Empirical antibiotic policy for secondary care 2009—Northern Health and Social Care Trust
| Infection| | First-line antibiotic therapy | Penicillin allergy |
|---|---|---|
| UTI moderate | Co-amoxiclav intravenous 1.2 g three times a day | Teicoplanin intravenous 600 mg twice daily ×3 doses then once daily as per serum levels+gentamicin intravenous 5mg/kg once daily OR aztreonam intravenous 1–2 g three times a day |
| UTI severe | Piperacillin/tazobactam intravenous 4.5 g three times a day | Teicoplanin intravenous 600 mg twice daily ×3 doses then once daily as per serum levels+gentamicin OR aztreonam intravenous 1–2 g three times a day |
| UTI pregnancy | Co-amoxiclav intravenous 1.2 g three times a day | Gentamicin |
| UTI Catheter associated with systemic sepsis | Piperacillin/tazobactam intravenous 4.5 g three times a day | Teicoplanin intravenous 600 mg twice daily ×3 doses then once daily as per serum levels+gentamicin intravenous 5mg/kg once daily OR aztreonam intravenous 1–2 g three times a day |
| COPD—infective exacerbation (not pneumonia) | Clarithromycin oral/intravenous 500 mg twice daily OR doxycycline oral 200 mg once daily for 48 h then 100 mg once daily | |
| CAP CURB-65 0-1 | Amoxicillin oral 500 mg–1 g three times a day | Clarithromycin oral 500 mg twice daily OR doxycycline oral 200 mg once daily for 48 h then 100 mg once daily |
| CAP CURB-65 2 | Amoxicillin oral 500 mg–1 g three times a day | Clarithromycin oral 500 mg twice daily OR doxycycline oral 200 mg once daily for 48 h then 100 mg once daily |
| CAP CURB-65 3 | Amoxicillin intravenous 1 g three times a day +clarithromycin intravenous 500 mg twice daily | Teicoplanin intravenous 600 mg twice daily ×3 doses then once daily as per serum levels+clarithromycin intravenous 500 mg twice daily |
| CAP CURB-65 4-5 | Co-amoxiclav intravenous 1.2 g three times a day+clarithromycin intravenous 500 mg twice daily | Discuss with microbiology |
| Aspiration pneumonia community acquired | Amoxicillin intravenous 500 mg–1 g three times a day+metronidazole intravenous 500 mg three times a day | Clarithromycin intravenous 500 mg twice daily+metronidazole intravenous 500 mg three times a day |
| HAP—Mild/moderate | Co-amoxiclav intravenous 1.2 g three times a day | Teicoplanin intravenous 600 mg twice daily×3 doses then once daily as per serum levels+aztreonam intravenous 1–2 g three times a day+metronidazole intravenous 500 mg three times a day |
| HAP—Severe | Piperacillin/tazobactam intravenous 4.5 g three times a day | Teicoplanin intravenous 600 mg twice daily×3 doses then once daily as per serum levels+aztreonam intravenous 1–2 g three times a day+metronidazole intravenous 500 mg three times a day |
CAP, community-acquired pneumonia; COPD, chronic obstructive pulmonary disease; HAP, hospital acquired pneumonia; UTI, urinary tract infections.