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
9789351528500
Printed at
fm3ABOUT 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”
fm7EDITORS
Burke A. Cunha, MD, MACP
Editor
Cheston B. Cunha, MD
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 TherapyEmpiric 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
- 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 for 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
- 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 Antimicrobial 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 and Medical Director for Infection
- AstraZeneca Pharmaceuticals Macclesfield, UK
- Antifungal Therapy
- Paul E. Sax, MD
- Clinical Director, Division of Infectious Diseases and HIV Program
- 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
- 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 of Pharmacy
- 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
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.
fm12ABBREVIATIONS
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, Overview of Antimicrobial TherapyProteus, 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
HGA
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-b-lactamase
NHAP
nursing home acquired pneumonia
NNRTI
non-nucleoside reverse transcriptase inhibitor
NP
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
TAH/BSO
TB
M. tuberculosis
TDF
tenofovir disoproxil fumarate
TEE
transesophageal echocardiogram
TEN
toxic epidermal necrolysis
TID
three times per day
TMP
trimethoprim
TMP–SMX
trimethoprim-sulfamethoxazole
TPN
total parenteral nutrition
TRNG
tetracycline-resistant N.gonorrhoeae
TSS
toxic shock syndrome
TTE
transthoracic echocardiogram
TTP
thrombotic thrombocytopenic purpura
TURP
transurethral resection of prostate
UC
ulcerative colitis
UTI
urinary tract infection
VA
ventriculoatrial
VAP
ventilator associated pneumonia
VCA
viral capsid antigen
VEE
Venezuelan equine encephalitis virus
VISA
vancomycin intermediate S. aureus
VLM
visceral larval migrans
VP
ventriculoperitoneal
VRE
vancomycin resistant enterococci
VRSA
vancomycin resistant S. aureus
VSE
vancomycin-sensitive enterococci
VZV
varicella zoster virus
WBC
white blood cells
WEE
western equine encephalitis
WNE
west nile encephalitis
XMRV
xenotropic murine leukemia related virus
yrs
years