Antimicrobial choice for disease conditions

S. No Type of disease Organisms Initial Treatment/ Preferred  Alternatives Comments  Comments
1 Typhoid fever Salmonella Typhi, Salmonella Paratyphi A Oral:  cotrimoxazole or azithromycin Parenteral: ceftriaxone Cefixime Change the empiric regimen based on susceptibility testing. Duration of treatment: 10-14 days. 
2 Rickettsial infections Orientia tsutsugamushi,Rickettsia conorii,
R. typhi 		Doxycycline Azithromycin chloramphenicol Duration of treatment: 7 days
3 Leptospirosis Leptospira sp Penicillin G or doxycycline Ceftriaxone Duration of treatment: 7 days
4 Vivax malaria P. vivax Oral Chloroquine Artemether-lumefantrine Followed by primaquine
5 Falciparum malaria P. falciparum If the patient is able to take orally:
Except for North eastern states:
Oral Artesunate and Pyrimethamine on the first day.
In Northeastern states:
Artemether-Lumefantrine should be used.
If the patient is unable to take orally:
IV Artesunate. Switch over to oral therapy when as soon as possible. Add a second agent such as doxycycline or clindamycin		 Artemether-lumefantrine Followed by primaquine single dose. All mixed infections should be treated with full course of ACT and primaquine 0.25 mg per kg daily for 14 days.  

*   All these regimens need to be tailored according to susceptibility patterns at individual centres.