From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
The latest Sanford antibiotics guideline recommends piperacillin/tazobactam as the initial empirical treatment for early, non-ventilator, hospital-acquired pneumonia (NV-HAP) due to its effectiveness in reducing clinical failure compared to ceftriaxone plus clindamycin 1.
Key Recommendations
- For empiric therapy of community-acquired pneumonia in outpatients, the current recommendation is amoxicillin 1g three times daily for 5 days, or doxycycline 100mg twice daily for 5 days in penicillin-allergic patients.
- For urinary tract infections, nitrofurantoin 100mg twice daily for 5 days is recommended for uncomplicated cystitis, while more severe infections may require fluoroquinolones or cephalosporins.
- For skin and soft tissue infections, cephalexin 500mg four times daily for 5-7 days is typically recommended for cellulitis.
Antimicrobial Stewardship Principles
- Use the narrowest spectrum antibiotic effective for the suspected pathogen.
- Appropriate dosing based on patient factors.
- Limit treatment duration to the minimum necessary period.
Recent Studies
- A study published in 2021 found that ceftriaxone is as effective as broad-spectrum antibiotics, such as piperacillin-tazobactam or carbapenems, in the treatment of aspiration pneumonia 2.
- Another study published in 2023 found that cefepime, meropenem, and piperacillin-tazobactam have similar treatment outcomes in patients with polymicrobial infections with methicillin-susceptible Staphylococcus aureus (MSSA) bacteremia or pneumonia 3.
Considerations
- The choice of antibiotic should be based on the suspected pathogen, patient factors, and local resistance patterns.
- Antimicrobial stewardship principles should be applied to minimize adverse effects and reduce antimicrobial resistance development.
- The latest Sanford Guide to Antimicrobial Therapy provides comprehensive recommendations for antibiotic use across various infections and should be consulted for specific guidance 1, 2, 3.