University of Pennsylvania Medical
Center Guidelines for Antimicrobial Therapy
Click on Our Bug for HUP/UPPMC Antimicrobial Susceptibility Data (updated 3/15/08)
TABLE OF CONTENTS
New Postings
Updated IDSA guidelines for:
Updated CDC/NIH guidelines for:
ACIP Guidelines for Immunization Ages 0-18 years (1/08)
Antiinfectives on Our Formulary
Commonly
Used Formulary Antiinfectives and Restriction Categories
Formulary
Antimicrobial Costs
Drotrecogin
Alfa (Xigris) information and approval (UPHS
only)
Clinical Microbiology Laboratory
Antimicrobial Susceptibilities at UPHS
HUP Antimicrobial
Susceptibility Profiles for 2007 Jan-Dec
Presbyterian
Medical Center Susceptibility Profiles for 2007 Jan-Dec
Antimicrobial Susceptibility Testing and Interpretation & Drug Resistance
Antimicrobial Susceptibility of Rapidly Growing Mycobacteria
How
to Interpret Susceptibility Results - What "S", "I", and "R" Means
and How Testing is Performed
British Society for Antimicrobial Chemotherapy Guidelines for Antimicrobial Susceptibility Testing including great updated (March 04) phenotypic tables by David Livermore (offsite link)
Drug Resistance Mechanisms and Prevalence
Problem bacteria at HUP (UPHS only) Gram Stains - Method, Interpretation, and Atlas
All
About Gram Stains and Gram Staining - Includes a Gram Stain Atlas
New
Gram Stain Atlas Specimen Collection
Alphabetical guide to laboratory specimen collection for all types of laboratory tests at UPHS (UPHS only)
Guide to Specimen Collection for Biowarfare Agents(UPHS only)
Mumps testing guidelines from CDC (4/06) Problem Sets
Teaching problem sets and lectures (UPHS only) HIV Testing
HIV antibody testing methods used at HUP Laboratory Administration
Laboratory Errrors and Patient Safety Newsletter Bacterial Taxonomy
Professor
Euzeéby
Deutsche
Sammlung von Mikroorganismen und Zellkulturen
UPHS Guidelines
for Antimicrobial Therapy
Bone
and Joint Infections
Central
Nervous System Infections
Ear,
Nose and Throat Infections
Endocarditis(link
to 2005 AHA Guidelines)
Gastrointestinal
Infections
Genitourinary
Tract Infections
Group B Streptococcal Perinatal
Prophylaxis
Liver transplantation antimicrobial prophylaxis
Neutropenia
and Fever
Ocular
Infections
HIV-Opportunistic
Infections
Pulmonary
Infections
Renal transplantation antimicrobial prophylaxis
Sepsis
Skin
and Soft Tissue Infections
UPHS Guidelines for Infection Control
Infection
Control Isolation System
Discontinuing
Isolation
Guidelines
for Blood Culture Collection
Tuberculosis
Guidelines
UPHS Guidelines for Antimicrobial Prophylaxis
Guidelines
for Surgical Wound Prophylaxis
Antimicrobial
Prophylaxis for Prevention of Bacterial Endocarditis(Link to the 2007 AHA
Guidelines)
UPHS Drug Dosing and Administration Guidelines
Vancomycin
Use and Dosing Guidelines (now includes calculator)
Aminoglycoside
Dosing Guidelines (now includes calculator)
Once-daily Tobramycin
Dosing in Cystic Fibrosis Patients
Recommendations
for the Administration and Dosing of Amphotericin B deoxycholate
Recommendations
for Chloramphenicol Dosing
Antimicrobial
Dosing in Renal Impairment
Voriconazole Usage Guidelines
Amphotericin B Liposomal (Ambisome)
Usage Guidelines
Tigecycline Usage Guidelines
Posaconazole Usage Guidelines
Non-UPHS Guidelines and
Information
Endocarditis and Endovascular Infections
Endocarditis Diagnosis and Management
AHA Diagnosis
and Management of Infectious Endocarditis -1998 (link to
AHA
web page or link to
offsite pdf file 168kb)
AHA Infective Endocarditis (2005, offsite link) Endocarditis Prophylaxis
AHA Endocarditis Prophylaxis Guidelines - April 2007 (pdf, 602 kb, off site link)
BSAC Endocarditis Guidelines -2004 (PubMed abstract) or off site pdf (
125 kb)
BSAC Endocarditis Prophylaxis Guidelines - 2006 off site pdf (103 kb)
Modified
Duke Criteria for Endocarditis Nonvalvular Device Infections and Prophylaxis
AHA Nonvalvular Cardiovascular Device-Related
Infections -2003 (link to AHA
web page or link to offsite
AHA pdf file) -access may require subscription
Guidelines
for the Management of Intravascular
Catheter–Related Infections (319 kb, pdf) 2001 by the Infectious Diseases Society of
America
Guidelines For The Prevention Of Intravascular
Catheter-Related Infections (August 2002; CDC, IDSA, SHEA, et
al) (pdf
file 340 kb) or link to CDC
html file
Fungal Infections
Introduction
to Antifungal Drugs (pdf, 33 kb), ©2000 by the Infectious Diseases Society of
America
Guidelines
for Treatment of Fungal Infections (pdf, 57 kb), ©2000 by
the Infectious Diseases Society of America
Treatment of Aspergillosis (pdf, 483 kb), ©2008
by the Infectious Diseases Society of America
Management
of Patients with Blastomycosis (pdf, 56 kb), ©2000 by
the Infectious Diseases Society of America
Treatment
of Candidiasis (pdf, 281 kb), ©2003 by the Infectious Diseases Society of
America
Treatment
of Coccidiodomycosis (pdf, 98 kb), ©2005 by the Infectious Diseases Society of
America
Management
of Cryptococcal Disease (pdf, 84 kb), ©2000 by
the Infectious Diseases Society of America
Management
of Patients with Histoplasmosis (pdf, 172 kb), ©2007 by
the Infectious Diseases Society of America
Management
of Patients with Sporotrichosis (pdf, 120 kb), ©2007 by
the Infectious Diseases Society of America
Dr. Fungus-
A website with extensive information on fungi
Gastrointestinal Tract Infections
Diagnosis and Management of Foodborne Illnesses - CDC RR-4,
Apr 2004 (offsite
html or onsite pdf
368kb)
Practice
Guidelines for the Management of Infectious Diarrhea -IDSA Jan
2001 (pdf
284 kb), 2001 by the Infectious Diseases Society of America
Intraabdominal Infections
Guidelines
for the selection of anti-infective agents for complicated intra-abdominal
infections - IDSA, Sept 2003 2003 by the Infectious
Diseases Society of America
Antimicrobial therapy for intraabdominal infections. Surgical Infection Society, 2002, offsite pdf of executive summary (182 kb) offsite pdf of background document (
567 kb)
2005 Guidelines from the International Society of Peritoneal Dialysis for the Diagnosis and Management of Peritoneal Dialysis-Associated Peritonitis
Chronic Hepatitis B Antiviral Treatment Guidelines Leading Article JAC 2006 Amer Assoc Study Liver Dis Guidelines 2007 (offsite pdf, 482 kb)
Chronic Hepatitis C - Amer Assoc Study Liver Dis Guidelines 2004 (offsite pdf, 431 kb) Urinary Tract Infections
Diagnosis and treatment of asymptomatic bacteriuria in adults - IDSA, ASN, AGA, March 2005 ©2005 by the Infectious Diseases Society of America pdf 133 kb
1999 Practice Guidelines for Antimicrobial Treatment of Uncomplicated Cystitis and Pyelonephritis in Women (pdf, 217 kb), 1999 by the Infectious Diseases Society of America Sexually Transmitted Diseases
CDC August 2006Guidelines for the Treatment of Sexually Transmitted Diseases (pdf 700 kb) OR offsite html link
See also Hepatitis and HIV sections
Guidelines for Infection Control and Immunization
Infection Control Guidelines
CDC Guidelines for the Prevention of Nosocomial
Pneumonia (2003 published Mar04 offsite
html link or onsite pdf file
(811kb)
Guidelines
for Preventing Opportunistic Infections Among Hematopoetic Stem
Cell Transplant Recipients (CDC, IDSA, ASBMT, Oct 2000)
pdf
file 714 kb or link to CDC
html file
Guidelines For The Prevention Of Intravascular
Catheter-Related Infections (August 2002; CDC, IDSA, SHEA, et al) (pdf file 340 kb) or link to CDC html file
Guidelines for the Prevention of Perinatal Group B Streptococcal Disease (August 2002; CDC) pdf file 2.2 MB or link to CDC html file
CDC-HICPA Guidelines for Environmental Infection Control in Health-Care Facilities (June 2003) link to pdf file (1 MB) or html document
HICPAC Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings, 2007 (6/07, 1.3 mb pdf)
CDC- Prevention of TB Transmission in Health Care Facilities, Dec 2005 (pdf 1.2 mb)
Guideline for Hand Hygiene in Healthcare Settings (October 2002; CDC) pdf file 506kb or link to CDC html file
Post-exposure Prophylaxis
Postexposure
needlestick prophylaxis- Interactive UCLA web site
CDC
guidelines for postexposure prophylaxis for HIV, HBV, and HCV
(August 2001,
pdf, 343kb)
Immunization
Adult and Pediatric Immunization Guidelines (2002; IDSA) pdf file 670 kb or link to IDSA html file 2002 by the Infectious Diseases Society of America
Adult Immunization Schedule Oct 2007-Sept 2008, Oct 2007, ACIP pdf file 162kb
Pertussis Treatment and Postexposure Prophylaxis, CDC, Dec 2005, pdf file 210kb
Smallpox vaccination and adverse Reactions (Jan 2003; CDC) link to pdf file (13MB) or html document ACIP-HICPAC Use of Tdap (Tetanus, reduced diphtheria toxoid, acellular pertussis) Vaccine in Adults, Dec 2006 (pdf 412 kb)
ACIP Immunization Schedule for Persons 0-18 Years of Age, Jan 2008, (pdf 258 kb)
Surgical Prophylaxis
Antimicrobial Prophylaxis for Surgery IDSA June 2004 (pdf 124kb), 2004 by the Infectious Diseases Society of America
Communicable Disease Reporting
Reporting communicable diseases
in Philadelphia (external link to Philadelphia Dept. of Public Health Division of Disease Control)
Infectious Diseases Society of America
and British Society for Antimicrobial Chemotherapy Guidelines
2002
Guidelines for the Use of Antimicrobial Agents in Neutropenic
Patients with Unexplained Fever (pdf, 95 kb), or
link to IDSA html file ©2002 by the Infectious Diseases Society
of America
Practice
Guidelines for Evaluating New Fever in Critically Ill Adult Patients,
(264 kb), ©1998 by the Infectious
Diseases Society of America
Fungal
Infections
The Clinical Assessment, Treatment, and Prevention
of Lyme Disease, Human Granulocytic Anaplasmosis,
and Babesiosis - IDSA Oct 2006, pdf 2.8 mb Excellent update of guidelines ©2006 by the Infectious Diseases Society of America
Practice
Guidelines for Outpatient Parenteral Antimicrobial Therapy
(pdf 189 kb, June 2004), ©2004
by the Infectious Diseases Society of America
Diagnosis
and Treatment of Diabetic Foot Infections (pdf 426kb, Oct
2004) ©2004 by
the Infectious Diseases Society of America
Practice
Guidelines for the Management of Bacterial Meningitis (pdf
319kb, Nov 2004) ©2004
by the Infectious Diseases Society of America
Practice Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections (pdf 313 kb, Nov 2005)
©2005 by the Infectious Diseases Society of America
Guidelines for the prophylaxis and treatment of methicillin-resistant Staphylococcus aureus ( MRSA) infections in the UK- BSAC Working Party offsite link (230 kb, pdf) (2/06)
Use of antibiotics in penetrating craniocerebral injuries -BSAC Working Party (1997), offsite link
The management of neurosurgical patients with postoperative bacterial or aseptic meningitis or external ventricular drain-associated ventriculitis- BSAC Working Party (2000), offsite link
Guideline for the management of the hot swollen joint in adults -BSR, BSAC, et al. (2006) offsite link
Treatment of Hospital Infections - great educational resource by the British Soc for Antimicrobial Chemotherapy (2002)
Pneumonia & Upper Respiratory Tract
Community Acquired Pneumonia
Hospital and Healthcare-Associated Pneumonia
CDC Guidelines for the Prevention of Nosocomial Pneumonia (2003
published Mar04) offsite html link or onsite pdf file (811kb)
ATS/IDSA Guidelines for the Management of Adults with Hospital-Acquired, Ventilator-associated, and Healthcare-associated pneumonia (2004, published 2005)-Offsite ATS link (360Kb, pdf)
Upper Respiratory Tract Infections
Tuberculosis
General Primers and Definitions
CDC
Core Clinical Curriculum on Tuberculosis - includes information
on prophylaxis, diagnosis, antituberculous drugs, epidemiology,
and therapy (offsite link, updated periodically)
American Thoracic Society /CDC/IDSA Statement on Diagnostic Standards and Classification of Tuberculosis in Adults and Children -1999 (published April 2000, pdf 474 kb)
WHO TB and HIV Clinical Manual (2nd ed, 2004) pdf 726 kb
WHO/IAUTLD TB Manual for Medical Students (1999) pdf 1.1 mb
IAUTLD Diagnostic Atlas of Intrathoracic TB in Children (2003) pdf 6.2 mb
IUATLD TB Guide for Medical Specialists (2003)- pdf 8 mb
NICE - TB Clinical Diagnosis and Management (UK National Institute for Health and Clinical Excellence (2006) - all excellent, offsite links: main page, synopsis (pdf 110k), complete NICE guidelines (pdf 430 kb), full review by Royal College of Physicians (pdf, 1 mb)
Treatment Guidelines
American Thoracic Society/CDC/IDSA Statement on the Treatment of Tuberculosis (Oct 2002, pdf 525 kb)
Practice Guidelines for the Treatment of Tuberculosis -IDSA Oct 2000, pdf 70kb; ©2000 by the Infectious Diseases Society of America
Also see the above NICE guidelines
HIV Specific Treatment and Prevention Guidelines
Prevention and Treatment of Tuberculosis Among Patients Infected
with Human Immunodeficiency Virus: Principles of Therapy and
Revised Recommendations - CDC Recommendation October 1998 (pdf 750 kb) OR offsite link
Appendix to above HIV /TB treatment html document (link to CDC web)
Managing drug interactions in the treatment of HIV-related tuberculosis -CDC recommendations Dec 2007
pdf 228 kb OR offsite link
Diagnosis and Treatment of Latent TB
American Thoracic Society/CDC/IDSA/AAP Statement on Targeted Tuberculin Testing and Treatment of Latent Tuberculosis Infection -1999 (published April 2000, pdf 699 kb) -Also view the warnings on use of rifampin/pza together (Aug 2002, html)
TB Drug Side-effect and Interactions
ATS-Hepatotoxicity of anti-Tb drugs (offsite pdf, 1.2 mb, 2006)
Managing drug interactions in the treatment of HIV-related tuberculosis -CDC recommendations Dec 2007 pdf 228 kb OR offsite link Non-Tuberculous Mycobacterial Infections
ATS-IDSA guidelines for the diagnosis and treatment of non-tuberculous mycobacterial infections (offsite link, pdf 930 kb, 2/07)
WHO, IUATLD Tuberculosis Guidelines, Especially for Low Income Countries
Laboratory Diagnosis and Management
IUATLD Direct Microscopy Guide for the Diagnosis of TB (5th ed, 2000) pdf 707kb
IUATLD Guide for Nat. TB Ref. Labs and National Laboratory Networks (1998) pdf 1.1 mb
Res. Inst. of TB/IUATLD AFB Microscopy Training (2005)-complete document pdf 11.4 mb
Research Inst. of TB/IUATLD AFB Microscopy Training (2005)Part 1 pdf 4mb
Research Inst. of TB/IUATLD AFB Microscopy Training (2005) Part 2 pdf 6mb
Research Inst. of TB/IUATLD AFB Microscopy Training (2005) Part 3 pdf 1.5 mb
Priorities for tuberculosis bacteriology services in low income countries. IUATLD (2007) Offsite link (pdf 5.4 mb)
Clinical Manuals
WHO TB and HIV Clinical Manual (2nd ed, 2004) pdf 726 kb
WHO/IAUTLD TB Manual for Medical Students (1999) pdf 1.1 mb
WHO Diagnosis and Treatment of Smear Negative Pulmonary and Extrapulmonary TB in HIV prevalent, resource-constrained regions (2007) pdf 460 kb
IAUTLD Diagnostic Atlas of Intrathoracic TB in Children (2003) pdf 6.2 mb
IUATLD TB Guide for Medical Specialists (2003)-complete document pdf 8 mb
IUATLD TB Guide for Medical Specialists (2003) Part 1 pdf 5.8 mb
IUATLD TB Guide for Medical Specialists (2003) Part 2 pdf 2mb
IUATLD TB Guide for Medical Specialists (2003) Part 3 pdf 1.9 mb
Best practice for the care of patients with tuberculosis. A guide for low-income countries. IUATLD (2007) Offsite link (pdf 832 kb)
Epidemiology of Tuberculosis IUATLD (2003) (pdf 4 mb)
Links
WHO (World Health Organization)
IUATLD (International Union Against Tuberculosis and Lung Diseases, has other useful manuals for the management of lung diseases)
Parasitic, Tick-Borne Diseases, Travel Medicine
CDC
Malaria Treatment and Diagnosis (2007) (off site link)
CDC Malaria Treatment Guidelines
Only (May 2007 pdf, 38 kb)
Tick borne North American rickettsial diseases - excellent review of epidemiology, treatment and diagnosis
- CDC March 2006 (pdf 790 kb)
The Clinical Assessment, Treatment, and Prevention
of Lyme Disease, Human Granulocytic Anaplasmosis,
and Babesiosis - IDSA Oct 2006, pdf 2.8 mb Excellent update of guidelines ©2006 by the Infectious Diseases Society of America
Treatment of Nervous System Lyme Disease - American Academy of Neurology, May 2007 (offsite link, 190 kb pdf)
IDSA Guidelines for the Practice of Travel Medicine (Jan 07, 3.8 Mb, pdf). A very good travel medicine primer.
©2007 by the Infectious Diseases Society of America
US Military Medical Textbooks - great chapters on parasitic and non-parasitic infectious diseases (offsite link)
HIV-Related Information
Guidelines for the Use of Antiretroviral
Agents in HIV-Infected Adults and Adolescents - March 2004 USPHS pdf 1.0mb OR
go
to the offsite html link
Link to AIDSinfo US Dept
HHS Website
2004 USPHS/IDSA Guidelines for the Treatment
of
Opportunistic Infections in Persons Infected with Human
Immunodeficiency Virus (Dec 2004), pdf
860K OR link
to CDC site
Prevention and Treatment of Tuberculosis Among Patients Infected
with Human Immunodeficiency Virus: Principles of Therapy and Revised
Recommendations - CDC Recommendation October 1998 (pdf
750 kb) OR link
to CDC html document
Managing drug interactions in the treatment of HIV-related tuberculosis -CDC recommendations Dec 2007 pdf 228 kb OR offsite link
Postexposure
prophylaxis for HIV, HBV, HCV - CDC Aug 2001
Management of Occupational HIV exposure - CDC Sept 2005
Guidelines
for the evaluation and management of dyslidipemia in HIV-infected
adults - IDSA Aug 2003 2003 by the Infectious
Diseases Society of America
National HIV/AIDS Clinician's
Consultation Center
Primary
Care Guidelines for the Management of Persons Infected with Human
Immunodeficiency Virus IDSA (pdf 192kb, Sept 2004) 2004 by the Infectious
Diseases Society of America
Treating
Opportunistic Infections in HIV-exposed and Infected Children-
CDC,NIH, IDSA, Dec 2004 pdf
741 kb or offsite
link and appendices A,
B,
C
HIV Testing in Health Care Settings- Revised Recommendations - CDC Sept 2006 (pdf 214 kb)
Reducing perinatal transmission and treatment of HIV-infected pregnant women -US Public Health Service Nov 2007 (pdf 8 mb)
Bioterrorism
CDC Bioterrorism
Webpages (link)
CDC
Interim Smallpox Response Plan and Guidelines (Jan 2002, link)
Smallpox diagnosis Powerpoint slides- Prof. Stanley Foster,
Emory University view
online( requires Internet Explorer) OR download
slide set (30 Mb, Powerpoint) (both offsite links)
Classical
Clinical Description of Inhalation Anthrax (Dec 1960 Am J. Med.
paper by Plotkin and colleagues)
Consensus
Statements on Bioterrorism Agents, published in JAMA (links)
WHO Draft Guidelines on Biological and Chemical
Terrorism(Nov 2001)pdf,
444 kb, link
to site, and description of biological (212
kb pdf) and chemical agents(120 kb pdf)
Johns Hopkins Center for
Civilian Biodefense Studies (link)
U.S. Army Medical Research Institute of Infectious Diseases
Medical Management of Biological Casualties Handbook (link)
OR (pdf
-378kb)
Medical Letter
Recommendations on anthrax
postexposure prophylaxis (link to 48 kb pdf),
smallpox
vaccine (link to 57kb pdf) and use of drugs
and vaccines against bioweapons (link to 50 kb pdf)
Powerpoint
slides of
cutaneous anthrax - much better quality than the CDC ones - from
PHLS website (see below) ppt, 98kb.
PHLS
website on anthrax with very good guidelines and good pictures of anthrax and
smallpox (link to pdf file, 113kb)
IDSA Bioterrorism Webpages
(link)
European
Guidelines on Bioterrorism ("Bichat" Guidelines)-
excellent brief summaries by agent, January 2005 |