Page 74 - HPP ANTIMICROBIAL GUIDELINE 2018
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Suggested Treatment
                      Infection/ Condition                                                                                             Comments
                                                                Preferred                              Alternative

                 Shigella sp.                    Ciprofloxacin 750mg PO q12hr             Ceftriaxone 50-75mg/kg IV daily for    In immunocompromised
                                                 for 3 days                               5 days. (for severe disease)         patients duration of antibiotic
                                                                                                                               10 days
                                                 OR
                                                 Azithromycin 500mg PO q24h                                                    Avoid prescribing
                                                 for 3 days                                                                    fluoroquinolones if the
                                                                                                                               ciprofloxacin MIC is
                                                                                                                               0.12ug/mL or higher


                 Giardia                         Metronidazole 400mg PO q8h for 7 days


                 Entamoeba histolytica           Metronidazole 800 mg PO q8h for
                                                 5–10 days


                 Clostridium difficile
                 Mild to moderate                Vancomycin 125mg PO q6h for                                                   Repeating test on stool within
                                                 10- 14 days                                                                   7 days is not recommended

                 severe, complicated             Vancomycin 250mg- 500mg PO q6h                                                Oral vancomycin
                                                 PLUS                                                                          preparation guide:
                                                 Metronidazole 500mg IV q8h for 10-14 days                                     -Use the vial with 500mg
                                                                                                                                vancomycin.
                                                                                                                               -Dilute it with 10ml water for
                 First recurrence                Same as for initial episode                                                    injection.
                                                                                                                               -The solution becomes
                 Second recurrence               Vancomycin 125mg PO q6h for 7-14 days                                          50mg /ml
                                                 then                                                                          -For 125mg PO draw out
                                                 125mg PO q12h for 7 days then                                                  2.5ml.
                                                 125mg PO q24 for  7 days then                                                 -Add 30ml of drinking water to
                                                 125mg PO every other day for 7 days then                                      the 2.5ml. (optional)
                                                 125mg PO every 3 days for 14 days                                             -Administer orally or through
                                                                                                                               NG tube.



               HPP AMG                                                   Gastrointestinal Infections                                                     32
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