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Author: Admin | 2025-04-28
Piperacillin and tazobactam) and either a macrolide or a fluoroquinolone. For inpatient treatment of severe CAP in patients hospitalized in an ICU, the ATS recommends that those not at risk for Ps. aeruginosa infection receive a 2-drug empiric regimen consisting of an IV β-lactam anti-infective (cefotaxime, ceftriaxone) and either an IV macrolide (azithromycin) or IV fluoroquinolone. If risk factors for Ps. aeruginosa are present in patients with severe CAP admitted to an ICU, the ATS recommends an empiric regimen that includes 2 antipseudomonal agents and provides coverage for multidrug-resistant S. pneumonia and Legionella. Therefore, the ATS recommends that these patients receive a 2-drug empiric regimen that includes an IV antipseudomonal β-lactam anti-infective (e.g., cefepime, piperacillin and tazobactam, imipenem, meropenem) and an IV antipseudomonal fluoroquinolone (e.g., ciprofloxacin) or, alternatively, a 3-drug empiric regimen that includes one of the IV antipseudomonal β-lactams, an IV aminoglycoside, and either an IV macrolide (e.g., azithromycin) or an IV nonpseudomonal quinolone. When an IV macrolide is indicated, azithromycin usually is preferred over erythromycin because of ease of administration and lower incidence of adverse effects.Skin and Skin Structure InfectionsAcute mild to moderate infections of the skin and soft tissue caused by Staphylococcus aureus have been treated with erythromycins, but resistance may develop during treatment. Azithromycin and clarithromycin also have been used in the treatment of skin and skin structure infections caused by Staphylococcus aureus or Streptococcus pyogenes and appear to have efficacy comparable to that of erythromycin or an oral cephalosporin.AcneOral erythromycins are used with good results in the treatment of acne† [off-label]. .AmebiasisAlthough the manufacturers state that oral erythromycin can be used for the treatment of intestinal amebiasis caused by Entamoeba histolytica, a regimen of metronidazole or tinidazole followed by a luminal amebicide such as iodoquinol or paromomycin is recommended for the treatment of intestinal amebiasis. AnthraxErythromycin is used as an alternative agent in the treatment of anthrax† [off-label]. Parenteral penicillins generally have been considered the drugs of choice for the treatment of naturally occurring or endemic anthrax caused by susceptible strains of Bacillus anthracis, including clinically apparent GI, inhalational, or meningeal anthrax and anthrax septicemia,
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