Spectrum: Local Antimicrobial Stewardship, for Providence Health Care

Severe/malignant otitis externa

Most likely organisms

Pseudomonas

S. aureus (MRSA)

S. aureus (MSSA)

IV

Piperacillin-tazobactam 4.5 g IV q6h

+ / -

Vancomycin 25mg/kg IV loading dose x 1 dose followed by 15mg/kg IV with interval to be determined by vancomycin nomogram

View Vancomycin nomogram

Severe Penicillin Allergy

Ciprofloxacin 400mg IV q8h

AND

Vancomycin 25mg/kg IV loading dose x 1 dose followed by 15mg/kg IV with interval to be determined by vancomycin nomogram

View Vancomycin nomogram

Oral Stepdown

Ciprofloxacin 750mg PO BID

+/-

Doxycycline 100mg PO BID

OR

Cotrimoxazole DS 2 tablets PO BID