Combination Regimens

This guidance only applies if there are no previous culture results indicating resistance to the proposed oral agent and no positive cultures are available for the current infective episode.

If the current agents are available in an oral formulation, a direct conversion is possible with the exception of PO Vancomycin; it is not absorbed from the GI tract and the PO formulation is therefore only indicated for treatment of C. difficile infection.

In pregnant patients, ciprofloxacin is contraindicated - discuss appropriate empirical choices with an infection specialist.

IV regimen

PO regimen

Amoxicillin + Gentamicin + Metronidazole 

Co-Amoxiclav 625mg every 8 hours

Temocillin + Amoxicillin

Co-Amoxiclav 625mg every 8 hours

Amoxicillin + Gentamicin 

Ciprofloxacin 500mg every 12 hours

Co-Amoxiclav + Gentamicin for HAP

Co-Amoxiclav 625 mg every 8 hours; stop Gentamicin after 72hrs or at time of IVOS

Vancomycin + Gentamicin + Metronidazole 

Ciprofloxacin 500mg every 12 hours + Metronidazole 400mg every 8 hours

Vancomycin + Gentamicin 

Ciprofloxacin 500mg every 12 hours

Vancomycin + Ciprofloxacin

Ciprofloxacin 500mg every 12 hours