Spectrum: Local Antimicrobial Stewardship, for Markham Stouffville Hospital

High Risk Regimens

IV Monotherapy

Pipercillin-Tazobactam 4.5 g IV q6h*

*Preferred regimen

OR

Meropenem 500 mg IV q6h**

**First choice if known history of ESBL infection

Anaphylaxis to Beta-Lactam

Ciprofloxacin 400 mg IV q8h
or 750 mg PO q12h

PLUS

Vancomycin 25-30 mg/kg IV loading dose, followed by 15-20 mg/kg q12h (Round to nearest 250 mg dose)

Additional Antimicrobials

For MDR Pathogens

For CDI, IAI or Perianal Abscess

Indications for adding Vancomycin