Which medications in the drug class Antibiotics, Other are used in the treatment of Systemic Inflammatory Response Syndrome (SIRS)?

Updated: May 07, 2018
  • Author: Lewis J Kaplan, MD, FACS, FCCM, FCCP; Chief Editor: Michael R Pinsky, MD, CM, Dr(HC), FCCP, FAPS, MCCM  more...
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Answer

Antibiotics, Other

Empiric antimicrobial therapy must be comprehensive and should cover all likely pathogens in the context of the clinical setting. The therapy should be guided by available practice guidelines and knowledge of the local antibiogram, as well as the patient's risk factors for resistant pathogens and allergies. The key is to stop antibiotics when infection is ruled out or narrow the antibiotic spectrum once a pathogen is found.

Cefepime (Maxipime)

Cefepime, a fourth-generation cephalosporin, is used for the treatment of Pseudomonas infections. Its gram-negative coverage is comparable to that of ceftazidime, and cefepime has better gram-positive coverage. Cefepime is a zwitter ion that rapidly penetrates gram-negative cells. It is the best beta-lactam antibiotic for intramuscular (IM) administration. Cefepime's poor capacity to cross the blood-brain barrier precludes the drug's use for meningitis treatment.

Vancomycin

Vancomycin is used to treat enterococcal infections when ampicillin is contraindicated because of significant penicillin allergy and when strains are resistant to ampicillin but susceptible to vancomycin. Target levels of 30-50 µg/mL (peak) and 10-15 µg/mL (trough) for endocarditis and other serious infections. Patients with SIRS often require increased dosages to achieve target concentrations, especially patients with higher creatinine clearances.

Levofloxacin (Levaquin)

Levofloxacin, a second-generation quinolone, acts by interfering with deoxyribonucleic acid (DNA) gyrase in bacterial cells. A bactericidal drug, levofloxacin is highly active against gram-negative and gram-positive organisms, including Pseudomonas aeruginosa.


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