For patients with renal insufficiency where aminoglycosides are not desired, a beta-lactam may be combined with a fluoroquinolone only IF 2 agents are needed.
Two beta-lactam agents should not be used concurrently (e.g. Pip/Tazo/Cefepime/Meropenem).
See section on double-coverage of gram-negative infections.
Double Coverage of Gram-Negative Infections
Potential sources (e.g. pneumonia, peritonitis, central venous catheters) must be considered when selecting therapy.
Broad-spectrum empiric therapy is ONLY appropriate while cultures are pending i.e. first 48-72 hours.
Antibiotic regimen should be evaluated daily and regimen should be streamlined based on culture data.
Vancomycin should almost always be stopped if no resistant Gram-positive organisms are recovered in cultures.