Spectrum: Local Antimicrobial Stewardship, for UCLA Health

Blood Culture Results Positive

Procedures

1.

Initiate empiric antibiotic.

  • IV Vancomycin unless otherwise specified by ID consultant*

  • Await culture results for specific antibiotic selection

Vancomycin IV

*Additional Gram Negative Coverage

*Consider need for additional gram negative coverage if:

  • < 36 months old

  • Immunocompromised

  • Sickle cell

2.

Observe on antibiotics

  • Consider transfer to pediatric service.

  • Start CCS Application and consult social work

  • Await culture results for specific antibiotic selection

  • Repeat CRP every 48 hours

3.

Physical therapy evaluation for gait training toe-touch weight bearing for lower extremity osteomyelitis

4. Continue IV antibiotic until clinical exam improved, WBC normalized & CRP appropriately down-trending.

Consider PICC for prolonged IV therapy.

Clinical Improvement?

Yes

No