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abx_init.json
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{
"version": "3",
"ownOrgan": [
{
"id": "1",
"name": "Abdominal Wha?",
"orderid": "1",
"modified": null,
"ownInfection": [
{
"id": "1",
"title": "Intra-abdominal Infection",
"subtitle": "Uncomplicated, not healthcare associated",
"organ_id": "1",
"orderid": "1",
"modified": null,
"ownTreatment": [
{
"id": "1",
"location": "Inpatient",
"first": "Ceftriaxone 2g IV + Metronidazole 500mg",
"alt": "Ceftriaxone 2g IV + Metronidazole 500mg",
"notes": "Examples: Appendicitis, cholanigitis, cholecystitis",
"infection_id": "1",
"orderid": null,
"modified": null
}
]
},
{
"id": "2",
"title": "Intra-abdominal Infection",
"subtitle": "Healthcare associated, hemodynamically stable",
"organ_id": "1",
"orderid": "2",
"modified": null,
"ownTreatment": [
{
"id": "2",
"location": "Inpatient",
"first": "Piperacillin-tazobactam 4.5g IV every 8 hours",
"alt": "Severe PCN allergy: Levofloxacin 750mg IV\/PO + metronidazole 500mg IV\/PO",
"notes": "",
"infection_id": "2",
"orderid": null,
"modified": null
}
]
},
{
"id": "3",
"title": "Spontaneous Bacterial Peritonitis",
"subtitle": " ",
"organ_id": "1",
"orderid": "3",
"modified": null,
"ownTreatment": [
{
"id": "3",
"location": "Inpatient",
"first": "Ceftriaxone 2gm IV",
"alt": "Severe PCN allergy: Levofloxacin 750mg",
"notes": " ",
"infection_id": "3",
"orderid": null,
"modified": null
}
]
},
{
"id": "4",
"title": "Upper GI Bleed",
"subtitle": "Prophylaxis in Cirrhosis",
"organ_id": "1",
"orderid": "4",
"modified": null,
"ownTreatment": [
{
"id": "4",
"location": "Inpatient",
"first": "Ceftriaxone 1gm IV",
"alt": "Severe PCN allergy: Levofloxacin 750mg",
"notes": " ",
"infection_id": "4",
"orderid": null,
"modified": null
}
]
},
{
"id": "5",
"title": "Necrotizing Pancreatitis",
"subtitle": " ",
"organ_id": "1",
"orderid": "0",
"modified": null,
"ownTreatment": [
{
"id": "5",
"location": "ICU",
"first": "See recommendations for sepsis and septic shock depending on clinical condition.",
"alt": "Consider surgery (Barnett if possible) and consider GI (Attwell if possible) and ID consult (Haas) for co-management. All three attendings would be interested in a multidisciplinary approach to management of these patients",
"notes": " ",
"infection_id": "5",
"orderid": null,
"modified": null
}
]
}
]
},
{
"id": "2",
"name": "CNS",
"orderid": "2",
"modified": null,
"ownInfection": [
{
"id": "6",
"title": "Bacterial Meningitis",
"subtitle": " ",
"organ_id": "2",
"orderid": null,
"modified": null,
"ownTreatment": [
{
"id": "6",
"location": "Inpatient",
"first": "Ceftriaxone 2g IV + Vancomycin 30mg\/kg (max 2g) + Ampicillin 2g IV (if risk factors for Listeria)",
"alt": "Ceftriaxone 2g IV + Vancomycin 30mg\/kg (max 2g) + Bactrim 5mg\/kg\/IV (if risk for Listeria)",
"notes": "Risk factors for listeria: age >50, pregnancy, immunocompromised; If lymphocytic pleocytosis, consider viral causes and the addition of acyclovir.",
"infection_id": "6",
"orderid": "",
"modified": null
}
]
}
]
},
{
"id": "3",
"name": "HEENT",
"orderid": "3",
"modified": null,
"ownInfection": [
{
"id": "7",
"title": "Dental Infection",
"subtitle": "",
"organ_id": "3",
"orderid": "0",
"modified": null,
"ownTreatment": [
{
"id": "7",
"location": "Outpatient",
"first": "Pen VK 500 mg four times\/day for 7 days",
"alt": "Clindamycin 450 mg TID for 7 days",
"notes": "",
"infection_id": "7",
"orderid": null,
"modified": null
},
{
"id": "8",
"location": "Inpatient",
"first": "Ampicillin\/Sulbactam 3g IV every 6 hours",
"alt": "Clindamycin 600mg IV",
"notes": " ",
"infection_id": "7",
"orderid": null,
"modified": null
}
]
},
{
"id": "8",
"title": "Group A Strep Pharyngitis",
"subtitle": " ",
"organ_id": "3",
"orderid": "1",
"modified": null,
"ownTreatment": [
{
"id": "9",
"location": "Outpatient",
"first": "Pen VK 500 mg BID or 10 days OR Pen G (Bicillin-LA) 1.2 million units IM once",
"alt": "PCN allergic WITH anaphylaxis: Azithromycin 500mg PO QD x 5 days ",
"notes": "PCN allergic, no anaphylaxis: cephalexin 500mg BID x 10 days",
"infection_id": "8",
"orderid": null,
"modified": null
}
]
},
{
"id": "9",
"title": "Viral URI ",
"subtitle": " ",
"organ_id": "3",
"orderid": "2",
"modified": null,
"ownTreatment": [
{
"id": "10",
"location": "Outpatient",
"first": "symptomatic relief ",
"alt": "symptomatic relief",
"notes": "consider influenza in differential diagnosis, see influenza testing and treatment recommendations ",
"infection_id": "9",
"orderid": null,
"modified": null
}
]
},
{
"id": "10",
"title": "Sinusitis ",
"subtitle": "Mild, less than 10 days",
"organ_id": "3",
"orderid": "3",
"modified": null,
"ownTreatment": [
{
"id": "11",
"location": "Outpatient",
"first": "symptomatic relief ",
"alt": "symptomatic relief ",
"notes": "Only if no double worsening. Double worsening: defined as initial clinical improvement followed by clinical worsening",
"infection_id": "10",
"orderid": null,
"modified": null
}
]
},
{
"id": "11",
"title": "Severe Sinusitis",
"subtitle": "More than 10 days, double worsening",
"organ_id": "3",
"orderid": "4",
"modified": null,
"ownTreatment": [
{
"id": "12",
"location": "No Resistance Risk Factors",
"first": "Amoxicillin-clavulanate 875 PO BID for 5 days",
"alt": "Doxycycline 100 mg BID for 5 dats",
"notes": "Double worsening: defined as initial clinical improvement followed by clinical worsening. Risk factors for antibiotic resistance: Age less than 2 or older than 65; daycare exposure; prior antibiotics within the past month; prior hospitalization past 5 days; comorbidities; immunocompromised ",
"infection_id": "11",
"orderid": null,
"modified": null
}
]
},
{
"id": "12",
"title": "Severe Sinusitis",
"subtitle": "More than 10 days, double worsening",
"organ_id": "3",
"orderid": "5",
"modified": null,
"ownTreatment": [
{
"id": "13",
"location": "With Resistance Risk Factors",
"first": "Doxycycline 100 mg BID for 7 days",
"alt": "Levofloxacin 500mg daily for 7 days",
"notes": "see above; if hospitalized, first line is ceftriaxone 2g IV daily; Sudden onset of severe sinusitis in an uncontrolled diabetic should prompt review of risk factors for invasive fungal sinusitis. Consider consulting with ENT or Infectious Disease. ",
"infection_id": "12",
"orderid": null,
"modified": null
}
]
}
]
},
{
"id": "4",
"name": "Genitourinary",
"orderid": "4",
"modified": null,
"ownInfection": [
{
"id": "13",
"title": "Cystitis",
"subtitle": "Simple",
"organ_id": "4",
"orderid": null,
"modified": null,
"ownTreatment": [
{
"id": "14",
"location": "Simple",
"first": "Nitrofurantoin 100 mg BID for 5 days",
"alt": "Levofloxacin 250 mg daily for 3 days",
"notes": "No urine culture",
"infection_id": "13",
"orderid": null,
"modified": null
},
{
"id": "15",
"location": "Pregnancy",
"first": "Nitrofurantoin 100 mg BID for 7 days",
"alt": "Cephalexin 250 mg four times\/day for 7 days ",
"notes": "Urine culture monthly; candidate for suppressive therapy if > 2 cultures positive ",
"infection_id": "13",
"orderid": null,
"modified": null
}
]
},
{
"id": "14",
"title": "Pyelonephritis",
"subtitle": "",
"organ_id": "4",
"orderid": null,
"modified": null,
"ownTreatment": [
{
"id": "16",
"location": "Outpatient",
"first": "No Risk Factors for FQ resistance: Levofloxacin 500 mg daily for 7 days",
"alt": "Risk Factors for FQ resistance (see notes): Ceftriaxone 1gram IV\/IM daily vs gentamicin 3-5 mg\/kg IV daily (if pseudomonas risk). Adjust abx based on CandS data ",
"notes": "Risk factors are hospitalization or abx exposure >7d w\/in past year. Get urine culture; if systemic symptoms=blood culture+admit. If enterococcus a concern, call antimicrobial stewardship pager at 303-201-3342 ",
"infection_id": "14",
"orderid": null,
"modified": null
},
{
"id": "17",
"location": "Inpatient (Nonpregnant)",
"first": "Ceftriaxone 2g IV",
"alt": " ",
"notes": "Urine culture",
"infection_id": "14",
"orderid": null,
"modified": null
},
{
"id": "18",
"location": "Inpatient (Pregnant)",
"first": "Ceftriaxone 1 gram IV\/IM (1-2 doses) then cephalexin 500 mg four times\/day for 14 days; discuss with OB ",
"alt": "discuss with OB or call antimicrobial stewardshp pager at 303-201-3342 ",
"notes": "urine culture; d\/w OB follow up and need for suppressive therapy ",
"infection_id": "14",
"orderid": null,
"modified": null
}
]
},
{
"id": "15",
"title": "Cervicitis, Urethritis, Rectal",
"subtitle": " ",
"organ_id": "4",
"orderid": null,
"modified": null,
"ownTreatment": [
{
"id": "19",
"location": "No Penicillin Allergy",
"first": "Ceftriaxone 250mg IM X 1 PLUS Azithromycin 1g PO X 1 ",
"alt": "Cefixime 400mg PO X 1 PLUS doxycycline 100mg PO BID x 7 days ",
"notes": "Elevated MICs to cefixime were noted in 1.8% of specimens referred for resistance testing through the STD clinic from Jan 2010 through August 2012 ",
"infection_id": "15",
"orderid": null,
"modified": null
},
{
"id": "20",
"location": "Penicillin Allergy",
"first": "Azithromycin 2g PO X 1 ",
"alt": " ",
"notes": " ",
"infection_id": "15",
"orderid": null,
"modified": null
}
]
},
{
"id": "16",
"title": "Pelvic Inflammatory Disease",
"subtitle": " ",
"organ_id": "4",
"orderid": null,
"modified": null,
"ownTreatment": [
{
"id": "21",
"location": "Outpatient",
"first": "Ceftriaxone 250 mg IM once with doxycycline 100 mg BID x 14 days PLUS metronidazole 500mg PO BID x 14 days ",
"alt": "severe PCN allergy: call antimicrobial stewardshp pager at 303-201-3342 ",
"notes": " ",
"infection_id": "16",
"orderid": null,
"modified": null
}
]
},
{
"id": "17",
"title": "Complicated UTI",
"subtitle": "Inpatient Regimens",
"organ_id": "4",
"orderid": null,
"modified": null,
"ownTreatment": [
{
"id": "22",
"location": "Community Acquired",
"first": "Ceftriaxone 1gm IV",
"alt": "Aztreonam 2g IV",
"notes": " ",
"infection_id": "17",
"orderid": null,
"modified": null
}
]
}
]
},
{
"id": "5",
"name": "Pulmonary",
"orderid": "5",
"modified": null,
"ownInfection": [
{
"id": "18",
"title": "COPD Exacerbation",
"subtitle": "Inpatient and Outpatient",
"organ_id": "5",
"orderid": null,
"modified": null,
"ownTreatment": [
{
"id": "23",
"location": "Outpatient",
"first": "None (if mild exacerbation); for moderate exacerbations first line is Doxycycline 100mg PO BID for 5 days",
"alt": "Azithromycin 500mg X 1 then 250mg daily x 4 days ",
"notes": "Consider CXR ",
"infection_id": "18",
"orderid": null,
"modified": null
},
{
"id": "24",
"location": "Inpatient",
"first": "Azithromycin 500mg IV\/PO",
"alt": " Doxycycline 100mg PO ",
"notes": " ",
"infection_id": "18",
"orderid": null,
"modified": null
}
]
},
{
"id": "19",
"title": "Pneumonia",
"subtitle": "Inpatient and Outpatient",
"organ_id": "5",
"orderid": null,
"modified": null,
"ownTreatment": [
{
"id": "25",
"location": "Outpatient",
"first": "Doxycycline 100 mg BID for 5 days",
"alt": "Azithromycin 500 mg QD for 3 days",
"notes": " ",
"infection_id": "19",
"orderid": null,
"modified": null
},
{
"id": "26",
"location": "Inpatient, Community Acquired",
"first": "Ceftriaxone 1g IV and azithromycin 500mg IV",
"alt": "Severe PCN allergy: Levofloxacin 750mg daily (has activity against M. tuberculosis)",
"notes": " ",
"infection_id": "19",
"orderid": null,
"modified": null
},
{
"id": "27",
"location": "Inpatient, Health Care Associated",
"first": "Vancomycin 20mg\/kg IV (MAX dose 2g) + Cefepime 2g IV",
"alt": "Severe PCN allergy: Vancomycin 30mg\/kg IV + Levofloxacin 750mg IV",
"notes": " ",
"infection_id": "19",
"orderid": null,
"modified": null
}
]
},
{
"id": "20",
"title": "Empyema",
"subtitle": " ",
"organ_id": "5",
"orderid": null,
"modified": null,
"ownTreatment": [
{
"id": "28",
"location": "Inpatient",
"first": "Ampicillin\/Sulbactam 3g IV every 6 hours",
"alt": " Clindamycin 600mg IV",
"notes": " ",
"infection_id": "20",
"orderid": null,
"modified": null
}
]
}
]
},
{
"id": "6",
"name": "Skin and Soft Tissue",
"orderid": "6",
"modified": null,
"ownInfection": [
{
"id": "21",
"title": "Abscess",
"subtitle": "",
"organ_id": "6",
"orderid": null,
"modified": null,
"ownTreatment": [
{
"id": "29",
"location": "Without Cellulitis",
"first": "Drainage, no abx indicated unless risk factors present (see comments) ",
"alt": " ",
"notes": "inadequate drainage; diabetes, valvular heart disease, immunosuppressing condition or medication ",
"infection_id": "21",
"orderid": null,
"modified": null
},
{
"id": "30",
"location": "With Cellulitis",
"first": "Drainage + Bactrim DS BID for 5 days",
"alt": "Drainage + Clindamycin 450mg TID for 5 days; 2nd alternate: doxycycline 100mg PO BID for 5 days",
"notes": "IandD with culture; see footnote regarding bactrim under cellulitis with drainage ",
"infection_id": "21",
"orderid": null,
"modified": null
}
]
},
{
"id": "22",
"title": "Bites",
"subtitle": "Dog, Cat, or Human",
"organ_id": "6",
"orderid": null,
"modified": null,
"ownTreatment": [
{
"id": "31",
"location": "Outpatient",
"first": "Augmentin 875 mg BID for 3-5 days (prophylaxis) or 7 days (treatment)",
"alt": "Clindamycin 300-450mg mg TID + Levofloxacin 500mg daily for 7 days",
"notes": "high risk for deep infection in which antibiotic prophylaxis\/treatment would be warranted: obvious cellulitis, deep puncture wound, over bone\/joint, decreased lymphatic supply, immunocompromised, DM ",
"infection_id": "22",
"orderid": null,
"modified": null
}
]
},
{
"id": "23",
"title": "Cellulitis",
"subtitle": "Inpatient and Outpatient",
"organ_id": "6",
"orderid": null,
"modified": null,
"ownTreatment": [
{
"id": "32",
"location": "Outpatient, no Purulence",
"first": "Cephalexin 1g PO TID for 5 days",
"alt": "Doxycycline 100 mg BID x 5 days OR clindamycin 450mg PO TID for 5 days",
"notes": " ",
"infection_id": "23",
"orderid": "0",
"modified": null
},
{
"id": "33",
"location": "Outpatient, with Purulence",
"first": "Bactrim DS 1-2 tabs PO BID for 5 days",
"alt": "Doxycycline 100 mg BID x 5 days OR clindamycin 450mg PO TID x 5 days ",
"notes": "*Caution should be used in patients with reduced renal function or on other medications known to increase potassium levels, life threatening cases of hyperkalemia have been reported ",
"infection_id": "23",
"orderid": "1",
"modified": null
},
{
"id": "34",
"location": "Inpatient, no Purulence",
"first": "Cefazolin 2g IV",
"alt": "Severe PCN allergy: Vancomycin 20mg\/kg IV X 1 (max dose 2g)",
"notes": " ",
"infection_id": "23",
"orderid": "2",
"modified": null
},
{
"id": "35",
"location": "Inpatient, with Purulence",
"first": "Vancomycin 20mg\/kg IV X 1 (max dose 2g)",
"alt": "Bactrim DS BID x 5 days",
"notes": " ",
"infection_id": "23",
"orderid": "3",
"modified": null
}
]
},
{
"id": "24",
"title": "Diabetic Foot",
"subtitle": "Inpatient and Outpatient",
"organ_id": "6",
"orderid": null,
"modified": null,
"ownTreatment": [
{
"id": "36",
"location": "Outpatient, no Cellulitis",
"first": "avoid antibiotics unless systemically ill ",
"alt": " ",
"notes": "call podiatry for additional management or book in podiatry ID clinic, most patients would benefit from optimization of wound care and close follow up ",
"infection_id": "24",
"orderid": null,
"modified": null
},
{
"id": "37",
"location": "Outpatient, with Cellulitis",
"first": "Clindamycin 450mg PO TID for 7 days",
"alt": "Bactrim DS 2 tabs PO BID for 7 dyas",
"notes": "*Caution should be used in patients with reduced renal function or on other medications known to increase potassium levels, life threatening cases of hyperkalemia have been reported ",
"infection_id": "24",
"orderid": null,
"modified": null
},
{
"id": "38",
"location": "Inpatient, no Cellulitis",
"first": "avoid antibiotics unless systemically ill, call ortho-ID for additional management",
"alt": " ",
"notes": " ",
"infection_id": "24",
"orderid": null,
"modified": null
},
{
"id": "39",
"location": "Inpatient, with Cellulitis",
"first": "Vancomycin 20mg\/kg IV X 1 (max dose 2g)",
"alt": " ",
"notes": " ",
"infection_id": "24",
"orderid": null,
"modified": null
}
]
}
]
},
{
"id": "7",
"name": "Neutropenia",
"orderid": "7",
"modified": null,
"ownInfection": [
{
"id": "25",
"title": "Febrile Neutropenia",
"subtitle": " ",
"organ_id": "7",
"orderid": null,
"modified": null,
"ownTreatment": [
{
"id": "40",
"location": "Inpatient",
"first": "Cefepime 2g IV",
"alt": "Severe PCN allergy: Aztreonam 2g IV Add Vancomycin if line infection suspected",
"notes": " ",
"infection_id": "25",
"orderid": null,
"modified": null
}
]
}
]
}
]
}