Guidelines
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.
Antimicrobial Formulary and Restrictions
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.
Surgical and Medical Antimicrobial Prophylaxis
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 Guidelines and Protocols
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:
Syndrome Specific Antibiotics:
- Breast Abscess
- Cellulitis Dalbavancin Protocol
- C diff Treatment in Adults
- Community Acquired Pneumonia (CAP) in Adults
- Community Acquired Pneumonia (CAP) in Pediatrics
- Empyema in Pediatrics
- Fungal Infections in Adults
- Hospital- and Ventilator-Acquired Pneumonia (HAP/VAP) in the ICU in Adults
- Hospital- and Ventilator-Acquired Pneumonia (HAP/VAP) in the ICU in Pediatrics
- Meningitis in Adults
- Meningitis in Pediatrics
- Musculoskeletal Infections in Pediatrics
- Neutropenic Fever in Pediatrics
- Necrotizing Pancreatitis
- Sepsis (via EMR Sepsis bundle)
- Septic Shock in the ED in Pediatrics
- Urinary Tract Infection (UTI) in Adults
- Urinary Tract Infection (UTI) in Pediatrics
Antibiotic Dosing:
- Aminoglycoside Dosing and Monitoring
- Antifungal Level Testing
- Beta-Lactam Extended Infusion Dosing
- Catheter Lock Therapy for Catheter Related Bloodstream Infection (CRBSI)
- Daptomycin Dosing
- Hemodialysis and Renal Replacement Therapy Dosing
- HIV Antivirals and Formulations
- Vancomycin Dosing and Monitoring
- Vancomycin Dose Conversion
Miscellaneous:
National Guidelines
National guidelines are produced regularly by the 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.
Healthcare-Associated Meningitis and Ventriculitis - 2017 - by IDSA/AAN/AANS/NCS
Neuroborreliosis (Lyme) - 2011 - by AAN/IDSA
Neurocysticercosis (Taenia solium) - 2018 - by IDSA/ASTMH
Archived:
Candidemia and Candidiasis - 2016 - by IDSA
Cardiac Device Infections - 2017 - by HRS/ACC/AHA/APHRS/EHRA/IDSA/LAHRS/PACES/STS
Catheter-Related Bloodstream Infection (CRBSI) - 2009 - by IDSA
Infective Endocarditis (IE) Treatment - 2015 - by AHA/IDSA
Archived:
Aspergillosis - 2016 - by IDSA
Bronciolitis - 2014 - AAFP/AAP
Coccidioidomycosis - 2016 - by IDSA
Community-Acquired Pneumonia in Adults (CAP) - 2019 - by IDSA/ATS
Hospital-Acquired and Ventilator-Associated Pneuomina (HAP/VAP) - 2016 - by IDSA/ATS
Influenza (Flu) - 2018 - by IDSA
Mucormycosis (formerly Zygomycosis) - 2019 - by ECMM
Non-Tuberculous Mycobacterial Pulmonary Disease - 2020 - by IDSA/ATS/ERS/ESCMID
Otitis Externa - 2014 - AAO-HNS
Otitis Media - 2013 - AAFP/AAP
Tuberculosis (TB) Diagnosis - 2016 - by IDSA/ATS/CDC
Tuberculosis (TB) Treatment, Drug-Susceptible - 2016 - by IDSA/ATS/CDC
Latent Tuberculosis (LTBI) Treatment - 2020 - by CDC
Archived:
Blastomycosis - 2008 (Archived) - by IDSA
Cryptococcus - 2010 (Archived) - by IDSA
Histoplasmosis - 2007 (Archived) - by IDSA
Non-Tuberculous Mycobacterial Disease - 2007 (Archived) - by IDSA/ATS
Clostridioides difficile - 2021 - by IDSA
Hepatitis B Virus (HBV) - 2018 - by AASLD
Hepatitis C Virus (HCV) - 2017 - by IDSA/AASLD
Infectious Diarrhea - 2017 - by IDSA
Intra-Abdominal Infections (IAI) - 2017 - by SIS
Archived:
Intra-Abdominal Infections (IAI) - 2010 (Archived) - by IDSA
Asymptomatic Bacteriuria - 2019 - by IDSA
Group B Strep in Pregnant Women - 2019 - ACOG
Group B Strep in Neonates - 2019 - AAP
Sexually Transmitted Diseases (STD) - 2021 - by CDC
Archived:
Catheter-Associated Urinary Tract Infection (CAUTI) - 2010 (Archived) - by IDSA
Uncomplicated Urinary Tract Infection (UTI) and Pyelonephritis - 2011 (Archived) - by IDSA
Cellulitis and Skin and Soft Tissue - 2014 - by IDSA
Leishmaniasis - 2016 - by IDSA/ASTMH
Lyme Disease - 2020 - by IDSA/AAN/ACR
Prosthetic Joint Infection (PJI) Diagnosis and Prevention - 2019 - by AAOS/IDSA
Surgical Antibiotic Prophylaxis - 2013 - by IDSA/SIS/SHEA/ASHP
Tickborne Diseases - 2018 - by CDC
Vertebral Osteomyelitis - 2015 - by IDSA
Archived:
Diabetic Foot Infections - 2012 (Archived) - by IDSA
Methicillin-Resistant Staphylococcus Aureus (MRSA) - 2011 (Archived) - by IDSA
Prosthetic Joint Infection (PJI) Treatment - 2012 (Archived) - by IDSA
Beta-Lactam Allergy?
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.