Pre requirements
Antibiotic treatment modalities and duration depend on the infected site and the patient’s condition.
Don’t forget to perform urine culture before starting any antibiotic treatment
Adult antibiotic & antifungal dosage & route
Paediatric antibiotic & antifungal dosage & route
African antibiotic treatment guidelines for common bacterial infections & syndromes
Procedure for managing critical microbiological results
Guidelines for women
Mild – moderate cases
- Ciprofloxacin (PO) 500mg/12h OR Ceftriaxone (IV) 1g/day
Don’t forget to adjust to urine culture results
Severe cases WITHOUT septic shock
If no known ESBL colonization and no risk factor for ESBL
View ESBL risk factors
- Ceftriaxone (IV) 1g daily OR Cefotaxime (IV) 1g 8 hourly
AND
- Amikacin (IV) 30 mg/kg daily OR Gentamicin (IV) 5 mg/kg daily (if amikacin not available)
- Aminoglycosides for 48h until urine culture results
- With PO relay on clinical improvement, depending on urine culture results
- Total antibiotic duration (IV + PO) at least 7 days, maximum 10 days
- Piperacillin-Tazobactam 12g/d in 3 doses to 16g/d in 4 doses
AND
- Amikacin (IV) 30 mg/kg daily OR Gentamicin (IV) 5 mg/kg daily (if Amikacin is not available)
IF NOT AVAILABLE
- Imipenem from 500mg/6h until 1g/8h OR Meropenem 1-2g/8h
AND
- Amikacin (IV) 30 mg/kg daily OR Gentamicin (IV) 5 mg/kg daily (if Amikacin is not available)
- Aminoglycosides for 48h, until urine culture results
- With PO relay on clinical improvement, depending on urine culture results
- Total antibiotic duration (IV + PO) at least 7 days, maximum 10 days
Severe cases WITH septic shock
If no known ESBL colonization and no risk factor for ESBL
View ESBL risk factors
Ceftriaxone (IV) 1g daily OR Cefotaxime (IV) 1 g 8 hourly
AND
Amikacin (IV) 30 mg/kg daily OR Gentamicin (IV) 5 mg/kg daily (if Amikacin is not available)
- Aminoglycosides for 48h, until urine culture results
- With PO relay on clinical improvement, depending on urine culture results
- Total antibiotic duration (IV + PO) at least 7 days, maximum 10 days
- Imipenem from 500mg/6h until 1g/8h OR Meropenem 1-2g/8h
AND
- Amikacin (IV) 30 mg/kg daily OR Gentamicin (IV) 5 mg/kg daily (if Amikacin is not available)
- Aminoglycosides for 48h, until urine culture results
- With PO relay on clinical improvement, depending on urine culture results
- Total antibiotic duration (IV + PO) at least 7 days, maximum 10 days
Adult antibiotic & antifungal dosage & route
Non ESBL-secreting Enterobacteriaceae
- Amoxicillin 1g/8h po
- Amoxicillin – clavulanic acid 1g/8h po
- Cefixime 200mg/12h po (pregnant and children)
- Ciprofloxacin 500mg/12h po
- Trimethoprim-sulfamethoxazole 800mg-160mg/12h po
ESBL-secreting Enterobacteriaceae
- Ciprofloxacin 500mg/12h po
- Trimethoprim-sulfamethoxazole 800mg-160mg/12h po
- Piperacillin-tazobactam ≤80kg: 4g/8h IV >80kg: 4g/6h
- Cefoxitin 2g/8h IV (only for Escherichia coli)
- Temocillin 2g/8h IV
- Meropenem 2g/8h IV OR Ertapenem ≤80kg: 1g/j IV >80kg: 1g/12h IV in the absence of any other alternative
Pseudomonas aeruginosa
- Ciprofloxacin 500mg/12h po
- Ceftazidime 2g/8h IV
- Cefepime 2g/8h IV
- Piperacillin-tazobactam ≤80kg: 4g/8h IV >80kg: 4g/6h
- Meropenem 2g/8h IV in the absence of any other alternative
Enterococcus spp
- Amoxicillin 2g/8h po
- Linezolide 600mg/12h po
- Vancomycin: loading dose 30 mg/kg in one hour then 30 mg/kg/24h in continuous infusion
Guidelines for men
Poorly symptomatic (without fever)
Delayed treatment then secondary treatment adapted to urine culture results
Mild to Moderate Acute Uncomplicated Prostatitis
- Ceftriaxone (IV) 2g/day OR Ciprofloxacin (PO) 500mg/12h OR Trimethoprim-sulfamethoxazole (PO) 800mg-160mg/12h
Don’t forget to adjust to urine culture results
Severe cases WITHOUT septic shock
If no known ESBL colonization and no risk factor for ESBL
View ESBL risk factors
- Ceftriaxone (IV) 2 g daily OR Cefotaxime (IV) 2 g 8 hourly
AND
- Amikacin (IV) 30 mg/kg daily OR Gentamicin (IV) 5 mg/kg daily (if Amikacin is not available)
Aminoglycosides for 48h, until urine culture results
With PO relay on clinical improvement, depending on urine culture results
Total antibiotic duration (IV + PO) 14 days
If no known ESBL colonization and no risk factor for ESBL
View ESBL risk factors
- Piperacillin-Tazobactam 12g/d in 3 doses to 16g/d in 4 doses
AND
- Amikacin (IV) 30 mg/kg daily OR Gentamicin (IV) 5 mg/kg daily (if Amikacin is not available)
IF NOT AVAILABLE
- Imipenem from 500mg/6h until 1g/8h OR Meropenem 1-2g/8h
AND
- Amikacin (IV) 30 mg/kg daily OR Gentamicin (IV) 5 mg/kg daily
Aminoglycosides for 48h, until urine culture results
With PO relay on clinical improvement, depending on urine culture results
Total antibiotic duration (IV + PO) 14 days
Severe cases WITH septic shock
If no known ESBL colonization and no risk factor for ESBL
View ESBL risk factors
- Ceftriaxone (IV) 2 g daily OR Cefotaxime (IV) 2 g 8 hourly
AND
- Amikacin (IV) 30 mg/kg daily OR Gentamicin (IV) 5 mg/kg daily (if Amikacin is not available)
Aminoglycosides for 48h, until urine culture results
With PO relay on clinical improvement, depending on urine culture results
Total antibiotic duration (IV + PO) 14 days
If no known ESBL colonization and no risk factor for ESBL
View ESBL risk factors
- Imipenem from 500mg/6h until 1g/8h OR Meropenem 1-2g/8h
AND
- Amikacin (IV) 30 mg/kg daily OR Gentamicin (IV) 5 mg/kg daily (if Amikacin is not available)
Aminoglycosides for 48h, until urine culture results
With PO relay on clinical improvement, depending on urine culture results
Total antibiotic duration (IV + PO) 14 days
Non ESBL-secreting Enterobacteriaceae
- Trimethoprim-sulfamethoxazole 800mg-160mg/12h po
- Ciprofloxacin 500mg/12h po
- Ceftriaxone (IV) 2g daily
ESBL-secreting Enterobacteriaceae
- Ciprofloxacin 500mg/12h po
- Trimethoprim-sulfamethoxazole 800mg-160mg/12h po
- Piperacillin-tazobactam ≤80kg: 4g/8h IV >80kg: 4g/6h
- Cefoxitin 2g/8h IV (only for Escherichia coli)
- Temocillin 2g/8h IV
- Meropenem (2g/8h IV) OR Ertapenem ≤80kg: 1g/j IV >80kg: 1g/12h IV in the absence of any other alternative
Pseudomonas aeruginosa
- Ciprofloxacin 500mg/12h po
- Ceftazidime 2g/8h IV
- Cefepime 2g/8h IV
- Piperacillin-tazobactam ≤80kg: 4g/8h IV >80kg: 4g/6h
- Meropenem 2g/8h IV in the absence of any other alternative
Enterococcus spp
- Amoxicillin 2g/8h po
- Linezolide 600mg/12h po
- Vancomycin: loading dose 30 mg/kg in one hour then 30 mg/kg/24h in continuous infusion