Sandbox g09
- Bacterial pericarditis
- Empiric antimicrobial therapy
- Purulent pericarditis
- Preferred regimen: Vancomycin 1 g IV q12h targeting trough levels of 1520 g/mL for 28 days AND Ciprofloxacin 400 mg IV q12h for 28 days
- Alternative regimen (1): Vancomycin 1 g IV q12h targeting trough levels of 1520 g/mL for 28 days AND Cefepime 2 g IV q12h for 28 days
- Alternative regimen (2): Vancomycin 1 g IV q12h targeting trough levels of 1520 g/mL for 1442 days AND Ceftriaxone 2 g IV q24h for 1442 days
- Specific considerations
- Purulent pericarditis with contiguous pneumonia
- Preferred regimen: Vancomycin 1 g IV q12h targeting trough levels of 1520 g/mL AND (Ceftriaxone 12 g IV q12h OR Cefotaxime 2 g IV q68h) AND (Ciprofloxacin 400 mg IV q12h OR Levofloxacin 500750 mg IV q24h)
- Purulent pericarditis with contiguous head and neck infection
- Preferred regimen: Imipenem 500 mg IV q68h OR Ampicillin-Sulbactam 3 g IV q6h
- Purulent pericarditis secondary to infective endocarditis
- Preferred regimen: Vancomycin 1520 mg/kg IV q812h targeting trough levels of 1520 g/mL AND Gentamicin 3 mg/kg/day IV q812h
- Purulent pericarditis after cardiac surgery, pediatric
- Preferred regimen: Vancomycin 15 mg/kg IV q6h targeting trough levels of 1520 g/mL AND (Ceftriaxone 100 mg/kg/day IV q1224h OR Cefotaxime 200300 mg/kg/day IV q68h) AND Gentamicin 67.5 mg/kg/day IV q8h
- Purulent pericarditis in association with genitourinary infection, pediatric
- Preferred regimen: Vancomycin 15 mg/kg IV q6h targeting trough levels of 1520 g/mL AND (Ceftriaxone 100 mg/kg/day IV q1224h OR Cefotaxime 200300 mg/kg/day IV q68h) AND Gentamicin 67.5 mg/kg/day IV q8h
- Purulent pericarditis in immunocompromised host, pediatric
- Preferred regimen: Vancomycin 15 mg/kg IV q6h targeting trough levels of 1520 g/mL AND (Ceftriaxone 100 mg/kg/day IV q1224h OR Cefotaxime 200300 mg/kg/day IV q68h) AND Gentamicin 67.5 mg/kg/day IV q8h
- Culture-directed antimicrobial therapy
- Bacterial pericarditis caused by penicillin-susceptible Streptococcus pneumoniae
- Preferred regimen: Penicillin G 524 MU/day IM/IV q46h for 1442 days OR Cefotaxime 2 g IV q68h for 1442 days OR Ciprofloxacin 400 mg IV q12h for 1442 days OR Levofloxacin 500750 mg IV q24h for 1442 days
- Bacterial pericarditis caused by penicillin-resistant Streptococcus pneumoniae
- Preferred regimen: Ciprofloxacin 400 mg IV q12h for 1442 days OR Levofloxacin 500750 mg IV q24h for 1442 days OR Vancomycin 1 g IV q12h targeting trough levels of 1520 g/mL for 1442 days
- Bacterial pericarditis caused by MSSA
- Preferred regimen: Nafcillin 12 g IV q4h for 1442 days OR Oxacillin 12 g IV q4h for 1442 days OR Cefazolin 12 g IV q48h for 1442 days OR Vancomycin 1 g IV q12h targeting trough levels of 1520 g/mL for 1442 days OR Clindamycin 600900 mg IV q8h for 1442 days
- Bacterial pericarditis caused by MRSA
- Preferred regimen: Vancomycin 1 g IV q12h targeting trough levels of 1520 g/mL for 1442 days OR Linezolid 600 mg IV q12h for 1442 days
- Bacterial pericarditis caused by Neisseria meningitidis
- Preferred regimen: Penicillin G 524 MU/day IM/IV q46h for 1442 days OR Cefotaxime 2 g IV q68h for 1442 days OR Ceftriaxone 2 g IV q24h for 1442 days
- Bacterial pericarditis caused by Gram-negative bacilli
- Preferred regimen: Ciprofloxacin 400 mg IV q12h for 1442 days OR Levofloxacin 500750 mg IV q24h for 1442 days OR Cefepime 2 g IV q12h for 1442 days
- Bacterial pericarditis caused by anaerobes
- Preferred regimen: Clindamycin 600900 mg IV q8h for 1442 days OR Metronidazole 7.5 mg/kg IV q6h for 1442 days OR Ampicillin-Sulbactam 3 g IV q6h for 1442 days
- Bacterial pericarditis caused by Mycoplasma pneumoniae
- Preferred regimen: Doxycycline 100 mg IV q12h for 1442 days OR Azithromycin 500 mg IV q24h for 1442 days
- Bacterial pericarditis caused by Legionella pneumophila
- Preferred regimen: Ciprofloxacin 400 mg IV q12h for 1442 days OR Levofloxacin 500750 mg IV q24h for 1442 days OR Azithromycin 500 mg IV q24h for 1442 days
- Viral pericarditis
- CMV pericarditis
- Preferred regimen: immunoglobulin 1 time per day 4 ml/kg on day 0, 4, and 8; 2 ml/kg on day 12 and 16.
- Coxsackie B pericarditis
- Preferred regimen: Interferon alpha or beta 2,5 Mio. IU/m2 surface area s.c. 3per week.
- Adenovirus and parvovirus B19 perimyocarditis
- Preferred regimen: Immunoglobulin 10 g intravenously at day 1 and 3 for 68 hours
- Fungal pericarditis