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Med Topo · Tools

Antibiotic decision tool

Pick the source for empiric therapy, duration, and IV→PO step-down. Then, optionally, search the organism that grew — you get directed therapy from the local antibiogram, filtered to agents that actually work at that site.

Assumptions: an active agent, clinical improvement, and adequate source control. Bloodstream durations count from the first negative blood culture. Susceptibility figures are digitized from a local 2026 regional antibiogram (2025 data) — verify against the source and your patient before use.
How the directed list is filtered by source
When you pick an organism, the tool shows its local %S only for agents that are appropriate for that site — an antibiotic is hidden even if it covers the bug when it can't do the job there. Examples baked in:
  • Nitrofurantoin & fosfomycin — cystitis only; excluded for pyelonephritis, any bacteremia, or non-urinary sources (they don't reach kidney tissue or blood).
  • Daptomycin — excluded for pneumonia (inactivated by lung surfactant).
  • Tigecycline — avoided for bacteremia (low serum levels).
  • Oral beta-lactams — deprioritized for prostatitis (poor prostate penetration; FQ or TMP-SMX preferred).
  • Meningitis — only CNS-penetrating agents, at meningitis breakpoints.
Color: ≥90% green, 75–89% amber, <75% red. Organisms with <30 isolates are flagged — interpret with caution.
General IV → oral step-down criteria
Switch when hemodynamically stable, clinically improving, afebrile ~24–48 h, and able to take/absorb oral medication. Prefer high-bioavailability agents (fluoroquinolones, TMP-SMX, linezolid, metronidazole, fluconazole, doxycycline). Keep IV for endocarditis (except structured partial-oral), CNS infection, undrained collections, and S. aureus bacteremia (largely).

Med Topo · Tools — educational quick-reference; not a substitute for guidelines, an ID consult, local stewardship, or clinical judgment. Antibiogram values are digitized from a de-identified local 2026 regional antibiogram (2025 data) and may contain transcription error — verify against the source.  ·  Back to Tools