Diskitis Medication

Updated: May 13, 2020
  • Author: Alvin Marcovici, MD; Chief Editor: Jeffrey A Goldstein, MD  more...
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Medication

Medication Summary

Parenteral narrow-spectrum antibiotics should be prescribed according to the organism isolated. If cultures are consistently negative, administer broad-spectrum antibiotics for several weeks.

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Antibiotics

Class Summary

Empiric antimicrobial therapy must be comprehensive and should cover all likely pathogens in the context of the clinical setting.

Vancomycin (Lyphocin, Vancocin, Vancoled)

Potent antibiotic that is directed against gram-positive organisms and is active against Enterococcus species. Useful in the treatment of septicemia and skin structure infections. Indicated for patients who cannot receive or have failed to respond to penicillins or cephalosporins or who have infections with resistant staphylococci. For abdominal penetrating injuries, it is combined with an agent active against enteric flora and/or anaerobes.

To avoid toxicity, the current recommendation is to assay vancomycin trough levels after the third dose is drawn and a half an hour prior to the next dose. Use CrCl to adjust the dosage in patients diagnosed with renal impairment.

Used in conjunction with gentamicin for prophylaxis in patients who are allergic to penicillin and are undergoing gastrointestinal or genitourinary procedures.

Nafcillin (Unipen, Nallpen, Nafcil)

Initial therapy for suspected penicillin-G–resistant streptococcal or staphylococcal infections. Use parenteral therapy initially for severe infections. Change to oral therapy as condition warrants.

Due to thrombophlebitis, particularly in the elderly, administer parenterally only for short term (1-2 d); change to oral route as clinically indicated.

Ceftazidime (Tazidime, Tazicef, Ceptaz, Fortaz)

Third-generation cephalosporin with broad-spectrum, gram-negative activity; lower efficacy against gram-positive organisms; higher efficacy against resistant organisms. Arrests bacterial growth by binding to one or more penicillin-binding proteins.

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