..

⭕ Community-Acquired Infections of Mild-to-Moderate Severity in Adults Antibiotics:

✅used for empiric treatment of community-acquired intra-abdominal infections should be active against enteric gramnegative aerobic and facultative bacilli and enteric gram-positive streptococci.

✅ For patients with mild-to-moderate, community-acquired infections, regimens with substantial anti-pseudomonal activity are not required.

✅ Empiric coverage of Enterococcus is not necessary in patients with mild-to-moderate community-acquired intra-abdominal infection.

✅ The use of agents listed as appropriate for high-severity, community-acquired infection and healthcare-associated infection is not recommended for patients with mild-to-moderate, community-acquired infection, because such regimens may carry a greater risk of toxicity and facilitate acquisition of more resistant organisms.


🔰Therapeutic Notes🔰
🟡@WikipharmaDr 🔴

⭕High-Severity Community-Acquired Infections in Adults.

✅ The empiric use of antimicrobial regimens with broad-spectrum activity against gram-negative organisms including Pseudomonas spp., such as meropenem, imipenem/cilastatin, piperacillin–tazobactam, ciprofloxacin or levofloxacin in combination with metronidazole, or ceftazidime or cefepime in combination with metronidazole, is recommended for patients with high-severity, community-acquired intra-abdominal infection.

☑️Aztreonam plus metronidazole is an alternative, but addition of an agent effective against gram-positive is recommended.

🔰Therapeutic Notes🔰
🟡@WikipharmaDr 🟡

⭕Healthcare-Associated Infections in Adults.

✅ Empiric antibiotic therapy for healthcare-associated intra-abdominal infections should be driven by local microbiologic results.

✅ To achieve empiric coverage of likely pathogens, multidrug regimens that include agents with expanded spectra of activity against gram-negative aerobic and facultative bacilli may be needed. These agents include meropenem, imipenem/cilastatin, piperacillin/
tazobactam, or metronidazole combined with either cefepime or ceftazidime.

✅ For multidrug-resistant aerobic gram-negative pathogens, aminoglycosides, colistin, polymyxin B, meropenem/vaborbactam, imipenem/relebactam, eravacycline, cefiderocol, ceftazidime/avibactam, or ceftolozane/tazobactam may be required.

🔰Therapeutic Notes🔰
🟡@WikipharmaDr 🟡

⭕#Note

✅Ampicillin/sulbactam is not recommended for use because of high rates of resistance to this agent among community-acquired E. coli.

✅Quinolone-resistant E. coli have become common in some communities, and quinolones should not be used unless hospital surveys indicate 90% susceptibility of E. coli to quinolones.

🔰Therapeutic Notes🔰
🟡@WikipharmaDr 🟡

⭕Duration of Therapy:

✅ Antimicrobial therapy of established infection should be limited to 4 days, unless it is difficult to achieve adequate source control. Longer durations of therapy have not been associated with improved outcome.

✅For acute stomach and proximal jejunum perforations, in the absence of acid-reducing therapy or malignancy and when source control is achieved within 24 hours, prophylactic anti-infective therapy directed at aerobic gram-positive cocci for 24 hours is adequate.

✅ Bowel injuries attributable to penetrating, blunt, or iatrogenic trauma that are repaired within 12 hours and any other intraoperative contamination of the operative field by enteric contents should be treated with antibiotics for ≤24 hours .

✅Acute appendicitis without evidence of perforation, abscess, or local peritonitis requires only prophylactic administration of narrow spectrum regimens active against aerobic and facultative and obligate anaerobes; treatment should be discontinued within 24 hours .

✅ The administration of prophylactic antibiotics to patients with severe necrotizing pancreatitis prior to the diagnosis of infection is not recommended.

🔰Therapeutic Notes🔰
🟡@WikipharmaDr 🟡

🔰Therapeutic Notes🔰
🟡@WikipharmaDr 🟡

🔰Therapeutic Notes🔰
🟡@WikipharmaDr 🟡

🔰Therapeutic Notes🔰
🟡@WikipharmaDr 🟡

⭕Initial Treatment Strategies for Inpatients with Community-acquired Pneumonia by Level of Severity and Risk for Drug Resistance (MRSA) :

⬅️أولا: إذا كان المريض
⭕Nonsevere inpatient pneumonia:
نعطيه
✔️b-Lactam + macrolide Or
✔️ respiratory fluroquinolone
و إذا كان المريض :
✅Prior Respiratory Isolation
of MRSA:
✔️Add coverage of MRSA drugs and obtain cultures/nasal PCR to allow
deescalation or confirmation of need to continued therapy.
أما إذا كان المريض
✅Recent Hospitalization and
Parenteral Antibiotics and
Locally Validated Risk
Factors for MRSA:
✔️Obtain cultures but withhold
MRSA coverage unless
culture results are positive. If
rapid nasal PCR is available,
withhold additional empiric
therapy against MRSA if rapid
testing is negative or add
coverage if PCR is positive
and obtain for culture.

⬅️ثانيا: إذا كان المريض :
⭕Severe inpatient pneumonia:
نبدأ نعطيه
✔️b-Lactam + macrolide Or
✔️ b-lactam + fluroquinolone
وإذا كان :
✅Prior Respiratory Isolation
of MRSA:
✔️ MRSA coverage and obtain
cultures/nasal PCR to allow
deescalation or confirmation of
need for continued therapy
أما إذا كان :
✅Recent Hospitalization and
Parenteral Antibiotics and
Locally Validated Risk
Factors for MRSA :
✔️Add MRSA coverage
obtain nasal PCR and
cultures to allow deescalation
or confirmation of need for
continued therapy.

🔆#IDSA guideline
🔰Therapeutic Notes🔰
🟡@WikipharmaDr 🟡

Standards of Care in Diabetes 2025

Standards of Care in Diabetes 2025

كتاب
Naplex 2025

#Clinical_Note

الحالة التي شاركت بها في المؤتمر..

1-s2.0-S0168822721005453-main1.pdf

Diabetes and Ramadan: Practical guidelines 2021😁👇

رمضان كريم
وكل عام وأنتم من الذين شملتهم مغفرة الله ورحمته، وجعلنا وإياكم من عتقائه..💛🙏