Abdominal Infections

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Indications to Add MRSA Therapy

Indications

The choice of Piperacillin/Tazobactam covers almost all pathogens encountered in severe intra-abdominal infections, including gram positive organisms, gram negative organisms and anaerobes. The addition of Vacomycin only adds coverage for MRSA, which is infrequently the pathogen in an intra-abdominal infection. Also consider that the combination of Vancomycin and Piperacillin/Tazobactam has been associated with acute renal failure.

Indications to add MRSA coverage:

  • Health care-associated complicated intra-abdominal infection plus known MRSA colonization (Nares positive for MRSA)
  • MRSA high risk due to prior treatment failure or significant antibiotic exposure

First line treatment

  • Vancomycin 15 mg/kg IV every 12 hours*

Notes

*For any toxic patient, consider a Vancomycin loading dose of 25 mg/kg followed by 15 mg/kg every 12 hours. Every Vancomycin order requires pharmacokinetic consult.

 

Disclaimer: The contents of this application are for the exclusive and specific use of University of Mississippi Medical Center faculty and trainees. Any other use is neither authorized nor sanctioned by UMMC. The information is for educational purposes only. The contents of this application are for the exclusive and specific use of UMMC faculty and trainees. Any other use is neither authorized nor sanctioned by UMMC. The information is for educational purposes only.