Some IV to PO conversions are easy (linezolid, azithromycin), but some require more thought. If a provider wants some IV to PO suggestions, the following are some to consider. These choices can be more complex than a 1:1 conversion (for example, ceftriaxone IV to PO conversion for a UTI will likely be different than for […]
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Vancomycin Tips
Vancomycin 2020 Dosing Guidelines ASHP To Load or Not Load The 2020 vancomycin dosing guidelines offer these guidelines for loading doses: Why Do We Use AUC “Bayesian” Dosing? Although vancomycin historically has been classified as a concentration-dependent antibiotic. In more recent years, it has been classified as “exposure” or “AUC-dependent.” What this means is that […]
The Hitchhiker’s Guide To Antimicrobials
This is a resource that I used to update quite frequently and give to students, but I kind of forgot about it until a past student asked me if I still had it. I updated it this week because it was a pretty handy resource, but it was kind of out of date. You can […]
Degradation Properties of Beta-Lactamases
This may look better in PDF Form. I have a whole section on resistance too. *These are basics, it’s a little more complicated in some cases.Grey is degraded, lighter grey is possible.
Extended Infusions: What’s Up With That?
Extended infusions (and continuous infusions) are all the rage and Bling-3 just made them seem even better. Why do they work for some drugs and not others? First, we have to look at the pharmacokinetics of the drugs. Beta-lactams are the most common drugs given by extended or continuous infusion. Beta-lactams are most effective when […]
Infections in Immunocompromised Patients
Typically, these regimens are tailored to these complex patients and guidelines serve as a starting point. Practitioners must consider current meds, immunosuppression, and individual patient risks. These practices also vary by site and individual practitioner. Kedia, S., Acharya, P.S., Mohammad, F., Nguyen, H., Asti, D., Mehta, S., Pant, M., & Mobarakai, N. (2013). Infectious Complications […]
Suggested Durations of Therapy
For a given clinical infection: Type of Infection Site Diagnosis Duration of Therapy Comments Bacteremia Gram-negative (GNB) bacteremia with removable focus (no endocarditis) 7-14 days Equal efficacy in 3 RCT Bone Osteomyelitis, adult, acute 42-56 days In patients with uncomplicated vertebral osteomyelitis, 6 weeks as efficacious as 12 weeks (Lancet 2015;385:875) Osteomyelitis, adult, chronic […]
Kinetics
Antimicrobial Resistance
Microbes have a variety of mechanisms for resisting antimicrobials. Some mechanisms are intrinsic (naturally produced by the organism), some are induced by certain conditions or drugs, some are genetically acquired mutations, and others can be passed from organism to organism. The last two mechanisms are one reason why preventing the formation of resistant organisms is […]
Diabetic Foot Infections – PEDIS Grades and Treatments
IDSA Diabetic Foot Guidelines Grade Infection Severity Clinical Manifestations Treatment Location Treatment 1 Uninfected Wound without purulence or inflammation Outpatient Topical antibiotics 2 Mild >2:purlence or erythema, pain, tenderness, warmth, or induration, cellulitis <2cm around ulcer; infection limited to skin/subQ tissue, no complications Mostly Outpatient—Oral 1. Cephalexin 500 mg PO every 6 hours2. Trimethoprim/sulfamethoxazole 2 160 -800 […]