Indefinite antimicrobial therapy: Difference between revisions

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(Created page with "* Includes suppressive and prophylactic therapy, as well as use for treatment of non-infectious diseases (e.g. acne and reactive airways) {| class="wikitable" !Indication !Antimicrobial !Alternative |- ! colspan="3" |Prophylaxis |- |PJP prophylaxis following transplantation |TMP-SMX SS or DS daily or thrice weekly |Dapsone 50-100 mg p.o. daily Atovaquone 1500 mg p.o. daily Pentamidine 300 mg inhaled every 3-4 weeks Clindamycin 300 mg p.o. daily plus pyrimethamine 15 mg...")
 
m (typos and links)
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! colspan="3" |Prophylaxis
  
! colspan="3" |Prophylaxis
 
|-
  
|-
−
|PJP prophylaxis following transplantation
 +
|[[PJP prophylaxis]] following transplantation
−
|TMP-SMX SS or DS daily or thrice weekly
 +
|[[TMP-SMX]] SS or DS daily or thrice weekly
−
|Dapsone 50-100 mg p.o. daily
 +
|[[Dapsone]] 50-100 mg p.o. daily
−
Atovaquone 1500 mg p.o. daily
 +
[[Atovaquone]] 1500 mg p.o. daily
−
Pentamidine 300 mg inhaled every 3-4 weeks
 +
[[Pentamidine]] 300 mg inhaled every 3-4 weeks
  +
−
Clindamycin 300 mg p.o. daily plus pyrimethamine 15 mg p.o. daily
 +
[[Clindamycin]] 300 mg p.o. daily plus pyrimethamine 15 mg p.o. daily
 
|-
  
|-
 
|Post-splenectomy
  
|Post-splenectomy
−
|Amoxicillin 250-500 mg p.o. daily
 +
|[[Amoxicillin]] 250-500 mg p.o. daily
 
|
  
|
 
|-
  
|-
 
|[[Rheumatic fever]]
  
|[[Rheumatic fever]]
−
|benzathine penicillin 1.2 g IM every 3-4 weeks
 +
|[[Benzathine penicillin]] 1.2 g IM every 3-4 weeks
−
Penicillin V 250 mg p.o. twice daily
 +
[[Penicillin V]] 250 mg p.o. twice daily
  +
−
Sulphonamide 1 g p.o. daily
  
−
Erythromycin 250 mg p.o. twice daily
 +
[[Sulphonamide]] 1 g p.o. daily
  +
  +
[[Erythromycin]] 250 mg p.o. twice daily
 
|
  
|
 
|-
  
|-
 
|[[Spontaneous bacterial peritonitis]]
  
|[[Spontaneous bacterial peritonitis]]
−
|Norfloxacin 400 mg p.o. daily
 +
|[[Norfloxacin]] 400 mg p.o. daily
−
|TMP-SMX DS p.o. daily
 +
|[[TMP-SMX]] DS p.o. daily
−
Ciprofloxacin 750 mg p.o. weekly
 +
[[Ciprofloxacin]] 750 mg p.o. weekly
 
|-
  
|-
 
|[[Urinary tract infection]]
  
|[[Urinary tract infection]]
−
|TMP-SMX SS half tablet p.o. daily or thrice weekly
 +
|[[TMP-SMX]] SS half tablet p.o. daily or thrice weekly
−
TMP 100-300 mg p.o. daily
 +
[[Trimethoprim]] 100-300 mg p.o. daily
  +
⚫
Ciprofloxacin 125 mg p.o. daily
  
−
Cefalexin 125-250 mg p.o. daily
 +
[[Ciprofloxacin]] 125 mg p.o. daily
  +
⚫
Nitrofurantoin 50-100 mg p.o. daily
  
−
Norfloxacin 200 mg p.o. daily
 +
[[Cefalexin]] 125-250 mg p.o. daily
  +
  ⚫
[[Nitrofurantoin]] 50-100 mg p.o. daily
  +
  ⚫
[[Norfloxacin]] 200 mg p.o. daily
 
|
  
|
 
|-
  
|-
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|-
  
|-
 
|[[Prosthetic joint infection]] with MSSA
  
|[[Prosthetic joint infection]] with MSSA
−
|Cefalexin 500 mg p.o. three or four times daily
 +
|[[Cefalexin]] 500 mg p.o. three or four times daily
−
Cefadroxil 500 mg p.o. twice daily
 +
[[Cefadroxil]] 500 mg p.o. twice daily
−
|Dicloxacillin 500 mg p.o. three to four times daily
 +
|[[Dicloxacillin]] 500 mg p.o. three to four times daily
−
Clindamycin 300 mg p.o. four times daily
 +
[[Clindamycin]] 300 mg p.o. four times daily
  +
−
Amoxicillin/clavulanic acid 500 mg p.o. three times daily
 +
[[Amoxicillin/clavulanic acid]] 500 mg p.o. three times daily
 
|-
  
|-
 
|[[Prosthetic joint infection]] with MRSA
  
|[[Prosthetic joint infection]] with MRSA
−
|TMP-SMX DS 1 tab p.o. twice daily
 +
|[[TMP-SMX]] DS 1 tab p.o. twice daily
−
|Minocycline or doxycycline 100 mg p.o. twice daily
 +
|[[Minocycline]] or [[doxycycline]] 100 mg p.o. twice daily
−
Fluoroquinolone +/- rifampin
 +
[[Fluoroquinolone]] +/- [[rifampin]]
  +
−
Fusidic acid + rifampin
 +
[[Fusidic acid]] + [[rifampin]]
⚫
Cefalexin 500 mg p.o. three to four times daily
  
  +
  ⚫
[[Cefalexin]] 500 mg p.o. three to four times daily
 
|-
  
|-
 
|[[Prosthetic joint infection]] with beta-hemolytic streptococci and enterococci
  
|[[Prosthetic joint infection]] with beta-hemolytic streptococci and enterococci
−
|Penicillin V 500 mg p.o. two to four times daily
 +
|[[Penicillin V]] 500 mg p.o. two to four times daily
−
Amoxicillin 500 mg p.o. three times daily
 +
[[Amoxicillin]] 500 mg p.o. three times daily
 
|
  
|
 
|-
  
|-
 
|[[Prosthetic joint infection]] with Gram-negative bacilli
  
|[[Prosthetic joint infection]] with Gram-negative bacilli
−
|Ciprofloxacin 250-500 mg p.o. twice daily
 +
|[[Ciprofloxacin]] 250-500 mg p.o. twice daily
−
TMP-SMX DS 1 tab p.o. twice daily
 +
[[TMP-SMX]] DS 1 tab p.o. twice daily
 
|
  
|
 
|-
  
|-
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|-
  
|-
 
|[[Acne]]
  
|[[Acne]]
−
|Minocycline 100 mg p.o. daily
 +
|[[Minocycline]] 100 mg p.o. daily
−
|Doxycycline, lymecycline, azithromycin, clindamycin, trimethoprim
 +
|[[Doxycycline]], [[lymecycline]], [[azithromycin]], [[clindamycin]], [[trimethoprim]]
 
|-
  
|-
 
|[[Cystic fibrosis]]
  
|[[Cystic fibrosis]]
−
|Azithromycin 250-500 mg p.o. daily
 +
|[[Azithromycin]] 250-500 mg p.o. daily
 
|
  
|
 
|-
  
|-
 
|[[Inflammatory bowel disease]]
  
|[[Inflammatory bowel disease]]
−
|Metronidazole 10-20 mg/kg/day
 +
|[[Metronidazole]] 10-20 mg/kg/day
−
Ciprofloxacin 500 mg p.o. twice daily plus metronidazole
 +
[[Ciprofloxacin]] 500 mg p.o. twice daily plus metronidazole
−
|Rifaximin
 +
|[[Rifaximin]]
−
Clarithromycin + rifabutin + clofazimine
 +
[[Clarithromycin]] + [[rifabutin]] + [[clofazimine]]
  +
−
Clofazimine
 +
[[Clofazimine]]
 
|-
  
|-
 
|Reactive airway disease
  
|Reactive airway disease
−
|Azithromycin 250 mg p.o. daily
 +
|[[Azithromycin]] 250 mg p.o. daily
−
Azithromycin 500 mg p.o. thrice weekly
 +
[[Azithromycin]] 500 mg p.o. thrice weekly
−
|Moxifloxacin 400 mg p.o. daily for 5 days followed by pulsed every 8 weeks
 +
|[[Moxifloxacin]] 400 mg p.o. daily for 5 days followed by pulsed every 8 weeks
 
|}
  
|}
   

Revision as of 11:38, 18 May 2023

  • Includes suppressive and prophylactic therapy, as well as use for treatment of non-infectious diseases (e.g. acne and reactive airways)
Indication Antimicrobial Alternative
Prophylaxis
PJP prophylaxis following transplantation TMP-SMX SS or DS daily or thrice weekly Dapsone 50-100 mg p.o. daily

Atovaquone 1500 mg p.o. daily Pentamidine 300 mg inhaled every 3-4 weeks

Clindamycin 300 mg p.o. daily plus pyrimethamine 15 mg p.o. daily

Post-splenectomy Amoxicillin 250-500 mg p.o. daily
Rheumatic fever Benzathine penicillin 1.2 g IM every 3-4 weeks

Penicillin V 250 mg p.o. twice daily

Sulphonamide 1 g p.o. daily

Erythromycin 250 mg p.o. twice daily

Spontaneous bacterial peritonitis Norfloxacin 400 mg p.o. daily TMP-SMX DS p.o. daily

Ciprofloxacin 750 mg p.o. weekly

Urinary tract infection TMP-SMX SS half tablet p.o. daily or thrice weekly

Trimethoprim 100-300 mg p.o. daily

Ciprofloxacin 125 mg p.o. daily

Cefalexin 125-250 mg p.o. daily

Nitrofurantoin 50-100 mg p.o. daily

Norfloxacin 200 mg p.o. daily

Suppressive Therapy
Prosthetic joint infection with MSSA Cefalexin 500 mg p.o. three or four times daily

Cefadroxil 500 mg p.o. twice daily

Dicloxacillin 500 mg p.o. three to four times daily

Clindamycin 300 mg p.o. four times daily

Amoxicillin/clavulanic acid 500 mg p.o. three times daily

Prosthetic joint infection with MRSA TMP-SMX DS 1 tab p.o. twice daily Minocycline or doxycycline 100 mg p.o. twice daily

Fluoroquinolone +/- rifampin

Fusidic acid + rifampin

Cefalexin 500 mg p.o. three to four times daily

Prosthetic joint infection with beta-hemolytic streptococci and enterococci Penicillin V 500 mg p.o. two to four times daily

Amoxicillin 500 mg p.o. three times daily

Prosthetic joint infection with Gram-negative bacilli Ciprofloxacin 250-500 mg p.o. twice daily

TMP-SMX DS 1 tab p.o. twice daily

Non-Antimicrobial Properties
Acne Minocycline 100 mg p.o. daily Doxycycline, lymecycline, azithromycin, clindamycin, trimethoprim
Cystic fibrosis Azithromycin 250-500 mg p.o. daily
Inflammatory bowel disease Metronidazole 10-20 mg/kg/day

Ciprofloxacin 500 mg p.o. twice daily plus metronidazole

Rifaximin

Clarithromycin + rifabutin + clofazimine

Clofazimine

Reactive airway disease Azithromycin 250 mg p.o. daily

Azithromycin 500 mg p.o. thrice weekly

Moxifloxacin 400 mg p.o. daily for 5 days followed by pulsed every 8 weeks

Further Reading

  • Life-long antimicrobial therapy: where is the evidence? J Antimicrob Chemother. 2018;73:2601-2612. doi: 10.1093/jac/dky174
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