Antimicrobial Use Guidelines (AMUG) version 21 - UW Health

Infection Treatment CommentsOtitis mediaOtitis media w/bulgingtympanic membrane 3,4Resistant bacterialotitis 3,4Gastroenteritis/GIChildren: Amoxicillin 80-100 mg/kg perday in two or three divided doses for 7daysAdults: Amoxicillin 500 mg PO BID orTIDCefuroxime axetil 30 mg/kg twice aday for 7 days-For otitis media withoutbulging tympanic membranesuggest delayed antibioticprescribing strategy asfollows: initiate treatment withfull-dose acetaminophen (upto 2.6 g per day in childrenless than 12 years), provide aprescription for amoxicillin tobe used only if otalgia or feverpersists or if there is no clinicalimprovement after 48-72hours 3-Treatment failure is definedas lack of improvement inclinical signs and symptomsafter 3 days of therapyH. pylori infection 5 Bismuth subsalicylate 525 mg PO fourtimes daily plus metronidazole 250 mgPO four times daily plus tetracycline500 mg PO four times daily for 2weeks plus ranitidine 150 mg PO twicedaily for 4 weeksTraveler’s Diarrhea –Mild (1-2 stools/24 hourswith minor symptoms) 6Traveler’s Diarrhea –Moderate (more than 2stools within 24 hours) 6Urogenital SystemAcute (uncomplicated)Lower Urinary TractInfection in Women 7Fluids only or loperamidehydrochloride 4 mg PO initially, then 2mg PO after each loose stool to amaximum of 8 mg per day or bismuthsubsalicylate 4 tablets PO every halfhour, maximum 8 dosesIf no distressing symptoms: fluids andloperamide or bismuth subsalicylate –if worsening consider single doseciprofloxacin 500 mg POIf distressing symptoms or critical trip:Oral fluids, ciprofloxacin 500 mg POBID for 1-3 days; avoid loperamideTrimethoprim-sulfamethoxazole160/800 mg PO BID for 3 days-Do not use loperamide ifdiarrhea is associated withfever or blood in stool-Resistance tofluoroquinolones inCampylobacter is increasinglycommon-Fluoroquinolones may not beused for longer than 3 weeks-The efficacy of trimethoprimis similar whether it is usedalone or in combination with