Unknown Infection Site

Community or Hospital Acquired, Past History of Infection with MRSA (or Intravascular Catheter in Place) and ESBL Producing Organism

 

Severity(classification)

1st line oral/iv antibiotics

Penicillin allergy
(see explanatory notes)

A/B/C

Grading not applicable

Review doses in renal impairment

MEROPENEM 1g iv tds


plus

TEICOPLANIN iv every 12 hours for 4 doses then once daily.

Dose

<50kg: 400mg

50-74kg: 600mg

75-100kg: 800mg

>100kg: 1000mg 

Maintain treatment pending pre-dose (trough) level on Day 5. Target level 15-60mg/L. (Click for dosing table)

 

 

 

 

 

Review initial therapy within 24 hrs.
If a source of infection becomes apparent use the appropriate antibiotic guideline. Modify therapy based on results of microbiological or other investigations. Discuss with microbiologist if required.

Severe penicillin allergy

AMIKACIN 15mg/kg iv od (max 1.5g od)
Only if serum creatinine <150micromol/L.
Maintain pre-dose (trough) serum level <5mg/l


plus

TEICOPLANIN iv every 12 hours for 4 doses then once daily.

Dose

<50kg: 400mg

50-74kg: 600mg

75-100kg: 800mg

>100kg: 1000mg 

Maintain treatment pending pre-dose (trough) level on Day 5. Target level 15-60mg/L. (Click for dosing table)

OR

 Review initial therapy within 24 hrs.
If a source of infection becomes apparent use the appropriate antibiotic guideline. Modify therapy based on results of microbiological or other investigations. Discuss with microbiologist if required.

 

 

if AMIKACIN is contra-indicated (see local policy):
DISCUSS WITH MICROBIOLOGIST

Last Reviewed: 18/01/17 

For guidance on the administration of intravenous antibiotics click here
(GHNHSFT intranet)