Antibiotic Treatment for Mixed Infections

Indications for Antibiotic Use

• The Infectious Diseases Society of America recommends the use of antibiotics for treating intra-abdominal infections and complicated skin and soft tissue infections, as well as severe/fulminant Clostridioides difficile infection 1, 2

Treatment Regimens

• For severe Clostridioides difficile infections, vancomycin and metronidazole are used together, with vancomycin dosed at 125-500mg PO/PR every 6 hours and metronidazole dosed at 500mg IV every 8 hours 2
• The combination of a third-generation cephalosporin (e.g. cefixime) and metronidazole is recommended for:
• For healthcare-associated infections or suspected resistant pathogens, broader coverage may be needed, including the use of carbapenems or piperacillin-tazobactam, as stated by the Clinical Infectious Diseases and World Journal of Emergency Surgery societies 4, 6, 7, 8
• Enterococcal coverage may be needed for healthcare-associated infections, postoperative infections, or immunocompromised patients, as recommended by the World Journal of Emergency Surgery society 9, 7
• Severe infections may warrant the use of carbapenems or piperacillin-tazobactam, as recommended by the World Journal of Emergency Surgery and Journal of Microbiology, Immunology and Infection societies 7, 8