Samaritan Infectious Disease - Antibiotic Guidelines Table View

Syndrome	Primary Rx	Alternate Rx	Comments
Pharyngitis, streptococcal	Penicillin V 500 mg qid x 10d	Erythromycin Clindamycin Cephalexin	Diagnosis is based on streptococcal throat screen or culture.
Sinusitis, acute	Amoxicillin 500-1000 mg tid Azithromycin 500 mg x 1; 250 mg daily thereafter Doxycycline 100 mg bid	Amoxicillin/clavulanate 2nd gen cephalosporin Resp quinolone TMP/SMX	Symptoms should have been present for more than 7 days. Antibiotic therapy is not always indicated.
Sinusitis, chronic	Value of antibiotics is uncertain; consider ENT and/or ID consultation.
Bronchitis, acute	Antibiotics are not indicated.		This is usually viral in origin.
Otitis media, acute	Amoxicillin-- Peds 15-30 mg/kg tid Adults 500-1000 mg tid	2nd generation cephalosporin Amoxicillin/clavulanate Azithromycin Ceftriaxone	Antibiotics are not always required.
COPD, acute exacerbation	Doxycycline 100 mg po bid Amoxicillin 500-1000 mg po tid	TMP/SMX 2nd gen cephalosporin Azithromycin Respiratory quinolone	Antibiotics are not always indicated.
Pneumonia, community acquired - outpatient	Azithromycin 500 mg po daily Doxycycline 100 mg po bid	(2nd gen cephalosporin or Amoxicillin) + Azithromycin	Use respiratory quinolone if significant comorbidities present.
Pneumonia, community acquired - inpatient, non-ICU	Ceftriaxone 1-2 gm IV qd + Azithromycin 500 mg qd	Resp quinolone	Streptococcus pneumoniae, Haemophilus influenzae, "atypicals" are common causes of this syndrome.
Pneumonia, community acquired - inpatient, ICU, non-pseudomonal	(Ceftriaxone 2 gm IV qd or Amp/sulbactam 3 gm IV q6) + (Azithromycin 500 mg qd or Resp quinolone)	Resp quinolone + Aztreonam	Add Vancomycin (or linezolid) for MRSA risk

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Respiratory quinolones--Levofloxacin, Moxifloxacin
2nd generation cephalosporins--Cefuroxime, Cefpodoxime