Antibiotics by diagnosis

Bone and Joint

Open Fracture

Ancef 2g IV

PLUS

Gentamicin 300 mg (1-1.7mg/kg) IV (especially if wound is dirty)

CNS

Meningitis

Vancomycin 750mg (15mg/kg) IV

PLUS

Ceftriaxone 2g (50mg/kg) IV

ADD

Ampicillin 2g (50mg/kg) IV if concern for Listeria

ENT

Otitis Media

Amoxicillin 500mg (45mg/kg) PO Q12

OR

Augmentin 500mg (45mg/kg) PO Q12

OR

Cefdinir 600mg (14mg/kg) PO Daily

Otitis Externa

Ciprodex 3gtt Q12

OR

Polysporin otic 5gtt Q6

Pharyngitis

Bicillin 1.2 million units (25k/kg) IM

OR

Azithromycin 500mg (12mg/kg) PO Daily

Eye

Corneal Abrasion

Erythromycin ophthalmic Q6

OR

Levofloxacin 0.5% 2gtt Q2 if patient is a contact user

Orbital Cellulitis

Vancomycin 1g (15mg/kg) IV Q12

GI

Appendicitis

Zosyn 4.5g (100 mg/kg) IV Q6

OR

Flagyl 500mg (7.5mg/kg) IV Q6

PLUS

Ciprofloxacin 400mg IV Q12

Cholecystitis

Augmentin 3g IV Q6

OR

Imipenem/Cilastin 500mg IV Q6

Diverticulitis

Flagyl 500mg PO Q6

PLUS

Ciprofloxacin 750mg PO Q12

Infectious Diarrhea

Empiric: Cipro 500mg PO Q12 x3d

Giardia: Flagyl 500mg PO Q8 x5d

C. diff: Flagyl 500mg PO Q8 x14d

GU

Epididymitis

Age <35 (gonorrhea suspected)

Doxycycline 100mg PO Q12 x14d

PLUS

Cefixime 400mg PO once

Age >35 (gonorrhea not suspected)

Ciprofloxacin 500mg PO Q12 x14d

Cervicitis/Urethritis

Cefixime 400mg PO once

OR

Azithromycin 1g PO once

ADD

Flagyl 2g PO once if concern for trichomoniasis

PID

Ceftriaxone 250mg 1M once

PLUS

Doxycycline 100 mg PO Q12 x14d

UTI

Macrobid 100mg PO BID x7d

OR

Bactrim DS PO Q12 x3d

OR

Cephalexin 500mg PO Q6 x7d

Pulmonary

Pneumonia

Outpatient

Azithromycin 500mg PO, 250mg PO x3d

OR

Doxycycline 100mg PO Q12 x7d

Inpatient, Community Acquired

Ceftriaxone 1g IV

PLUS

Azithromycin 500mg IV

Inpatient, Health Care Acquired

Vancomycin 1g IV (MRSA)

PLUS

Cefepime 2g IV (Pseudomonas)

PLUS

Tobramycin 4mg/kg IV (Pseudomonas)

Skin and Soft Tissue

Cellulitis/Superficial Abscess

Bactrim DS 2tab PO Q12 x5-10d

PLUS

Cephalexin 500mg PO Q6 x5-10

OR

Clindamycin 450mg PO Q8 x5-10d

Diabetic with systemic toxicity

Vancomycin 1g IV

PLUS

Unasyn 3g IV

OR

Zosyn 3.375g IV

Immunocompromised

Neutropenic Fever

Zosyn 4.5g IV

OR

Meropenem 1g IV

PLUS/MINUS

Gentamicin 2mg/kg IV

ADD

Vancomycin 1g IV for catheter related infection, colonization with MRSA, gram-positive culture unknown susceptibility, suspected sepsis

Pediatric

See Antibiotics By Diagnosis (Peds)

Sepsis

• See Initial Antibiotics in Sepsis (Main)

See Also

• Antibiotics (Main)
• Initial Antibiotics in Sepsis

Source

• CURRENT Medical Dx & Tx
• University of Cincinnati Department of Emergency Medicine "Handbook of EM Fundamentals"