- •Abbreviations
- •1 Overview of Antimicrobial Therapy
- •Factors in Antibiotic Selection
- •Factors in Antibiotic Dosing
- •Microbiology and Susceptibility Testing
- •PK/PD and Other Considerations in Antimicrobial Therapy
- •Antibiotic Failure
- •Pitfalls in Antibiotic Prescribing
- •References and Suggested Readings
- •2 Empiric Therapy Based on Clinical Syndrome
- •Empiric Therapy of CNS Infections
- •Empiric Therapy of HEENT Infections
- •Empiric Therapy of Lower Respiratory Tract Infections
- •Empiric Therapy of GI Tract Infections
- •Empiric Therapy of Genitourinary Tract Infections
- •Empiric Therapy of Sexually Transmitted Diseases
- •Empiric Therapy of Bone and Joint Infections
- •Empiric Therapy of Skin and Soft Tissue Infections
- •Sepsis/Septic Shock
- •Febrile Neutropenia
- •Transplant Infections
- •Toxin-Mediated Infectious Diseases
- •Bioterrorist Agents
- •References and Suggested Readings
- •Gram Stain Characteristics of Isolates
- •Parasites, Fungi, Unusual Organisms in Blood
- •Parasites, Fungi, Unusual Organisms in CSF/Brain
- •Parasites, Fungi, Unusual Organisms in Lungs
- •Parasites, Fungi, Unusual Organisms in Heart
- •Parasites, Fungi, Unusual Organisms in the Liver
- •References and Suggested Readings
- •5 HIV Infection
- •HIV Infection Overview
- •Stages of HIV Infection
- •Acute (Primary) HIV Infection
- •Initial Assessment of HIV Infection
- •Indications for Treatment of HIV Infection
- •Antiretroviral Treatment
- •Treatment of Other Opportunistic Infections in HIV
- •HIV Coinfections (HBV/HCV)
- •References and Suggested Readings
- •6 Prophylaxis and Immunizations
- •Surgical Prophylaxis
- •Post-Exposure Prophylaxis
- •Chronic Medical Prophylaxis
- •Endocarditis Prophylaxis
- •Travel Prophylaxis
- •Tetanus Prophylaxis
- •Immunizations
- •References and Suggested Readings
- •Empiric Therapy of CNS Infections
- •Empiric Therapy of HEENT Infections
- •Empiric Therapy of Lower Respiratory Tract Infections
- •Empiric Therapy of Vascular Infections
- •Empiric Therapy of Gastrointestinal Infections
- •Empiric Therapy of Bone and Joint Infections
- •Empiric Therapy of Skin and Soft Tissue Infections
- •Common Pediatric Antimicrobial Drugs
- •References and Suggested Readings
- •8 Chest X-Ray Atlas
- •References and Suggested Readings
- •9 Infectious Disease Differential Diagnosis
- •11 Antimicrobial Drug Summaries
- •Appendix
- •Malaria in Adults (United States)
- •Malaria in Children (United States)
- •Index
ANTIBIOTIC ESSENTIALS
Fourteenth Edition
Edited by
Burke A. Cunha, MD, MACP
Chief, Infectious Disease Division
Winthrop-University Hospital
Mineola, New York
Professor of Medicine
State University of New York
School of Medicine
Stony Brook, New York
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Antibiotic Essentials
Fourteenth Edition: 2015
ISBN 978-93-5152-850-0
Printed at
ABOUT THE EDITOR
Burke A. Cunha, MD, MACP, is Chief, Infectious Disease Division at Winthrop-University Hospital, Mineola, New York; Professor of Medicine, State University of New York School of Medicine, Stony Brook, New York; and is one of the world’s leading authorities on infectious diseases. During his career, he has written/edited over 1250 articles, 200 book chapters, and 30 books on infectious diseases. He has received numerous teaching awards, including the Aesculapius Award for teaching excellence and the Spatz Award for clinical excellence and teaching excellence. Dr. Cunha is a Fellow of the Infectious Disease Society of America, American Academy of Microbiology, American College of Clinical Pharmacology, Surgical Infection Society, American College of Chest Physicians and Society of Hospital Epidemiologists of America. He has had a long interest in clinical syndromic diagnosis, diagnostic reasoning, antimicrobial therapy and resistance, atypical pneumonias, surgical infections, infections in compromised hosts, zoonoses, FUOs, meningitis and encephalitis, endocarditis, and nosocomial infections. Dr. Cunha is a Master of the American College of Physicians, awarded for lifetime achievement as a Master Clinician and Master Teacher of Infectious Diseases.
DEDICATION
for Marie
“Grace in her steps, Heaven in her eye,
In every gesture, dignity and love”
Milton
iv |
A n t i b i o t i c E s s e n t i a l s |
TABLE OF CONTENTS
1. OVERVIEW OF ANTIMICROBIAL |
|
THERAPY |
1 |
Factors in Antibiotic Selection.................................... |
2 |
Spectrum............................................................................ |
2 |
Tissue Penetration......................................................... |
2 |
Antibiotic Resistance................................................... |
2 |
Safety Profile..................................................................... |
4 |
Cost........................................................................................ |
4 |
Factors in Antibiotic Dosing........................................ |
4 |
Dosing in Renal/Hepatic Insufficiency............. |
5 |
Routes of Elimination (Renal and Hepatic).... |
5 |
Microbiology and Susceptibility Testing.............. |
6 |
In Vitro vs. In Vivo Susceptibility........................... |
7 |
PK/PD and Other Considerations in |
|
Antimicrobial Therapy.................................................... |
9 |
Bactericidal vs. Bacteriostatic Therapy.............. |
9 |
Monotherapy vs. Combination Therapy......... |
9 |
Intravenous vs. Oral Switch Therapy............... |
10 |
Bioavailability of Oral Antibiotics...................... |
11 |
OPAT.................................................................................... |
11 |
Duration of Therapy.................................................. |
11 |
Empiric vs. Specific Antibiotic Therapy ............. |
12 |
Positive Blood Cultures vs. Bacteremia |
|
(MSSA, MRSA, CoNS)................................................ |
13 |
Drug Fever........................................................................... |
13 |
Relative Bradycardia....................................................... |
14 |
Antibiotic Failure.............................................................. |
14 |
Pitfalls in Antibiotic Prescribing.............................. |
15 |
2. EMPIRIC THERAPY BASED ON CLINICAL |
|
SYNDROME |
17 |
CNS Infections |
|
Acute Bacterial Meningitis......................................... |
18 |
Acute Nonbacterial/Chronic Meningitis........... |
21 |
Encephalitis......................................................................... |
25 |
Brain Abscess/Subdural Empyema/ |
|
Cavernous Vein Thrombosis/Intracranial |
|
Suppurative Thrombophlebitis......................... |
27 |
HEENT Infections |
|
Facial/Periorbital Cellulitis.......................................... |
29 |
Bacterial Sinusitis............................................................. |
30 |
Keratitis.................................................................................. |
31 |
Conjunctivitis..................................................................... |
32 |
Chorioretinitis.................................................................... |
34 |
Endophthalmitis............................................................... |
35 |
External Otitis..................................................................... |
37 |
Acute Otitis Media.......................................................... |
38 |
|||
Mastoiditis............................................................................ |
|
|
|
39 |
Suppurative Parotitis..................................................... |
40 |
|||
Pharyngitis........................................................................... |
|
|
|
40 |
Thrush (Oropharyngeal Candidiasis)................... |
43 |
|||
Mouth Ulcers/Vesicles.................................................. |
44 |
|||
Deep Neck Infections, Lemierre’s |
|
|||
Syndrome, Severe Dental Infections............. |
46 |
|||
Epiglottitis............................................................................ |
|
|
|
47 |
Lower Respiratory Tract Infections |
|
|||
Acute Bacterial Exacerbation of |
|
|||
Chronic Bronchitis....................................................... |
48 |
|||
Mediastinitis........................................................................ |
|
|
49 |
|
Community-Acquired Pneumonia....................... |
49 |
|||
Zoonotic Atypical Pneumonia................................ |
60 |
|||
Lung Abscess/Empyema............................................ |
67 |
|||
Nursing Home-Acquired Pneumonia................. |
68 |
|||
Nosocomial Pneumonia............................................. |
68 |
|||
Cardiovascular Infections |
|
|||
Subacute Bacterial Endocarditis............................ |
70 |
|||
Acute Bacterial Endocarditis..................................... |
74 |
|||
Prosthetic Valve Endocarditis................................... |
76 |
|||
Pericarditis/Myocarditis............................................... |
78 |
|||
Central IV Line/Pacemaker Infections................. |
79 |
|||
Vascular Graft Infections............................................. |
82 |
|||
Gastrointestinal Tract Infections |
|
|||
Esophagitis |
.......................................................................... |
|
|
84 |
Peptic Ulcer Disease...................................................... |
85 |
|||
Gastric Perforation.......................................................... |
85 |
|||
Diarrhea/Typhoid (Enteric) Fever.............................. |
86 |
|||
Cholecystitis........................................................................ |
|
|
92 |
|
Cholangitis........................................................................... |
|
|
|
93 |
Gallbladder Wall Abscess/Perforation................ |
93 |
|||
Acute Pancreatitis............................................................ |
94 |
|||
Pancreatic Abscess/Infected Pancreatic |
|
|||
Pseudocyst ..................................................................... |
|
95 |
||
Liver Abscess...................................................................... |
|
95 |
||
Hepatosplenic Candidiasis........................................ |
96 |
|||
Granulomatous Hepatitis........................................... |
96 |
|||
Viral Hepatitis..................................................................... |
|
97 |
||
Intraabdominal or Pelvic Peritonitis/ |
|
|||
Abscess (Colitis, Appendicitis, |
|
|||
Diverticulitis, |
Septic Pelvic |
|
||
Thrombophlebitis, Spontaneous |
|
|||
Bacterial |
Peritonitis, CAPD-Associated |
|
||
Peritonitis, |
TB Peritonitis).................................... |
100 |
Table of Contents |
v |
Genitourinary Tract Infections |
|
|
Dysuria-Pyuria Syndrome........................................ |
103 |
|
Cystitis.................................................................................. |
|
103 |
Catheter-Associated Bacteriuria/Candiduria....... |
104 |
|
Epididymitis..................................................................... |
|
106 |
Acute Pyelonephritis.................................................. |
107 |
|
Chronic Pyelonephritis.............................................. |
108 |
|
Renal TB.............................................................................. |
|
108 |
Renal Abscess (Intrarenal/Perinephric)........... |
109 |
|
Prostatitis/Prostatic Abscess.................................. |
110 |
|
Urosepsis............................................................................ |
|
111 |
Pelvic Inflammatory Disease, Salpingitis, |
|
|
Tuboovarian |
Abscess, Endometritis/ |
|
Endomyometritis, Septic Abortion.............. |
113 |
|
Sexually Transmitted Diseases |
|
|
Urethritis/Cervicitis........................................................ |
114 |
|
Vaginitis/Balanitis........................................................... |
115 |
|
Genital Vesicles................................................................ |
|
116 |
Genital Ulcers.................................................................... |
|
117 |
Suppurating Inguinal Adenopathy..................... |
118 |
|
Genital/Perianal Warts................................................. |
118 |
|
Syphilis.................................................................................. |
|
119 |
Bone and Joint Infections |
|
|
Septic Arthritis/Bursitis............................................... |
121 |
|
Lyme Disease/Lyme Arthritis.................................. |
127 |
|
Infected Joint Prosthesis............................................ |
128 |
|
Osteomyelitis.................................................................... |
|
129 |
Skin and Soft Tissue Infections |
|
|
Cellulitis, Erysipelas, Mastitis.................................... |
132 |
|
Complicated Skin/Skin Structure |
|
|
Infections (cSSSIs)..................................................... |
134 |
|
Skin Ulcers........................................................................... |
|
137 |
Skin Abscesses/Infected Cysts (Skin |
|
|
Pustules/Boils, Furunculosis).............................. |
140 |
|
Skin Vesicles (Non-Genital)....................................... |
142 |
|
Wound Infections........................................................... |
144 |
|
Superficial Fungal Infections Skin/Nail............. |
147 |
|
Skin Infestations.............................................................. |
150 |
|
Ischiorectal/Perirectal Abscess............................... |
151 |
|
Sepsis/Septic Shock |
151 |
|
Febrile Neutropenia |
158 |
|
Transplant Infections |
|
|
Bacteremia.......................................................................... |
|
160 |
Candidemia........................................................................ |
|
161 |
CMV/HHV-6/BK Virus.................................................... |
162 |
|
EVB/PTLD............................................................................. |
|
163 |
RSV........................................................................................... |
|
163 |
Adenovirus......................................................................... |
|
163 |
Encephalitis/Meningitis.............................................. |
164 |
Brain Abscess/Mass Lesions..................................... |
164 |
|
Focal/Segmental Pulmonary |
|
|
Infiltrates......................................................................... |
|
165 |
Diffuse Pulmonary Infiltrates................................... |
165 |
|
Viral Hepatitis.................................................................... |
|
166 |
Toxin-Mediated Infectious Diseases |
|
|
Toxic Shock Syndrome................................................ |
|
169 |
Botulism............................................................................... |
|
170 |
Tetanus.................................................................................. |
|
170 |
Diphtheria........................................................................... |
|
170 |
Bioterrorist Agents |
|
|
Anthrax................................................................................. |
|
173 |
Tularemia Pneumonia................................................. |
|
173 |
Pneumonic Plague........................................................ |
|
174 |
Botulism............................................................................... |
|
174 |
Smallpox.............................................................................. |
|
174 |
Ebola....................................................................................... |
|
174 |
3. ANTIBIOTIC SUSCEPTIBILITY PROFILES |
|
|
AND INITIAL THERAPY |
OF ISOLATES |
|
PENDING SUSCEPTIBILITYRESULTS |
185 |
|
Antibiotic Susceptibility Profiles (Penicillins, |
|
|
Macrolides, Tetracyclines, and Others)......... |
186 |
|
Antibiotic Susceptibility Profiles |
|
|
(Cephalosporins)....................................................... |
|
191 |
Antibiotic Susceptibility Profiles |
|
|
(Aminoglycosides, Fluoroquinolones, |
|
|
Carbapenems, and Others)................................. |
198 |
|
Gram Stain Characteristics of Isolates (by |
|
|
Morphology Arrangement, |
|
|
Oxygen Requirements)......................................... |
203 |
|
Alphabetical Index of Isolates................................. |
205 |
|
Key Factors in Antibiotic Selection (Isolate |
|
|
Known)............................................................................ |
|
207 |
Antibiotic Resistance Potential.............................. |
207 |
|
Aerobic Isolates............................................................... |
|
208 |
Capnophilic Isolates...................................................... |
|
235 |
Anaerobic Isolates.......................................................... |
|
236 |
Yeast/Fungi......................................................................... |
|
242 |
Gram Stain/Giemsa Stain Technique.................. |
246 |
|
CSF Gram Stain................................................................ |
|
246 |
Sputum Gram Stain....................................................... |
|
248 |
Urine Gram Stain............................................................. |
|
248 |
Fecal Gram Stain............................................................. |
|
249 |
4. PARASITES, FUNGI, UNUSUAL |
|
|
ORGANISMS |
|
253 |
Blood Pathogens |
|
|
Microfilaria in Blood...................................................... |
|
254 |
Trypanosomes in Blood.............................................. |
|
255 |
Spirochetes in Blood.................................................... |
|
257 |
Intracellular Inclusion Bodies in Blood.............. |
258 |
vi |
A n t i b i o t i c E s s e n t i a l s |
CSF/Brain Pathogens |
|
Cysts/Mass Lesions in CSF/Brain........................... |
261 |
Lung Pathogens |
|
Pulmonary Cystic Lesions/Masses....................... |
265 |
Pulmonary Coin Lesions............................................ |
266 |
Pulmonary Infiltrates/Mass Lesions..................... |
267 |
Heart Pathogens |
|
Chagas’ Disease................................................................ |
273 |
Liver Pathogens |
|
Liver Flukes......................................................................... |
273 |
Cystic Masses in Liver................................................... |
274 |
Hepatomegaly................................................................. |
275 |
Stool/Intestines Pathogens |
|
Intestinal Protozoa......................................................... |
276 |
Intestinal Nematodes (Roundworms)............... |
278 |
Intestinal Cestodes (Tapeworms)......................... |
281 |
Intestinal Trematodes |
|
(Flukes/Flatworms)................................................... |
282 |
Other Intestinal Infections........................................ |
282 |
Skin/Muscle Pathogens |
|
Infiltrative Skin/Subcutaneous Lesions........... |
283 |
Infiltrative Skin Lesions ± Ulcers/Sinus |
|
Tracts/Abscesses...................................................... |
284 |
Skin Vesicles/Bullae...................................................... |
288 |
Subcutaneous Serpiginous Lesions.................. |
288 |
Skin Papules/Nodules/Abscesses....................... |
289 |
Rickettsia (Fever/Petechial Skin Rash).............. |
294 |
Other Skin Lesions....................................................... |
297 |
Myositis............................................................................... |
298 |
5. HIV INFECTION |
301 |
Overview .......................................................................... |
302 |
Stages of HIV Infection.............................................. |
303 |
Acute (Primary) HIV Infection................................ |
304 |
Approach to HIV Testing.......................................... |
305 |
Initial Assessment of HIV Patients............................... |
308 |
Indications for Treatment of HIV |
|
Infection........................................................................ |
312 |
Antiretroviral Treatment........................................... |
313 |
Antiretroviral Treatment Failure........................... |
316 |
Opportunistic Infections in HIV Disease......... |
319 |
Treatment of Opportunistic Infections........... |
323 |
Treatment of Other Opportunistic |
|
Infections in HIV....................................................... |
338 |
HIV Coinfections (HBV/HCV).................................. |
344 |
6. PROPHYLAXIS AND |
|
IMMUNIZATIONS |
353 |
Surgical Prophylaxis.................................................... |
354 |
Post-Exposure Prophylaxis...................................... |
358 |
Chronic Medical Prophylaxis/Suppression......... |
364 |
HIV Pre-Exposure Prophylaxis (PrEP)........................ |
365 |
HIV Post-Exposure Prophylaxis (PEP)....................... |
366 |
HIV Opportunistic Infections......................................... |
366 |
Transplant Prophylaxis........................................................ |
367 |
Endocarditis Prophylaxis.......................................... |
369 |
Travel Prophylaxis......................................................... |
371 |
Malaria Prophylaxis...................................................... |
375 |
Tetanus Prophylaxis..................................................... |
377 |
Immunizations............................................................... |
378 |
7. PEDIATRIC INFECTIOUS DISEASES |
|
AND PEDIATRIC DRUG |
|
SUMMARIES |
386 |
CNS Infections............................................................... |
387 |
HEENT Infections......................................................... |
391 |
Lower Respiratory Tract Infections................... |
396 |
Vascular Infections...................................................... |
402 |
Gastrointestinal Infections..................................... |
403 |
Bone and Joint Infections...................................... |
407 |
Skin and Soft Tissue Infections........................... |
411 |
Common Pediatric Antimicrobial Drugs........ |
414 |
8. CHEST X-RAY ATLAS |
425 |
Unilateral Focal Segmental/Lobar Infiltrate |
|
Without Effusion..................................................................... |
426 |
Unilateral Focal Segmental/Lobar |
|
Infiltrate With Effusion........................................ |
431 |
Unilateral Ill-Defined Infiltrates Without |
|
Effusion ....................................................................... |
436 |
Unilateral Ill-Defined Infiltrates With |
|
Effusion ................................................................................. |
443 |
Bilateral Infiltrates Without Effusion ............... |
448 |
Bilateral Infiltrates With Effusion ....................... |
458 |
Cavitary Infiltrates (Thick-Walled) .................... |
463 |
Cavitary Infiltrates (Thin-Walled) ...................... |
470 |
9. INFECTIOUS DISEASE DIFFERENTIAL |
|
DIAGNOSIS |
474 |
10. ANTIBIOTIC PEARLS & PITFALLS |
507 |
11. ANTIMICROBIAL DRUG SUMMARIES |
521 |
APPENDIX |
720 |
INDEX |
731 |
COLOR ATLAS OF CSF, SPUTUM, AND |
|
URINE GRAM STAINS & FUNGAL STAINS |
|
vii
|
EDITORS |
|
|
Burke A. Cunha, MD, MACP |
Cheston B. Cunha, MD |
Editor |
Associate Editor |
CONTRIBUTORS
Burke A. Cunha, MD, MACP
Chief, Infectious Disease Division Winthrop-University Hospital Mineola, New York
Professor of Medicine
State University of New York School of Medicine
Stony Brook, New York
All chapters except HIV Infection & Pediatric ID
Jeffrey Baron, PharmD
Clinical Pharmacist
Winthrop-University Hospital
Mineola, New York
HBV, HCV, and HIV Guidelines
Antimicrobial Drug Summaries
Edward J. Bottone, PhD
Professor of Medicine
Professor of Microbiology
Professor of Pathology
Mount Sinai
School of Medicine
New York, New York
Medical Microbiology; Parasites,
Fungi, Unusual Organisms
John L. Brusch, MD
Associate Chief of Medicine
Cambridge Health Alliance
Infectious Disease Service
Cambridge Health Alliance
Medical Director, Somerville Hospital
Assistant Professor of Medicine
Harvard Medical School
Boston, Massachusetts
Endocarditis: Therapy & Prophylaxis
Cheston B. Cunha, MD
Director, Antibiotic Stewardship Program
Rhode Island Hospital and The Miriam Hospital
Infectious Disease Division
Assistant Professor of Medicine
Brown University Alpert School of Medicine
Providence, Rhode Island
Infectious Disease Differential Diagnosis
Overview of Antimicrobial Therapy
Empiric Therapy Based of Clinical Syndromes
Antimicrobial Drug Summaries
Daniel Caplivski, MD
Infectious Disease Division
Assistant Professor of Medicine
Mt. Sinai School of Medicine
New York, New York
Fungal Stain Atlas
Dennis J. Cleri, MD
St. Francis Medical Center
Professor of Medicine
Seton Hall University
School of Graduate Medical Education
Trenton, New Jersey
Bioterrorism
Staci A. Fischer, MD
Director, Transplant Infectious Diseases
Rhode Island Hospital
Infectious Disease Division
Associate Professor of Medicine
Brown University Alpert School of Medicine
Providence, Rhode Island
Transplant Infections: Therapy & Prophylaxis
viii |
A n t i b i o t i c E s s e n t i a l s |
Pierce Gardner, MD
Senior Advisor, Clinical Research and Training National Institutes of Health
John E. Fogarty International Center for Advanced Study in the Health Sciences Bethesda, Maryland
Prophylaxis and Immunization
Arthur Gran, MD
Infectious Disease Division
Winthrop-University Hospital
Mineola, New York
State University of New York
School of Medicine
Stony Brook, New York
Antimicrobial Drug Summaries
Jean E. Hage, MD
Infectious Disease Division
Winthrop-University Hospital
Mineola, New York
State University of New York
School of Medicine
Stony Brook, New York
Empiric Therapy of Clinical Syndromes;
Prophylaxis & Immunization;
Parasitic & Fungi; Unusual Organisms;
Antimicrobial Drug Summaries
Mark H. Kaplan, MD
Professor of Medicine
Infectious Diseases
University of Michigan School of Medicine
Ann Arbor, Michigan
HIV Drug Summaries
Douglas S. Katz, MD
Vice Chairman, Clinical Research and Education
Director, Body CT
Winthrop-University Hospital
Mineola, New York
Professor of Clinical Radiology
State University of New York School of Medicine
Stony Brook, New York
Chest X-ray Atlas
Raymond S. Koff, MD
Clinical Professor of Medicine
University of Connecticut School of Medicine
Farmington, Connecticut
Viral Hepatitis: Therapy & Prophylaxis
Leonard R. Krilov, MD
Chief, Pediatric Infectious Disease Division
Winthrop-University Hospital
Mineola, New York
Professor of Pediatrics
State University of New York
School of Medicine
Stony Brook, New York
Pediatric Infectious Diseases
David W. Kubiak, PharmD
Infectious Disease Clinical Pharmacist
Brigham and Women’s Hospital
Boston, Massachusetts
Antiretroviral Drug Summaries
Brian R Malone, BS, MS, RPh
Director, Pharmaceutical Services
Winthrop-University Hospital
Mineola, New York
Adjunct Affiliate Professor
College of Pharmacy St. John’s University
Queens, New York
Pediatric Drug Summaries
George H. McCracken, Jr., MD
Distinguished Professor of Pediatric Infectious
Disease and the Sarah M. and Charles E. Seay
Chair in Pediatric Infectious Disease
University of Texas Southwestern Medical Center
Dallas, Texas
Pediatric Infectious Diseases
James H. McGuire, MD
Master Clinician
Division of Infectious Diseases
Brigham and Women’s Hospital
Professor of Medicine
Harvard Medical School
Boston, Massachusetts
Parasites, Fungi, Unusual Organisms
Nardeen Mickail, MD
Infectious Disease Division
Winthrop-University Hospital
Mineola, New York
State University of New York
School of Medicine, Stony Brook, New York
Antimicrobial Drug Summaries
Contributors |
ix |
Maria D. Mileno, MD
Director, Travel Medicine
The Miriam Hospital
Infectious Disease Division
Associate Professor of Medicine
Brown University Alpert School of Medicine
Providence, Rhode Island
Prophylaxis and Immunizations
Robert Moore, MD
Chairman, Department of Radiology
Stony Brook University Hospital
Professor of Radiology
State University of New York School of Medicine
Stony Brook, New York
Chest X-ray Atlas
Sigridh Muñoz-Gomez, MD
Infectious Disease Division
Winthrop-University Hospital
Mineola, New York
State University of New York
School of Medicine
Stony Brook, New York
Antimicrobial Drug Summaries
Ronald L. Nichols, MD
William Henderson Professor of Surgery
Professor of Microbiology and Immunology
Tulane University School of Medicine
New Orleans, Louisiana
Surgical Prophylaxis and Therapy
Genovefa Papanicolaou, MD
Attending Physician, Infectious Disease Service
Memorial Sloan Kettering Cancer Center
Associate Professor of Medicine
Weill Cornell Medical College
New York, New York
Transplant Infections: Therapy & Prophylaxis
Muhammed Raza, MBBS
Infectious Disease Division
Winthrop-University Hospital
Mineola, New York
State University of New York
School of Medicine
Stony Brook, New York
Antimicrobial Drug Summaries
Michael F. Rein, MD
Professor of Medicine (Emeritus)
University of Virginia Health System
Charlottesville, Virginia
Sexually Transmitted Diseases
John H. Rex, MD
Adjunct Professor of Medicine University of Texas Medical School Houston, Texas
Vice-President
Medical Director for Infection AstraZeneca Pharmaceuticals Macclesfield, UK
Antifungal Therapy
Paul E. Sax, MD
Clinical Director
Division of Infectious Diseases and HIV
Division of Infectious Diseases
Brigham and Women’s Hospital
Associate Professor of Medicine
Harvard Medical School
Boston, Massachusetts
HIV Infection
David Schlossberg, MD
Tuberculosis Control Program
Philadelphia Department of Health
Professor of Medicine
Temple University School of Medicine
Philadelphia, Pennsylvania
Tuberculosis
Paul E. Schoch, PhD
Director
Clinical Microbiology Laboratory
Winthrop-University Hospital
Mineola, New York
Medical Microbiology and Gram
Stains Atlas
Daniel S. Siegal, MD
Department of Radiology
Mount Auburn Hospital
Harvard Medical School
Boston, Massachusetts
Chest X-ray Atlas
x |
A n t i b i o t i c E s s e n t i a l s |
Stephanie Strollo, MD
Infectious Disease Division
Winthrop-University Hospital
Mineola, New York
State University of New York
School of Medicine
Stony Brook, New York
Initial Therapy of Isolates Pending
Susceptibility Testing
Uzma Syed, DO
Infectious Disease Division
Winthrop-University Hospital
Mineola, New York
State University of New York
School of Medicine
Stony Brook, New York
Initial Therapy of Isolates Pending
Susceptibility Testing
Damary C. Torres, PharmD
Clinical Pharmacy Specialist
Winthrop-University Hospital
Mineola, New York
Associate Clinical Professor
College of Pharmacy St. John’s University
Queens, New York
Antimicrobial Drug Summaries
Kenneth F. Wagner, DO
Infectious Disease Consultant
National Naval Medical Center
Associate Professor of Medicine
Uniformed Services, University of
the Health Sciences
F. Edward Hebert School of Medicine
Bethesda, Maryland
Parasites, Fungi, Unusual Organisms
xi
ACKNOWLEDGMENTS
I would like to thank the many contributors who graciously contributed their time and energy; and especially Mark Freed, MD, past President and Editor-in-Chief of Physicians’Press, for his vision, commitment, and guidance.
Burke A. Cunha, MD
NOTICE
The clinical recommendations set forth in this book are those of the authors and are offered as general guidelines, not specific instructions for individual patients. Clinical judgement should always guide the physician in the selection, dosing, and duration of antimicrobial therapy for individual patients.
Not all recommendations in this book are approved indications by the U.S. Food and Drug Administration, and antimicrobial recommendations are not limited to indications in the package insert. The use of any drug should be preceded by careful review of the package insert, which provides indications and dosing approved by the U.S. Food and Drug Administration.
The information provided in this book is essential not exhaustive, and the reader is referred to other medical references and the manufacturer’s product literature for further information. Clinical use of the information provided and any consequences that may arise from its use is the responsibility of the prescribing physician. The authors, editors, and publisher do not warrant or guarantee the information herein contained and do not assume and expressly disclaim any liability for errors or omissions or any consequences that may occur from use of this information.
BASIS OF RECOMMENDATIONS
The therapeutic recommendations in Antibiotic Essentials are based on the contributors’ clinical expertise and experience as well as the literature and clinical guidelines.
xii |
A n t i b i o t i c E s s e n t i a l s |
ABBREVIATIONS
ABE |
acute bacterial endocarditis |
ABM |
acute bacterial meningitis |
ADA |
adenosine deaminase |
AFB |
acid fast bacilli |
AIH |
autoimmune lupoid hepatitis |
AIHA |
autoimmune hemolytic anemia |
AML |
acute myelogenous leukemia |
ANA |
antinuclear antibody |
ARDS |
adult respiratory distress syndrome |
AG |
Aspergillus galactomannan |
A-V |
atrio-ventricular |
β-lactams |
penicillins, cephalosporins, |
|
cephamycins (not monobactams or |
|
carbapenems) |
BAL |
bronchoalveolar lavage |
BG |
b 1, 3 D-glucan |
BMT |
bone marrow transplant |
BPH |
benign prostatic hypertrophy |
CAB |
catheter associated bacteriuria |
CABG |
coronary artery bypass grafting |
CAC |
catheter associated candiduria |
CAH |
chronic active hepatitis |
CA-MRSA |
community-acquired MRSA |
CAP |
community-acquired pneumonia |
CD4 |
CD4 T-cell lymphocyte |
CE |
California encephalitis virus |
CFS |
chronic fatigue syndrome |
CGD |
chronic granulomatous disease |
CIE |
counter-immunoelectrophoresis |
CLL |
chronic lymphocytic leukemia |
CML |
chronic myelogenous leukemia |
CMV |
Cytomegalovirus |
CNS |
central nervous system |
CO-MRSA |
community onset MRSA |
CoNS |
coagulase negative staphylococci |
CPH |
chronic persistent hepatitis |
CPK |
creatine phosphokinase |
CrCl |
creatinine clearance |
CRE |
carbapenemase resistant |
|
Enterobacteriaceae |
CSD |
cat scratch disease |
CSF |
cerebrospinal fluid |
CT |
computerized tomography |
CVA |
costovertebral angle |
CVC |
central venous catheter |
CVID |
common variable immune deficiency |
CVVH |
continuous veno venous |
|
hemo filtration |
CXR |
chest x-ray |
DFA |
direct fluorescent antibody |
DI |
diabetes insipidus |
|
DIC |
disseminated intravascular coagulation |
|
DM |
diabetes mellitus |
|
DOT |
directly observed therapy |
|
e.g. |
for example |
|
EBV |
Ebstein-Barr virus |
|
EEE |
Eastern equine encephalitis |
|
EEG |
electroencephalogram |
|
EIA |
enzyme immunoassay |
|
ELISA |
enzyme-linked immunosorbent assay |
|
EM |
erythema migrans |
|
EMB |
ethambutol |
|
Enterobacteriaceae: Citrobacter, Edwardsiella, |
||
|
Enterobacter, E. coli, Klebsiella, |
|
|
Proteus, Providencia, Shigella, |
|
|
Salmonella, |
Serratia, Hafnia, |
|
Morganella, Yersinia |
|
ESBLs |
extended spectrum β-lactamases |
|
esp |
especially |
|
ESR |
erythrocyte sedimentation rate |
|
ESRD |
end-stage renal disease |
|
ET |
endotracheal |
|
EV |
enterovirus |
|
EVD |
external ventricular drain |
|
FTA-ABS |
fluorescent treponemal |
|
|
antibody absorption test |
|
FUO |
fever of unknown origin |
|
G6PD |
glucose-6-phosphate dehydrogenase |
|
GC |
gonococcus/gonorrhea |
|
GCA |
giant cell arteritis |
|
GI |
gastrointestinal |
|
gm |
gram |
|
GU |
genitourinary |
|
GVHD |
graft versus host disease |
|
HA-MRSA |
hospital acquired MRSA |
|
HAP |
hospital acquired pneumonia |
|
HAV |
hepatitis A virus |
|
HBcAb |
hepatitis B core antibody |
|
HBoV |
human bocavirus |
|
HBsAg |
hepatitis B surface antigen |
|
HBV |
hepatitis B virus |
|
HCV |
hepatitis C virus |
|
HD |
hemodialysis |
|
HDV |
hepatitis D virus |
|
HEV |
hepatitis E virus |
|
HFHD |
high flux hemodialysis |
|
HFV |
hepatitis F virus |
|
HFM |
hand foot mouth disease |
Abbreviations |
xiii |
HGA |
human granulocytic anaplasmosis |
HHV-6,7,8 |
human herpes virus 6,7,8 |
HME |
human monocytic ehrlichiosis |
hMPV |
human metapneumovirus |
HPS |
Hanta virus pulmonary syndrome |
HPV |
human papilloma virus |
HTLV-1 |
human T-cell leukemia virus |
HRIG |
human rabies immune globulin |
HSV |
herpes simplex virus |
I & D |
incision and drainage |
IFA |
immunofluorescent antibody |
IgA |
immunoglobulin A |
IgG |
immunoglobulin G |
IgM |
immunoglobulin M |
IM |
intramuscular |
INH |
isoniazid |
IP |
intraperitoneal |
IT |
intrathecal |
ITP |
idiopathic thrombocytopenic purpura |
IV |
intravenous |
IV/PO |
IV or PO |
IVDA |
intravenous drug abuser |
IVIG |
intravenous immunoglobulin |
JE |
Japanese encephalitis |
kg |
kilogram |
L |
liter |
LCM |
lymphocytic choriomeningitis |
LDH |
lactate dehydrogenase |
LFTs |
liver function tests |
LGV |
lymphogranuloma venereum |
MAI |
Mycobacterium avium-intracellulare |
MCD |
multicentric Castleman’s disease |
mcg |
microgram |
mcL |
microliter |
MDR |
multidrug resistant |
MDRSP |
multidrug resistant S. pneumoniae |
MERS |
middle east respiratory syndrome |
mg |
milligram |
mL |
milliliter |
MIC |
minimum inhibitory concentration |
min |
minute |
MMR |
measles, mumps, rubella |
MPD |
myeloprolifevative disorder |
MRI |
magnetic resonance imaging |
MRSA |
methicillin-resistant S. aureus |
MRSE |
methicillin-resistant S. epidermidis |
MS |
multiple sclerosis |
MSSA |
methicillin-sensitive S. aureus |
MSSE |
methicillin-sensitive S. epidermidis |
MTT |
methlytetrathiazole |
MU |
million units |
MVP |
mitral valve prolapse |
NDM |
New Delhi metallo-β-lactamase |
NHAP |
nursing home acquired pneumonia |
NNRTI |
non-nucleoside reverse |
NP |
transcriptase inhibitor |
nosocomial pneumonia |
|
NRTI |
nucleoside reverse |
|
transcriptase inhibitor |
NSAIDs |
nonsteroidal anti-inflammatory drugs |
OI |
opportunistic infection |
OPAT |
outpatient parenteral antibiotic therapy |
PAN |
polyarteritis nodosa |
PBC |
primary biliary cirrhosis |
PBS |
protected brush specimen |
PCEC |
purified chick embryo cells |
PCN |
penicillin |
PCP |
Pneumocystis (carinii) jiroveci |
|
pneumonia |
PCR |
polymerase chain reaction |
PD |
peritoneal dialysis |
PDA |
patent ductus arteriosus |
PE |
Powassan encephalitis |
PEP |
post-exposure prophylaxis |
PI |
protease inhibitor |
PID |
pelvic inflammatory disease |
PML |
progressive multifocal leukoencephalopathy |
PMN |
polymorphonuclear leucocytes |
PO |
oral |
PPD |
tuberculin skin test |
PPIs |
proton pump inhibitors |
PPNG |
penicillinase-producing N. gonorrhoeae |
PTBM |
partially treated bacterial meningitis |
PVE |
prosthetic valve endocarditis |
PVL |
Panton-Valentine leukocidin |
PZA |
pyrazinamide |
q__d |
every __ days |
q__h |
every __ hours |
q month |
once a month |
q week |
once a week |
RA |
rheumatoid arthritis |
RBC |
red blood cells |
RE |
regional ileitis (Crohn’s disease) |
RMSF |
rocky mountain spotted fever |
RSV |
respiratory syncytial virus |
RUQ |
right upper quadrant |
RVA |
rabies vaccine absorbed |
SARS |
severe acute respiratory syndrome |
SBE |
subacute bacterial endocarditis |
SCID |
severe combined immune deficiency |
SGOT/SGPT |
serum transaminases |
SLE |
systemic lupus erythematosus |
St. LE |
Saint Louis encephalitis |
SOT |
solid organ transplant |
sp. |
species |
SPB |
spontaneous bacterial peritonitis |
SPEP |
serum protein electrophoresis |
SQ |
subcutaneous |
STD |
sexually transmitted diseases |
TA |
temporal arteritis |
TAA |
teichoic acid antibody titers |
xiv |
A n t i b i o t i c E s s e n t i a l s |
TAH/BSO |
total abdominal hysterectomy/bilateral |
VA |
|
|
salpingoophorectomy |
VAP |
|
TB |
M. tuberculosis |
VCA |
|
TDF |
tenofovir disoproxil fumarate |
VEE |
|
TEE |
transesophageal echocardiogram |
||
VISA |
|||
TEN |
toxic epidermal necrolysis |
||
VLM |
|||
TID |
three times per day |
||
VP |
|||
TMP |
trimethoprim |
||
VRE |
|||
TMP–SMX |
trimethoprim-sulfamethoxazole |
||
VRSA |
|||
TPN |
total parenteral nutrition |
||
VSE |
|||
TRNG |
tetracycline-resistant N.gonorrhoeae |
||
VZV |
|||
TSS |
toxic shock syndrome |
||
WBC |
|||
TTE |
transthoracic echocardiogram |
||
WEE |
|||
TTP |
thrombotic thrombocytopenic purpura |
||
TURP |
transurethral resection of prostate |
WNE |
|
UC |
ulcerative colitis |
XMRV |
|
yrs |
|||
UTI |
urinary tract infection |
ventriculoatrial
ventilator associated pneumonia viral capsid antigen
Venezuelan equine encephalitis virus vancomycin intermediate S. aureus visceral larval migrans ventriculoperitoneal
vancomycin resistant enterococci vancomycin resistant S. aureus vancomycin-sensitive enterococci varicella zoster virus
white blood cells
western equine encephalitis west nile encephalitis
xenotropic murine leukemia related virus years