Treatment
Table 2. Selected Oral Antibacterial Agents with Excellent
Oral Bioavailability Commonly Used to Treat Patients
with NVO
Oral agents
a
Comments
Metronidazole 500 mg PO
tid to qid
Can be used in the intital course of NVO due to Bacteroides
sp. and other suceptible anaerobes.
Moxifloxacin 400 mg PO
daily
Is not recommended for use in patients with staphylococcal
NVO, but may be used in patients with NVO due to
Enterobacteriaceae and other susceptible aerobic Gram
negative organisms.
Linezolid 600 mg PO bid Can be used in the intital course of NVO due to oxacillin-
resistant staphylocci when first line agents cannot be used.
Levofloxacin 500-750 mg
PO daily
Is not recommended for use in patients with staphylococcal
NVO as monotherapy but may be used in patients with NVO
due to Enterobacteriaceae and other susceptible aerobic Gram-
negative organisms.
Ciprofloxacin 500-750 mg
PO bid
Is not recommended for use in patients with staphylococcal
NVO but may be used in patients with NVO due to
Enterobacteriaceae and other susceptible aerobic Gram
negative organisms including Pseudomonas aeruginosa and
Salmonella sp.
Trimethoprin/
sulfamethoxazole 1-2 DS
tab PO bid
Is not recommended for use in patients with staphylococcal
NVO but may be recommended as a second line agent in
patients with NVO due to Enterobacteriaceae and other
susceptible aerobic gram negative organisms. May need to
monitor sulfamethoxazole levels.
Clindamycin 300-450 mg
PO qid
Recommended as second line choice for sensitive
staphylococcal NVO.
Doxycycline and rifampin Mostly used in patients with brucellar NVO.
a
Dosage needs to be adjusted based on patients' renal and hepatic function. Antimicrobials should
be chosen based on in vitro susceptibility as well as patient allergies, intolerances and potential
drug interactions or contraindications to a specific antimicrobial.
