anaerobic coverage + H.influenzae Sensitive Enterococcus strains + Listeria PCN Mouth Strep, oral anaerobes Anti-Staphylococcal: Anti-Pseudomonal: AMPICILLIN OXACILLIN / NAFCILLIN TICARCILLIN (hepatitis) (neutropenia) PIPERACILLIN MEZLOCILLIN Download the Johns Hopkins Guides app by Unbound Medicine. 100 day cough i. NOT FOR PNEUMONIA. Inappropriate initial therapy has been shown to cause increased morbidity and mortality, specifically related to Gram-negative infections (usually Pseudomonas and Acinetobacter spp. 6 Furthermore, in 1983 extended spectrum beta Bacampicillin (Spectrobid) Tazobactam is metabolised to a single metabolite, which has been found to be micro-biologically inactive. For acute appendicitis without evidence of perforation, abscess, or local peritonitis, treatment should be discontinued within 24 hours. The penicillinase-resistant organisms (nafcillin, oxacillin, cloxacillin, dicloxacillin) cover Staph (MSSA) and Strep. The penicillinase-resistant organisms (nafcillin, oxacillin, cloxacillin, dicloxacillin) cover Staph (MSSA) and Strep. . Use of other beta-lactams with CSF penetration (e.g. KEITH B. HOLTEN, M.D., and EDWARD M. ONUSKO, M.D., University of Cincinnati College of Medicine, Cincinnati, Ohio. Piperacillin, tazobactam, and desethyl piperacillin are also secreted into the bile. PIPERACILLIN I n a d d i t i o n t o a b o ve *NO COVERAGE for enterococci, listeria, MRSA . 6 Vancomycin 1 gram ivpb q12h (patient-specific dosing required) +/- antipseudomonal aminoglycoside. If an allergic reaction occurs, Zosyn should be discontinued and appropriate therapy instituted. Zosyn may cause severe cutaneous adverse reactions, such as Stevens-Johnson syndrome, toxic epidermal necrolysis, drug reaction with eosinophilia and systemic symptoms, and acute generalized exanthematous pustulosis. Select Try/Buy and follow instructions to begin your free 30-day trial. 1-3 ESBL enzymes are able to hydrolyze most of the beta-lactam antibiotics, including third-generation cephalosporins. Tenover, in Encyclopedia of Microbiology (Third Edition), 2009 Detecting Resistance to Vancomycin among Staphylococci. Antimicrobial therapy. Anaerobic coverage. Listeria is a harmful germ that can hide in many foods.Outbreaks of Listeria infections in the 1990s were primarily linked to deli meats and hot dogs. 2012;37 (8):38-41. Levaquin ( levofloxacin) and Zosyn ( piperacillin and tazobactam) are antibiotics used to treat bacterial infections. Invasive Listeria monocytogenes infections carry a high mortality despite antibiotic treatment. Academia.edu is a platform for academics to share research papers. Consider penicillin desensitization for pathogen-specific therapy in patients with severe allergies (see section on approach to patient with penicillin allergy). Many persons who take penicillins experience diarrhea, nausea, and vomiting. In this article, an infectious diseases and antimicrobial stewardship pharmacist identifies several examples of when dual beta-lactam therapy can be appropriate. In the late period of the study, appropriate antimicrobial selection (based on spectrum) was received in 71.1% of cases in the conventional group and in 92.1% and Symptoms of Listeria monocytogenes food poisoning can start the same day after eating contaminated food. Adverse maternal outcomes include postpartum infections and sepsis while adverse infant outcomes include stillbirth, premature birth, neonatal sepsis, chronic lung disease and brain injury leading to cerebral palsy and other neurodevelopmental disabilities. Viridans group streptococci should be tested for meropenem susceptibility using an MIC method. Ampicillin. Linezolid 600 mg orally or IV q12h. Listeria monocytogenes, monocytogenes meaning produces monocytes, a particular strain of Listeria has up to a 30% fatality rate in high-risk individuals. Surgical Antibiotic Prophylaxis p.19 10. Herpes simplex virus (HSV) Ampicillin + (Gentamicin or Cefotaxime) Acyclovir . The second generation penicillins are your anti-staphylococcal penicillins: methicillin, nafcillin and oxacillin. they do NOT cover MRSA, MRSE, or Listeria, H.influ, Neisseria, Pseudomonas, Enterobacter, Citrobacter, Serratia, other Proteus species and B.frag The methylthiotetrazole ring of some cephalosporins (cefamandole, cefotetan, cefmetazole, and cefoperazone) may cause severe disulfiram-like reactions; so alcohol and medications containing alcohol should be avoided. The average laboratory may find this task difficult to accomplish. Piperacillin is metabolised to a minor microbiologically active desethyl metabolite. a bacterial infection. Extended-spectrum beta-lactamases. We reviewed 13 cases of L. monocytogenes bacteremia at National Taiwan University Hospital over a 12-year period. e Increase to 3.375 g q4h or 4.5g q6h if P. aeruginosa is suspected. is aztreonam a However, some people do not have symptoms for as many as 70 days. Appropriate Prescribing of Oral Beta-Lactam Antibiotics. If a patient is very sick or immunocompromised, its OK to cover broadly for the first 1-3 days while you identify the pathogen as long as you narrow your choice as soon as possible. Listeria are not susceptible to the third generation cephalosporins (such as cefotaxime or ceftriaxone) usually given as empirical antibiotic treatment to unwell children. {{configCtrl2.info.metaDescription}} This site uses cookies. Sepsis is a substantial global health burden and is the leading cause of death among adults in intensive care units (ICUs).1 It affects more than 900,000 people annually in 2. 2. This guide does NOT apply to NICU or immunocompromised patients. Listeria possesses multiple characteristics that allow it to adapt to environmental stresses Streptococcus agalactiae or group B streptococcus (GBS)a gram-positive, -hemolytic organism in the Streptococcus genus that carries the Lancefield group B antigen. Listeria monocytogenes . Zosyn should be administered by intravenous infusion over 30 minutes. Monitoring Requirements: cover for GBS, listeria, enterococcus. For: Pseudomonas coverage. Ampicillin is an amino-penicillin and beta-lactam antibiotic that works by inhibiting the bacterial cell wall in susceptible organisms. Try the app for free! PRACTICAL USAGE OF ANTIBACTERIAL AGENTS Rema Merhi, D.O. But what does it not cover? ; Isolated from environmental sources such as water, sewerage and foodstuffs. This paper will review the activity of antimicrobials with regard to susceptibility testing and treatment of infections caused by aerobic (i.e. Authored by: Timothy P. Gauthier, Pharm.D., BCPS-AQ ID [Last updated: 17 April 2018] Has activity versus Gram positives, Gram negatives and anaerobes. Very broad antibiotics so easier to remember common bugs that it does NOT cover: MRSA, most strains of VRE, many Coag negative staph strains, Atypicals (Chlamydia, Mycoplasma, Legionella), ESBLs. Piperacillin and tazobactam are eliminated by the kidney via glomerular filtration and tubular secretion. percent] with meropenem) . Investigators have traced recent outbreaks to soft cheeses, celery, sprouts, cantaloupe, and ice cream. Be elegant. Similar to penicillin, it covers most Streptococcus species and has improved coverage of Listeria monocytogenes and Enterococcus. 6,22 Cefepime or carbapenems can be used if P. aeruginosa or resistant organisms are a concern . PGY-3 Infectious Disease University of Nevada School of Medicine Pisespong Patamasucon, M.D. aerobically growing) Gram-positive rods, without covering dosage and duration of therapy. Be smart. Ampicillin is a prescription penicillin-type antibiotic used to treat many different types of infections caused by bacteria, such as ear infections, bladder infections, pneumonia, gonorrhea, and E. coli or salmonella infection. based on piperacillin component; dalternative is 4.5 g every 8 hours since the %time>MIC is similar between the regimens for most pathogens; however should not be used for nosocomial pneumonia or if Pseudomonas aeruginosa is a suspected pathogen. Overview. Ceftazidime (3 rd gen) , Cefepime (4 th gen), Cipro, Aminoglycosides (CF patient gets >20yo get PNA with it; vs <20yo get S. aureus PNA), Carbapenems (he says they all cover but Ertapenem does not cover Pseudo), Aztreonam (monobactam), Zosyn (Piperacillin-Tazobactam) c. Pertussis (+ close contact prophylaxis). What Conditions does ZOSYN Treat? GBS are encapsulated organisms and ten antigenically distinct capsular serotypes have been described (1a, 1b, IIIX). Daptomycin 4 6 mg/kg IV once daily. Dilution tests remain the standard at present. Small Gram-positive rod, non-spore forming. This would be consistent with the potential ADR of lowering seizure-threshold with double beta-lactam therapy. IF LP MUST BE DELAYED, GET BLOOD CULTURES AND START THERAPY. Study Pharm: Cell wall synthesis inhibitors flashcards from Hoi Wan's class online, or in Brainscape's iPhone or Android app. You can cancel anytime within the 30-day trial, or continue using Johns Hopkins Guides to begin a 1-year subscription ($39.95) Grapherence [13] Aztreonam. Learn faster with spaced repetition. Am Fam Physician. The PK/PD concept p.8 6. This observational study investigated clinical features and outcome of invasive L. monocytogenes infections including the efficacy of empiric and definitive antibiotic therapies. 4. The adequacy of antimicrobial coverage was significantly different among the 3 groups. Vecuronium - enhanced and/or prolonged neuromuscular blockade which may lead to respiratory depression and paralysis. Listeria serotypes are designated by their O and H antigens.. Sero-types 1/2a, 1/2b, and 4b cause almost all human infections and serotype 4b is associated with outbreaks. A urinalysis involves checking the appearance, concentration and content of urine. Check with your doctor or nurse immediately if any of the following side effects occur while taking piperacillin / tazobactam: More common. Acute Bacterial Meningitis. Dual beta-lactam therapy can be appropriate, however instances where this is the case are relatively few and occur fairly infrequently. Chorioamnionitis is a common complication of pregnancy associated with significant maternal, perinatal, and long-term adverse outcomes. . Now, Listeria outbreaks are often linked to dairy products and produce. Vancomycin + (Gentamicin or Cefotaxime) Piperacillin-tazobactam . For example, the reason so many people use ampicillin instead of penicillin is to cover Listeria, but most people dont use an adequate dose to cover the CNS and the incidence of Listeria is far lower than the resistant forms of E. Coli.