Guidelines
Institutional guidelines and protocols
The ecology of many infectious diseases exist on multiple scales from the individual to the institution to the nation and globally. Here at UC Davis Medical Center we have developed localized guidelines incorporating data from our own patient populations to help providers make better antimicrobial decisions more easily. In addition, we've collected and organized many of the relevant national guidelines as well to help provide a centralized location for most your antimicrobial management needs.
In order to protect our "last line of defense" antibiotics for those who truly need them and to more economically provide excellent care, UC Davis Medical Center's antimicrobial formulary and restrictions are available for viewing for adults and children below.
Pre-operative antibiotics can help prevent surgical site infections for surgical procedures at higher risk. The following antimicrobial prophylaxis guidelines have been developed and are regularly updated using our own resistance data specifically for UC Davis Medical Center in order to maximize prophylactic benefit while minimizing unintended consequences.
In some heavily immunocompromised, high risk patients longer courses of antimicrobial prophylaxis may offer additional benefit. UC Davis Medical Center prophylaxis regimens have been developed to optimize antimicrobial prophylaxis in these instances as well.
UC Davis Medical Center has developed its own institutional guidelines and protocols synthesizing local antimicrobial resistance data with national recommendations. We additionally have a number of clinical decision making algorithms and protocols to help simplify sometimes complicated medical decision making for some uncommon infections or uncommonly used antimicrobials.
COVID-19
Empiric Antibiotics
- Outpatient – Adults (PDF)
- Outpatient – Pediatrics (PDF)
- Admission – Adults (PDF)
- Admission – Pediatrics (PDF)
Syndrome Specific Antibiotics
- Breast Abscess (PDF)
- Cellulitis Dalbavancin Protocol (PDF)
- C diff Treatment in Adults (PDF)
- Community Acquired Pneumonia (CAP) – Adults (PDF)
- Community Acquired Pneumonia (CAP) – Pediatrics (PDF)
- Hospital and Ventilator-Acquired Pneumonia (HAP/VAP) in the ICU – Adults (PDF)
- Hospital and Ventilator-Acquired Pneumonia (HAP/VAP) in the ICU – Pediatrics (PDF)
- Meningitis in Adults (PDF)
- Meningitis in Pediatrics (PDF)
- Musculoskeletal Infections in Pediatrics (PDF)
- Neutropenic Fever in Pediatrics (PDF)
- Necrotizing Pancreatitis (PDF)
- Sepsis (via EMR Sepsis bundle) (PDF)
- Septic Shock in the ED – Pediatrics (PDF)
- Urinary Tract Infection (UTI) – Pediatrics (PDF)
- Urinary Tract Infection (UTI) Caused by Vancomycin-Resistant Enterococci (VRE) (PDF)
Antibiotic Dosing
- Aminoglycoside Dosing and Monitoring (PDF)
- Antifungal Level Testing
- Beta-Lactam Extended Infusion Dosing (PDF)
- Catheter Lock Therapy for Catheter Related Bloodstream Infection (CRBSI) (Secure login only)
- Daptomycin Dosing (PDF)
- Hemodialysis and Renal Replacement Therapy Dosing (PDF)
- Vancomycin Dosing and Monitoring (PDF)
- Vancomycin Dose Conversion (PDF)
- IV to PO Antimicrobial Conversion Protocol – Adults (Secure login only)
Miscellaneous
National guidelines
National guidelines are produced regularly by the Disease Control and Prevention (CDC), Infectious Disease Society of America (IDSA), and others to provide generalized guidance on the management of common conditions. Tabbed below are the most up to date guidelines organized by location, syndrome, and pathogen.
- Aspergillosis – 2016 IDSA
- Bronchiolitis – 2014 AAFP/AAP
- Coccidioidomycosis – 2016 IDSA
- Community-Acquired Pneumonia in Adults (CAP) – 2019 IDSA/ATS
- Hospital-Acquired and Ventilator-Associated Pneumonia (HAP/VAP) – 2016 IDSA/ATS
- Influenza (Flu) – 2018 IDSA
- Mucormycosis (formerly Zygomycosis) – 2019 ECMM
- Non-Tuberculous Mycobacterial Pulmonary Disease – 2020 IDSA/ATS/ERS/ESCMID
- Otitis Externa – 2014 AAO-HNS
- Otitis Media – 2013 AAFP/AAP
- Sinusitis – 2015 AAO-HNS
- Tuberculosis (TB) Diagnosis – 2016 IDSA/ATS/CDC
- Tuberculosis (TB) Treatment, Drug-Susceptible – 2016 IDSA/ATS/CDC
- Latent Tuberculosis (LTBI) Treatment – 2020 CDC
Archived
There is increasing evidence that the vast majority, likely 90+%, of reported penicillin allergies are either out grown, inaccurate, or no longer relevant. Unfortunately, penicillin and related beta-lactam antibiotics are frequently the drugs of choice for many infections often being clinically superior to the alternatives. They additionally are well tolerated and significantly cheaper than their competitors. Most of these no longer clinically meaningful allergies can be identified and corrected through a combination of chart review, skin testing, and oral challenge. Here at UC Davis Medical Center we work through Inpatient Pharmacy to screen for possible erroneous beta-lactam allergies and proactively challenge low risk patients in order to open up better antibiotic options for patients in the future if the need should arise. Our protocols are viewable below.