Appropriate Antimicrobial Regimen
Table 3. Initial Intravenous, Adult Doses of Antibiotics for Empiric Treatment of Complicated Intra-Abdominal Infections
Antibiotic (Brand)
Ticarcillin/clavulanic acid (Timentin®
)
Carbapenems Doripenem (Doribax®
Ertapenem (Invanz®
Cephalosporins Cefazolin (Kefzol®
Imipenem/cilastatin (Primaxin® Meropenem (Merrem®
) )
Cefepime (Maxipime® Cefotaxime (Claforan® Cefoxitin (Mefoxin® Ceftazidime (Fortaz® Ceftriaxone (Rocephin® Cefuroxime (Zinacef®
Tigecycline (Tygacil® )
Fluoroquinolones Ciprofloxacin (Cipro®
Levofloxacin (Levaquin® Moxifloxacin (Avelox®
) Metronidazole (Flagyl®
, generic) )
, generic)
, generic) , generic)
, generic) , generic)
, generic) , generic) ) Adult Dosage*
β-lactam/β-lactamase inhibitor combinations Piperacillin/tazobactam (Zosyn®
3.375 g every 6 h† 3.1 g every 6 h (FDA Labeling is 200 mg/kg/day in divided doses every 6 hours for moderate infections and 300 mg/kg/day in divided doses every 4 hours for severe infections)
) )
500 mg every 8 h 1 g every 24 h 500 mg every 6 h or 1 g every 8 h 1 g every 8 h
1-2 g every 8 h 2 g every 8-12 h 1-2 g every 6-8 h 2 g every 6 h 2 g every 8 h 1-2 g every 12-24 h 1.5 g every 8 h
100 mg initial dose; 50 mg every 12 h
400 mg every 12 h 750 mg every 24 h 400 mg every 24 h
, generic) 500 mg every 8-12 h or 1500 mg every 24 h
Aminoglycosides Gentamicin, Tobramycin (generic) Amikacin (generic)
Aztreonam (Azactam® Vancomycin (generic)
) 5-7 mg/kg‡ 15-20 mg/kg‡ every 24 h§
1-2 g every 6-8 h 15-20 mg/kg¶
* Dosages are based on normal renal and hepatic function. †
every 24 h§ every 8-12 h§
‡ Initial dosing regimens for aminoglycosides should be based on adjusted body weight. §
¶ Initial dosing regimens for vancomycin should be based on total body weight.
For P. aeruginosa infections dosing may be increased to 3.375 gm q4h or 4.5 gm q6h. Serum drug concentration monitoring should be considered for dosage individualization.
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