Antimicrobial Use Guidelines (AMUG) version 21 - UW Health
Antimicrobial Use Guidelines (AMUG) version 21 - UW Health
Antimicrobial Use Guidelines (AMUG) version 21 - UW Health
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DAPTOMYCINInfectious Disease approval is required for all use of daptomycin (See Appendix I).Usual DoseAdult: 4 or 6 mg/kg once daily IV based on IBW (<strong>UW</strong>HC cost/day $136.04-203.28).Indications1. Complicated skin and skin-structure infections caused by resistant Gram-positive pathogens, including penicillinresistantStreptococcus pneumoniae, methicillin-resistant Staphylococcus aureus with vancomycin MIC greaterthan 1.5, and vancomycin-resistant enterococci.2. Gram-positive right-sided Endocarditis and complicated Staphylococcal bacteremias. Dose is 6 mg/kg/day.3. Empiric therapy for known Staph aureus bacteremia for 24-48 hours until the vancomycin MIC for MRSA is knownto be less than 1.5.CommentsIncreased dosing interval to every 48 hours recommended in renal insufficiency with creatinine clearance less than 30mL/min. Not indicated in pneumonia. Dosing in HD patients should occur after the dialysis session for inpatients. Therecommended dosing strategy for outpatient dialysis is the 2 minute infusion immediately following the HD session. Thismethod does not require a supplemental dosage increase.DARUNAVIRFor up-to-date information on the use of antiretrovirals, consult an HIV expert or www.aidsinfo.nih.gov/DELAVIRIDINE non-formulary at <strong>UW</strong>HCFor up-to-date information on the use of antiretrovirals, consult an HIV expert or www.aidsinfo.nih.gov/DICLOXACILLINUsual DoseAdult: 250-500 mg four times daily PO (<strong>UW</strong>HC cost/day $0.82-1.45).Pediatrics:** 12 – 25 mg/kg/day PO in divided doses Q6H (no suspension available – use nearest capsule size).Indications1. Infections caused by or suspected of being caused by methicillin-susceptible staphylococci. Dicloxacillin is the drug ofchoice for outpatient therapy of susceptible S aureus infections.2. Skin and soft tissue infections.CommentsDicloxacillin should not be used for initial treatment of severe, life-threatening infections but can be used as follow-up toparenteral therapy in osteomyelitis or septic arthritis. GI intolerance may require switch to alternate antimicrobial.Drug InteractionDicloxacillin decreases the anticoagulant effect of warfarin.DIDANOSINEFor up-to-date information on the use of antiretrovirals, consult an HIV expert or www.aidsinfo.nih.gov/DORIPENEM – non-formulary at <strong>UW</strong>HC. Therapeutically interchangeable with meropenem and imipenem at <strong>UW</strong>.Usual DoseAdult: 500 mg Q8H IV (<strong>UW</strong>HC cost/day $111.09)Pediatric: safety and efficacy not established in childrenComments