Brain abscess | Mixed anaerobes, pneumococci, streptococci | Ceftriaxone, 2 g intravenously every 12 hours plus metronidazole, 500 mg orally every 8 hours plus vancomycin, 15 mg/kg intravenously every 8 hours |
Endocarditis, acute (including injection drug user) | S aureus, E faecalis, viridans streptococci | Vancomycin, 15 mg/kg/dose intravenously every 12 hours |
Fever in neutropenic patient receiving cancer chemotherapy | S aureus, Pseudomonas, Klebsiella, E coli | Cefepime, 2 g intravenously every 8 hours |
Intra-abdominal sepsis (eg, postoperative, peritonitis, cholecystitis) | Gram-negative bacteria, Bacteroides, anaerobic bacteria, enterococcus | Piperacillin-tazobactam, 4.5 g intravenously every 6–8 hours, or ertapenem, 1 g every 24 hours |
Meningitis, bacterial, age > 50, community-acquired | Pneumococcus, meningococcus, Listeria monocytogenes,1 gram-negative bacilli, group B streptococcus | Ampicillin, 2 g intravenously every 4 hours, plus ceftriaxone, 2 g intravenously every 12 hours, plus vancomycin, 15 mg/kg intravenously every 8 hours |
Meningitis, bacterial, community-acquired | Streptococcus pneumoniae (pneumococcus),2 Neisseria meningitidis (meningococcus) | Ceftriaxone, 2 g intravenously every 12 hours,1 plus vancomycin, 15 mg/kg intravenously every 8 hours |
Meningitis, postoperative (or posttraumatic) | S aureus, gram-negative bacilli, coagulase-negative staphylococci, diphtheroids (eg, Propionibacterium acnes) (uncommon) pneumococcus (in posttraumatic) | Vancomycin, 15 mg/kg intravenously every 8 hours, plus cefepime, 3 g intravenously every 8 hours3 |
Osteomyelitis | S aureus, secondarily gram-negative aerobes | Vancomycin 15 mg/kg intravenously every 8 hours plus ceftriaxone 2 g intravenously every 24 hours |
Pneumonia, acute, community-acquired, non-ICU hospital admission | Pneumococci, M pneumoniae, Legionella, C pneumoniae | Ceftriaxone, 1 g intravenously every 24 hours or ampicillin-sulbactam 1.5–3 g intravenously every 6 hours) plus azithromycin, 500 mg intravenously every 24 hours; or a respiratory fluoroquinolone4 alone |
Pneumonia, postoperative or nosocomial | S aureus, mixed anaerobes, gram-negative bacilli | Cefepime, 2 g intravenously every 8 hours; or ceftazidime, 2 g intravenously every 8 hours; or piperacillin-tazobactam, 4.5 g intravenously every 6–8 hours; or imipenem, 500 mg intravenously every 6 hours; or meropenem, 1 g intravenously every 8 hours plus tobramycin, 5–7 mg/kg intravenously every 24 hours; or ciprofloxacin, 400 mg intravenously every 12 hours; or levofloxacin, 500 mg intravenously every 24 hours plus vancomycin, 15 mg/kg/dose intravenously every 12 hours |
Pyelonephritis with flank pain and fever (recurrent urinary tract infection) | E coli, Klebsiella, Enterobacter, Pseudomonas | Ceftriaxone, 1 g intravenously every 24 hours; or if culture results confirm susceptibility, ciprofloxacin, 400 mg intravenously every 12 hours (500 mg orally); or levofloxacin, 500 mg once daily (intravenously/orally) |
Septic arthritis | S aureus, N gonorrhoeae | Ceftriaxone, 1–2 g intravenously every 24 hours |
Septic thrombophlebitis (eg, IV tubing, IV shunts) | S aureus, gram-negative aerobic bacteria | Vancomycin, 15 mg/kg/dose intravenously every 12 hours, plus ceftriaxone, 1 g intravenously every 24 hours |