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Template:Ludwig's Antibiotics
From WikEM
- Must cover typical polymicrobial oral flora and tailored based on patient's immune status
- Most commonly a 3rd generation cehpalosporin + (clindamycin or metronidazole)
- If the patient is immuncompromised, the antibiotics need to also cover MRSA and gram-negative rods[1]
Immunocompetent Host[2]
- Ampicillin/Sulbactam 3g (50mg/kg) IV q6 hrs OR
- Penicillin G 2-4 MU IV q6 hrs + Metronidazole 500 mg IV q6 hrs OR
- Clindamycin 600 mg IV q6 hrs (option for those allergic to penicillin)
Immunocompromised[3]
- Cefepime 2 g IV q12 hrs + Metronidazole 500 mg IV q6 hrs OR
- Meropenem 1 g IV q8 hrs OR
- Imipenem/Cilastatin 500mg (20mg/kg) IV q6 hours
- Piperacillin-tazobactam 4.5g (80mg/kg) IV q6 hours
- Add Vancomycin 15-20 mg/kg q8 hrs (max 2 g per dose) if concern for MRSA risk factors
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