Intravenous empirical therapy for bronchiectasis exacerbations in adults

For adults with a bronchiectasis exacerbation who require empirical intravenous therapy, use:

1ceftriaxone 2 g intravenously, daily; see advice on modification and duration of therapy ceftriaxone ceftriaxone ceftriaxone

OR

1amoxicillin+clavulanate 2+0.2 g intravenously, 8-hourly; see advice on modification and duration of therapy. For dosage adjustment in adults with kidney impairment, see amoxicillin+clavulanate intravenous dosage adjustment amoxicillin + clavulanate amoxicillin+clavulanate amoxicillin+clavulanate

OR

1amoxicillin+clavulanate 1+0.2 g intravenously, 6-hourly; see advice on modification and duration of therapy. For dosage adjustment in adults with kidney impairment, see amoxicillin+clavulanate intravenous dosage adjustment. amoxicillin + clavulanate amoxicillin+clavulanate amoxicillin+clavulanate

For adults with a bronchiectasis exacerbation who have had a nonsevere (immediate or delayed) hypersensitivity reaction to a penicillin, use ceftriaxone at the dosage above.

For adults with a bronchiectasis exacerbation who have had a severe immediate1 hypersensitivity reaction to a penicillin, ceftriaxone (at the dosage above) can be considered if a beta-lactam antibiotic is strongly preferred (for considerations, see Severe immediate hypersensitivity: Implications of cross-reactivity between penicillins and cephalosporins).

For adults with a bronchiectasis exacerbation who have had a severe immediate1 hypersensitivity reaction to a penicillin in whom ceftriaxone is not used, or for patients who have had a severe delayed2 hypersensitivity reaction to a penicillin, use:

moxifloxacin 400 mg intravenously, daily; see advice on modification and duration of therapy. For dosage adjustment in adults with kidney impairment, see moxifloxacin dosage adjustment. moxifloxacin moxifloxacin moxifloxacin

1 Severe immediate hypersensitivity reactions include anaphylaxis, compromised airway, airway angioedema, hypotension and collapse.Return
2 Severe delayed hypersensitivity reactions include cutaneous adverse drug reactions (eg drug rash with eosinophilia and systemic symptoms [DRESS], Stevens–Johnson syndrome/toxic epidermal necrolysis [SJS/TEN], severe blistering or desquamative rash), and significant internal organ involvement (eg acute interstitial nephritis).Return