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Guide to ANTIMICROBIALS

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Guide to ANTIMICROBIALS Guide to ANTIMICROBIALS San Francisco VA Medical Center (SFVAMC) 2021 Edition 1 Guide to Antimicrobials 2021 Theora Canonica, Pharm.D. Harry Lampiris, M.D. Jennifer Mulliken, M.D. Mai Vu, Pharm.D. Drug Category may be changed from time to time. Please consult the hospital computer for current classification. Category I agents are available without prior approval although some restrictions may apply. Category II agents are restricted and require approval prior to use. To obtain approval for a Category II agent, Current antimicrobial sensitivity patterns and SFVAMC Guidelines for Antimicrobial Use in Adults available on the Antibiotic Stewardship Program page on SharePoint: https://dvagov.sharepoint.com/sites/SFC/ic/SitePages/AntibioticStewardship.aspx Acknowledgments: Thanks to past and current staff of the Pharmacy Service and Infectious Diseases Section for preparing, compiling, and reviewing the materials contained in this pamphlet. This edition of the SFVA Guide to Antimicrobials is dedicated to Daniel Maddix, Pharm.D. This material has been endorsed by the San Francisco VA Medical Center Infectious Diseases Section and represents recommended Medical Center policy. 2 Table of Contents Resources ....................................................................................................................................................... 5 Phone/Pager Numbers .................................................................................................................................. 5 Antibiogram: Non-Urine Isolates .................................................................................................................. 6 Antibiogram: Urine Isolates .......................................................................................................................... 7 San Francisco VA Medical Center Guidelines for the Use of Antimicrobial Agents in the Prevention of Bacterial Infection in Cirrhotic Patients ........................................................................................................ 8 San Francisco VA Medical Center Guidelines for the Empiric Therapy of Community Acquired Pneumonia and Urinary Tract Infections ...................................................................................................... 9 San Francisco VA Medical Center Guidelines for the Empiric Therapy of Hospital Acquired and Ventilator Associated Pneumonia ............................................................................................................... 10 San Francisco VA Medical Center Guidelines for the Treatment of Diarrhea ........................................... 11 Associated with Clostridioides difficile Infection (CDI) ............................................................................... 11 San Francisco VA Medical Center Beta-Lactam Test Dosing Protocol ....................................................... 13 San Francisco VA Medical Center Beta-Lactam Cross Reactivity Table ..................................................... 16 San Francisco VA Medical Center Guidelines for the Empiric Therapy of Purulent Skin and Soft Tissue Infections (SSTI) ........................................................................................................................................... 17 San Francisco VA Medical Center Guidelines for the Empiric Therapy of Non- Purulent Skin and Soft Tissue Infections (SSTI) ................................................................................................................................ 18 San Francisco VA Medical Center Guidelines for the Empiric Therapy of Recurrent Skin and Soft Tissue Infections (SSTI) ........................................................................................................................................... 19 San Francisco VA Medical Center Antibiotic Dosing for Skin and Soft Tissue Infections .......................... 20 San Francisco VA Medical Center Guidelines for Procalcitonin Use .......................................................... 21 ACYCLOVIR ................................................................................................................................................... 23 AMOXICILLIN/CLAVULANIC ACID (AUGMENTIN®) ..................................................................................... 24 AZTREONAM ................................................................................................................................................ 25 CEFAZOLIN .................................................................................................................................................... 26 CEFEPIME ..................................................................................................................................................... 27 CEFTRIAXONE ............................................................................................................................................... 28 CIPROFLOXACIN ........................................................................................................................................... 29 CLINDAMYCIN .............................................................................................................................................. 30 DAPSONE ...................................................................................................................................................... 31 DAPTOMYCIN ............................................................................................................................................... 32 ERTAPENEM ................................................................................................................................................. 33 FLUCONAZOLE .............................................................................................................................................. 34 FOSFOMYCIN (PO) ....................................................................................................................................... 36 3 GANCICLOVIR ............................................................................................................................................... 37 GENTAMICIN/TOBRAMYCIN ....................................................................................................................... 38 ISONIAZID ..................................................................................................................................................... 39 LEVOFLOXACIN ............................................................................................................................................. 40 LINEZOLID ..................................................................................................................................................... 41 MEROPENEM ............................................................................................................................................... 42 METRONIDAZOLE ......................................................................................................................................... 43 MICAFUNGIN SODIUM ................................................................................................................................ 44 NAFCILLIN ..................................................................................................................................................... 45 NITROFURANTOIN ....................................................................................................................................... 46 OSELTAMIVIR ............................................................................................................................................... 47 PIPERACILLIN/TAZOBACTAM (ZOSYN) ........................................................................................................ 48 POSACONAZOLE ........................................................................................................................................... 49 RIFABUTIN .................................................................................................................................................... 51 RIFAMPIN ..................................................................................................................................................... 53 VANCOMYCIN .............................................................................................................................................. 57 VORICONAZOLE ........................................................................................................................................... 59 San Francisco VA Medical Center Antiretroviral Agent Dosing Guidelines ............................................... 61 Nucleoside/tide Reverse Transcriptase Inhibitors (NRTIs) .................................................................... 61 NRTI Co-Formulations .............................................................................................................................. 64 Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs) .................................................................. 65 Fixed-dose Combinations Containing NRTI Pair Plus NNRTI .................................................................. 69 Protease Inhibitors (PI) ............................................................................................................................ 71 Fixed-Dose Combinations
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