
|Hypersensitivity including anaphylaxis
|
|
|-
|Ceftaroline
|NA
|2–3
|5 min push or
5–60 min
|Grav, IVP
|1
|1
|…
|Hypersensitivity including anaphylaxis
|
|
|-
|Ceftazidime
|NA
|3
|3–5 min push or 15–30 min infusion
|Grav, Elas, IVP
|1
|1
|…
|Hypersensitivity including anaphylaxis
|NA
|Dialysis-only dosing possible
|-
|Ceftazidime-avibactam
|NA
|3
|120 min
|Grav, EID
|1
|1
|…
|Hypersensitivity including anaphylaxis
|
|…
|-
|Ceftolozane-tazobactam
|NA
|3
|60 min
|Grav, EID
|1
|1
|…
|Hypersensitivity including anaphylaxis
|
|…
|-
|Ceftriaxone
|NA
|1–2
|1–4 min push or 30 min infusion
|Grav, Elas, IVP
|1
|1
|1
|Hypersensitivity including anaphylaxis
|
|See monitoring footnoted
|-
|Ciprofloxacin
|50–85
|2–3
|60 min
|Grav, Elas
|…
|…
|…
|Tendonitis/tendon rupture; peripheral neuropathy
|Known
|Consider change to po; see monitoring footnoted
|-
|Clindamycin
|90
|3–4
|10–60 min (not to exceed 30 mg/min)
|Grav, Elas
|1
|1
|1
|
|
|Consider change to po; see monitoring footnotef
|-
|Colistin
|NA
|2–4
|3–5 min IVP; 30 min for infusion
|Grav, IVP
|1
|2
|…
|Nephro- and neurotoxicity
|
|Inhaled colistin may be an option for respiratory tract infections
|-
|Daptomycin
|NA
|1
|2 min push or 30 min infusion
|Grav, Elas, IVP
|1
|1
|…
|Myopathy; rhabdomyolysis
|
|Baseline and weekly CK, discontinue if symptomatic and CK >1000 U/L (~5× ULN) or asymptomatic and CK >2000 U/L (~10× ULN);
dialysis-only dosing possible
|-
|Dalbavancin
|NA
|Once per week
|30 min
|Grav
|…
|…
|…
|Hypersensitivity including anaphylaxis
|
|Red man syndrome more likely if infusion <30 min; monitoring requirements unknown for treatment duration greater than 2 weeks
|-
|Ertapenem
|NA
|1
|30 min
|Grav, Elas
|1
|1
|1
|Hypersensitivity including anaphylaxis
|NA
|See stability footnoteg
|-
|Gentamicin
|NA
|1–3
|30–120 min depending on dose
|Grav, EID, Elas
|1
|2
|…
|Nephrotoxicity; ototoxicity
|
|See aminoglycoside monitoringf
|-
|Imipenem
|NA
|3–4
|20–60 min depending on dose
|Grav
|1
|1
|1
|Hypersensitivity including anaphylaxis; seizures
|
|See stability footnoteg
|-
|Levofloxacin
|90
|1
|60–90 min depending on dose
|Grav
|…
|…
|…
|Tendonitis/tendon rupture; cardiac arrhythmias; peripheral neuropathy
|Known
|Consider change to po; see monitoring footnote;d dialysis-only dosing possible
|-
|Linezolid
|100
|2
|30–120 min
|Grav, EID
|1
|…
|1
|Thrombocytopenia; leukopenia; anemia;
peripheral neuropathy; optic neuritis
|
|Consider change to po; monitor for neuropathy, optic neuritis in prolonged use; see monitoring footnote;d potential for drug interactions
|-
|Meropenem
|NA
|3–4
|30 min
|Grav, Elas
|1
|1
|1
|Hypersensitivity including anaphylaxis
|
|Dialysis-only dosing possible; see stability footnoteg
|-
|Metronidazole
|100
|2–4
|30–60 min
|Grav, EID, Elas
|1
|…
|…
|Peripheral neuropathy
|Conditional
|Consider change to po
|-
|Nafcillin
|NA
|4–6
|30–60 min
|Grav, EID
|1
|1
|1
|Hypersensitivity including anaphylaxis
|
|Central line commonly used because of concern for phlebitis risk
|-
|Oritavancin
|NA
|Once
|180 min
|Grav
|…
|…
|…
|Hypersensitivity including anaphylaxis; infusion related
|
|Red man syndrome more likely if infusion <60 min; monitoring requirements unknown for treatment duration greater than a single dose
|-
|Oxacillin
|NA
|4–6
|10–30 min
|Grav, Elas
|1
|1
|1
|Hypersensitivity including anaphylaxis; hepatotoxicity
|
|Central line commonly used because of concern for phlebitis risk
|-
|Penicillin G
|25–73
|4–6
|15–30 min
|Grav, EID
|1
|1
|1
|Hypersensitivity including anaphylaxis
|
|Oral penicillin V K is not a substitute for IV treatment of most clinical conditions requiring IV penicillin, eg, syphilis
|-
|Piperacillin-tazobactam
|NA
|3–4
|30–240 min (extended infusion)
|Grav, EID
|1
|1
|1
|Hypersensitivity including anaphylaxis
|
|
|-
|Polymyxin B
|NA
|1
|60–90 min
|Grav
|1
|2
|…
|Nephro- and neurotoxicity
|
|Monitor for nephrotoxicity, neurotoxicity
|-
|Rifampin
|70–90
|1–3
|30 min
|Grav
|1
|1
|1
|Hepatitis; hypersensitivity
|NA
|Potential for drug–drug interactions; consider change to po
|-
|Tedizolid
|91
|1
|60 min
|Grav
|1
|…
|1
|Thrombocytopenia; leukopenia; anemia; peripheral neuropathy; optic neuritis
|
|Consider change to po; monitor for neuropathy, optic neuritis in prolonged use; potential for drug interactions; see monitoring footnoted
|-
|Telavancin
|NA
|1
|60 min
|Grav
|1
|2
|…
|Nephrotoxicity; hypersensitivity including anaphylaxis; infusion-related prolongation of QTc
|Possible
|High rate of renal injury in patients aged >65 years, with preexisting renal impairment or other nephrotoxins; red man syndrome more likely if infusion <60 min
|-
|Tigecycline
|NA
|2
|30–60 min
|Grav
|1
|1
|1
|Nausea/ vomiting
|
|
|-
|Tobramycin
|NA
|1–3
|30–120 min depending on dose
|Grav, EID, Elas
|1
|2
|…
|Nephrotoxicity; ototoxicity
|
|See aminoglycoside monitoringf
|-
|Trimethoprim/ sulfamethoxazole
|85
|2–4
|60–90 min
|Grav
|1
|1
|1
|Hyperkalemia; rash; nephrotoxicity; Stevens Johnson syndrome
|Special
|Consider change to po; potential for drug–drug interactions; high fluid requirement; spurious increase in serum creatinine
|-
|Vancomycin
|NA
|1–2
|60–120 min depending on dose
|Grav, EID, Elas
|1
|1
|…
|Nephrotoxicity; infusion-related reactions
|
|Dialysis-only dosing possible; vancomycin trough levels or area under the curve/minimum inhibitory concentration weekly and with dose changes;
red man syndrome more likely if infusion <60 min
|-
! colspan="11" |Antifungals
|-
|Amphotericin B
|NA
|1
|Liposomal: 2 hours Deoxycholate: 2–4 hours
|EID (including pole pump)
Elas
|1
|2
|1
|Rates >10%; hypotension, rigors, nausea, vomiting, diarrhea, anemia, thrombocytopenia,
electrolyte abnormalities (K, Mg, Ca), renal failure, hypoglycemia, LFT abnormalities
|Conditional
|Sodium loading recommended; chemistry 10 preferredf
|-
|Anidulafungin
|NA
|1
|1.5 hours
|Grav
|1
|1
|1
|
|
|
|-
|Caspofungin
|NA
|1
|1 hour
|Grav, EID, Elas
|1
|1
|1
|
|
|
|-
|Fluconazole
|≥90
|1
|1–2 hours (not to exceed 200 mg/h)
|Grav, Elas
|…
|…
|1
|
|Known
|Consider change to po; watch for drug-drug interactions
|-
|Isavuconazole
|98
|1–3
|≥1 hour
|Grav (with pump)
|…
|…
|1
|
|
|Consider change to po; watch for drug–drug interactions
|-
|Micafungin
|NA
|1
|1 hour
|Grav
|1
|1
|1
|
|
|
|-
|Posaconazole
|Highly dependent on gastric pH
|1–2
|90 min with in-line filter
|Grav
|1
|1
|1
|
|Conditional
|Consider change to po; watch for drug–drug interactions
|-
|Voriconazole
|96
|2
|1–2 hours
|Grav
|1
|1
|1
|Hallucinations; auditory/ visual disturbances; skin changes; fluorosis with prolonged use
|Conditional
|Consider change to po; watch for drug–drug interactions; monitor plasma concentrations; avoid intravenous formulations if CrCl <50 unless benefits clearly outweigh risks (accumulation of cyclodextrin vehicle)
|-
! colspan="11" |Antivirals
|-
|Acyclovir
|10–30
|3
|1 hour
|Grav, Elas
|1
|1
|…
|Crystalluria; acute renal injury
|
|Hydration critical in preventing nephrotoxicity;
consider change to po valacyclovir, famciclovir, or acyclovir
|-
|Cidofovir
|NA
|1
|1 hour
|EID (including pole pump)
|1
|2
|1
|Rash; anemia; neutropenia; iritis; uveitis; decreased intraocular pressure; nephrotoxicity; metabolic acidosis
|
|Hydrate with NS before and after dose; consider probenecid; urinalysis weekly; chemistry 10 preferredf
|-
|Foscarnet
|NA
|1–3
|1–2 hours (not to exceed 1 mg/kg/ min)
|EID, Elas
|1
|2
|1
|Nephro- and neurotoxicity; anemia; granulocytopenia; electrolyte disturbances
|
|Hydrate with NS or D5W prior to first dose; chemistry 10 preferredf
|-
|Ganciclovir
|5–10
|1–2
|1 hour
|Grav, Elas
|2
|1
|…
|Dose-dependent myelosuppression
|
|Consider change to po valganciclovir
|}

Outpatient Parenteral Antimicrobial Therapy (OPAT) (IDSA 2018) - Revision history

Aidan at 18:01, 9 February 2023