Intravenous regimens | Comments | |
Cefazolin | 2 g every 8 hours | For MSSA or as a narrow-spectrum gram-negative active agent |
Ceftriaxone | 1 g every 24 hours | A narrow-spectrum gram-negative active agent |
Cefepime | 1 g every 8 hours or 2 g every 12 hours | |
Piperacillin-tazobactam | 3.375 g every 6 hours or 4.5 g every 6 hours | |
Meropenem | 1 g every 8 hours | |
Imipenem | 500 mg every 6 hours | |
Nafcillin | 2 g every 4 hours | For MSSA |
Oxacillin | 2 g every 4 hours | For MSSA |
Ciprofloxacin | 400 mg every 12 hours | |
Levofloxacin | 750 mg every 24 hours | |
Vancomycin | 20 to 35 mg/kg loading dose then 15 to 20 mg/kg every 8 to 12 hours¶ | For MRSAΔ |
Oral regimens | Comments | |
Trimethoprim-sulfamethoxazole | 1 double-strength tablet◊ every 12 hours | |
Ciprofloxacin | 500 mg every 12 hours | |
Ciprofloxacin XR | 1000 mg every 24 hours | |
Levofloxacin | 750 mg every 24 hours | |
Cefpodoxime | 200 mg every 12 hours | |
Cefixime | 400 mg every 24 hours | |
Amoxicillin | 1000 mg every 6 hours | For ampicillin-susceptible Enterococcus |
MSSA: methicillin-susceptible Staphylococcus aureus; MRSA: methicillin-resistant Staphylococcus aureus.
* This table lists antibiotic agents commonly used for renal or perinephric abscess but is not an exhaustive list. Advanced broad-spectrum agents, such as ceftazidime-avibactam, are generally reserved for patients with or at risk for infections resistant to other options.
¶ The vancomycin loading dose is based on actual body weight, rounded to the nearest 250 mg increment and not exceeding 3000 mg. Within this range, we use a higher dose for critically ill patients. Initial maintenance dose and interval are determined by nomogram and are typically 15 to 20 mg/kg every 8 to 12 hours for most patients with normal renal function. Subsequent dose and interval adjustments are based on AUC-guided (preferred) or trough-guided serum concentration monitoring. Refer to other UpToDate content for details.
Δ For alternative agents with activity against MRSA, refer to other UpToDate content on treatment of invasive MRSA infections.
◊ 160 mg trimethoprim with 800 mg sulfamethoxazole per tablet.Do you want to add Medilib to your home screen?