However, cefotaxime-resistant Enterobacter cloacae emerged as an important pathogen and continued to be prevalent even after the restored use of gentamicin as empiric treatment
. Despite the fact that cefotaxime was associated with faster development of resistance, the mortality rate did not increase during the study.
In our study, inappropriate antibiotic use was found most frequently in patients in whom empiric treatment
Amoxicillin-clavulanic acid, cephalosporins, gentamicin, and cotrimoxazole may be inadequate for the empiric treatment
of community or hospital-acquired UTI in children under the age of 2 years, because of the limited activity of these antibiotics against uropathogens in our geographic area.
The high resistance to first line antimicrobials, fluoroquinolones and resistance to third generation cephalosporins will leave us with no option but to resort to carbapenems and tigycyclines for empiric treatment
Currently, considering the still substantial MRSA resistance rates that exceed the 10%-15% level suggested by many experts as the threshold above which agents effective against CA-MRSA isolates should be administered for empiric treatment
, changes in the selection of empiric antibiotics are not warranted.
Most yeast infections, for example, are caused by Candida athicans, for which empiric treatment
with miconazole or fluconazole almost always works.
Distribution of antifungal agents used and duration of therapy prescribed were fairly similar between both patient groups (Table 2), while the median days-to-initiation-of-therapy after onset of sepsis in the empiric treatment
group was shorter than the culture-directed group by 4 days (P < 0.001).
Upon arrival to our facility he was examined and his antibiotic coverage was continued and broadened with the addition of amphotericin B and acyclovir for the empiric treatment
of fungal and viral organisms.
Since then, 3rd generation cephalosporins have been the only antibiotics recommended for empiric treatment
of gonorrhoea (6) but clinicians now face the emergence of 3rd-generation cephalosporin-resistant N.
for acute ethylene glycol (EG) intoxication was begun with a 10% ethanol solution (loading dose and IV maintenance infusion), pyridoxine (100 mg) and thiamine (100 mg).
Guidelines recommend a short course of trimethoprim-sulfamethoxazole (TMP-SMX) for the empiric treatment
of uncomplicated UTIs if resistance is less than 20%.
Upon admission, the patient was placed in respiratory isolation and started on rifampin, isoniazid, pyrazinamide, ethambutol, and pyridoxine daily for empiric treatment
of pulmonary tuberculosis.