What is the role of combination antimicrobial regimens for treatment of bacterial sepsis?

Updated: Feb 05, 2019
  • Author: Amber Mahmood Bokhari, MBBS; Chief Editor: Michael Stuart Bronze, MD  more...
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Combination therapeutic regimens include metronidazole plus either levofloxacin, aztreonam, a third- or fourth-generation cephalosporin, or an aminoglycoside.

Many advocate also using antistaphylococcal coverage (eg, vancomycin) empirically.

Although no drug regimen may be superior to another, time to first dose administration is very important. Mortality data suggest that early administration of appropriate antibiotics is correlated with better survival. Alternative agents may be used alone or in combination, with a good adverse-effect profile. [46, 29, 47, 28]

Antibiotics are normally continued until the septic process and surgical interventions have controlled the source of infection. Ordinarily, patients are treated for approximately 2 weeks, although duration may vary according to the source, site, and severity of the infection. As soon as patients are able to tolerate medications orally, they may be switched to an equivalent oral antibiotic regimen in an IV-to-oral conversion program.

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