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Lecture notes of 1 pages for the course pharmacy at pharmacy (revision)
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Blood infections, antibacterial therapySepticaemia (community-acquired)
A broad-spectrum antipseudomonal penicillin (e.g. piperacillin with tazobactam, ticarcillin with clavulanic
acid) or a broad-spectrum cephalosporin (e.g. cefuroxime)
o If meticillin-resistant Staphylococcus aureus suspected, add vancomycin (or teicoplanin).
o If anaerobic infection suspected, add metronidazole to broad-spectrum cephalosporin.
o If other resistant micro-organisms suspected, use a more broad-spectrum beta-lactam antibacterial
(e.g. meropenem).
Septicaemia (hospital-acquired)
A broad-spectrum antipseudomonal beta-lactam antibacterial (e.g. piperacillin with tazobactam, ticarcillin
with clavulanic acid, ceftazidime, imipenem with cilastatin, or meropenem)
o If meticillin-resistant Staphylococcus aureus suspected, add vancomycin (or teicoplanin).
o If anaerobic infection suspected, add metronidazole to broad-spectrum cephalosporin
Septicaemia related to vascular catheter
Vancomycin (or teicoplanin)
o If Gram-negative sepsis suspected, especially in the immunocompromised, add a broad-spectrum
antipseudomonal beta-lactam.
o Consider removing vascular catheter, particularly if infection caused by Staphylococcus aureus,
pseudomonas, or Candida species.
Meningococcal septicaemia
If meningococcal disease suspected, a single dose of benzylpenicillin sodium should be given before urgent transfer
to hospital, so long as this does not delay the transfer; cefotaxime may be an alternative in penicillin
allergy; chloramphenicol may be used if history of immediate hypersensitivity reaction to penicillin or to
cephalosporins.
Benzylpenicillin sodium or cefotaxime (or ceftriaxone)
If history of immediate hypersensitivity reaction to penicillin or to cephalosporins, chloramphenicol
To eliminate nasopharyngeal carriage, ciprofloxacin, or rifampicin, or ceftriaxone may be used.
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