12
Treatment
Candida species
g
Lipid formulation of
amphotericin B ±
flucytosine
Fluconazole or
voriconazole
Aspergillus species Voriconazole Lipid formulation of
amphotericin B, or
posaconazole
a
Add rifampin if organism is susceptible and prosthetic material is also in place.
b
Cefotaxime or ceriaxone
c
Consider adding rifampin if the MIC to ceriaxone is >2 μg/mL.
d
Many authorities would combine moxifloxacin with either vancomycin or a third-generation
cephalosporin (cefotaxime or ceriaxone).
e
May also need to administer via the intraventricular or intrathecal route.
f
Choice of agent based in in vitro susceptibility testing ; for organisms (e.g., Enterobacter, Citrobacter,
Serratia) that may hyperproduce β-lactamases, meropenem or trimethoprim-sulfamethoxazole may
be preferred.
g
Candida kruzei should not be treated with fluconazole. Candida glabrata may be treated with
fluconazole if it is susceptible, but many isolates will be susceptible only to high doses or will be
resistant.
Table 1. Recommended Antimicrobial Therapy in Patients
with Healthcare-Associated Ventriculitis and
Meningitis Based on Isolated Pathogen and In Vitro
Susceptibility Testing (cont'd)
Microorganism Standard Therapy Alternative Therapies
Table 2. Recommended Dosages of Antimicrobial Agents in
Infants and Children, and Adults with Normal Renal
and Hepatic Function
Total Daily Dose (Dosing Interval in Hours)
Antimicrobial Agent Infants and Children Adults
Amikacin
a
22.5 mg/kg (8) 15 mg/kg (8)
Amphotericin B lipid complex 5 mg/kg (24) 5 mg/kg (24)
Ampicillin 300–400 mg/kg (6) 12 g (4)
Aztreonam 120 mg/kg (6–8) 6–8 g (6–8)
Cefepime 150 mg/kg (8) 6 g (8)
Cefotaxime 300 mg/kg (6–8) 8–12 g (4-6)
Ceazidime 200 mg/kg (8) 6 g (8)
Ceriaxone 100 mg/kg (12–24) 4 g (12)
Ciprofloxacin 30 mg/kg (8–12) 800–1200 mg (8–12)
Daptomycin
Dose not established
b
6–10 mg/kg (24)
Fluconazole 12 mg/kg (24) 400–800 mg (24)
Gentamicin
a
7.5 mg/kg (8) 5 mg/kg (8)
