Antibiotic Treatment Duration By Disease State and Location

HOSPITAL MEDICINE, INFECTIOUS DISEASES, Pharmacy and Therapeutics

The following table was originally created by Dr. Kerkar, Dr. Mdluli, and Kyna Ngo, PharmD for use at DRMC as guidelines for the entire hospital. I have made a few additions to it from well-respected texts.

 

Disease State

Duration

Comments
Kidneys, bladder, urethra
(Renal System)		 Uncomplicated UTI 5 days
Complicated UTI and UTI in Males 7 days
Catheter-associated UTI 7 days
Pyelonephritis 14 days
Lungs

(Lower Resp Infections)

 

 COPD 5 days
CAP

Caused by atypical organisms

Legionella

 5 days

10 days

14 days
HCAP/VAP

Pseudomonas or Acinetobacter

 8 days

14 days
MSSA/MRSA PNA 14 days
URI Group A strep pharyngitis 10 days
Soft Tissue and Bone Infections Uncomplicated cellulitis 5 days
Purulent cellulitis 10 days
Osteomyelitis 4-6 Weeks “Because it takes 4-6 weeks for the bone to remodel and form new bone with new blood vessels.”  Per Dr. Gerardo Martin
Abdomen   Complicated intra-abdominal infection 7 days*

*Unless difficult to achieve adequate source control
C. difficile 14 days
  • This table of antibiotic durations based on diagnosis has been compiled using information from guidelines and clinical studies
  • Please use this as a reference when adding stop dates/duration of therapy for antibiotics
  • If there is no stop date/duration of therapy indicated in the progress notes, the antibiotic will be “hard stopped” using this table
    • When a drug is set to “hard stop,” a notification will appear in the inbox of the prescribing physician asking if they would like to continue or discontinue the antibiotic
  • If clinically warranted, antibiotic administration may be extended beyond the guideline-directed duration

 

Bacteremia
-“The duration of antibiotic therapy depends on the etiology of infection. In general, patients with bacteremia with a removable source of infection may be treated with 14 days of intravenous therapy from the first negative blood culture.”

 

Urinary system infections

3 > 5 > 7 > 14 days

Urethra > Bladder > Kidneys > Blood (sepsis 2/2 to urinary tract infection)

*Note, every UTI in a male is complicated.

 

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