Septic shock, hypotension, lactate >4mmol/L, or end-organ failure
and
previous ESBL/ampC-producing organism
recent piperacillin-tazobactam therapy
orrecent travel (patient/close contact) to South Asia
| Empiric Therapy | Dose | Duration |
|---|---|---|
| [Imipenem | 500mg IV q6h | 7 days |
| or | ||
| Meropenem] | 500mg IV q6h | |
| + | ||
| Vancomycin | 25-30mg/kg IV once then 15mg/kg IV q12h |
Carbapenem allergy
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Ciprofloxacin | 400mg IV q12h | 7 days |
| + | ||
| Gentamicin | 5-7mg/kg IV daily | |
| + | ||
| Vancomycin | 25-30mg/kg IV once then 15mg/kg IV q12h |