Infectious Diseases in Critical Care Medicine

Table 1

Empiric Antibiotic Selections in ICU

Abdomen

Blood

Central nervous system

Lung

Skin

Urine

Site

Peritonitis

Sepsis



shock

Bacterial meningitis

a

Posttrauma

CAP

HCAP

cSSTI

Complicated UTI

Potential pathogens

S. pneumoniaeEnterococcusEnterobacteriaceae

b

P. aeruginosa

c

S. aureusCoag (



)Staphylococcus

S. pneumoniaeE. coliP. aeruginosaOther gram (



)

S. pneumoniaeN. meningitidis

S. pneumoniaeS. aureusP. aeruginosaCoag (

)

Staphylococcus

S. pneumoniaeH. influenzaeAtypicals

S. aureusP. aeruginosaOther gram (



)

S. pneumoniae

Grp. A

Streptococcus

S. aureusC. perfringensGram (

)

Polymicrobial

EnterococcusEnterobacteriaceae

b

StaphylococcusP. aeruginosa

Piperacillin/tazobactum

$$

Add vancomycin or

linezolid forMRSA

Add clindamycin

d

for

toxin production

Carbapenems

e,f $$–$$$

Add vancomycin for

S. pneumoniae

Add vancomycin for MRSA

Add vancomycin or

linezolid forMRSA

Add clindamycin

d

for

toxin production

Fluoroquinolones

g$

Add metronidazole

unless moxi used

In combination with gram

(þ

) agent

Except

ciprofloxacin

Combination

h

Except moxifloxacin

Aminoglycosides

$

Combination

h,i

Combination

h,i

Combination

h,i

Ceftriaxone

$

Add vancomycin for

S. pneumoniae

Add azithromycin

(Continued

)

Selection of Antibiotics in Critical Care 489