Chapter 8: Treatment Algorithms for Infectious Diseases
Synopsis
Author
Mrs. Santhi Priya Adepu,
Assistant Professor, Department of Pharmacology, Sir C.R. Reddy College of Pharmaceutical Sciences, Andhra Pradesh, India
Abstract
Infectious disease management is predicated on algorithms that integrate pathogen identification with host-specific factors. The algorithm for bacterial infections is stratified by the site of infection; community-acquired pneumonia (CAP) management is guided by CURB-65/PSI scores, dictating outpatient (e.g., macrolide, doxycycline) versus inpatient (e.g., ceftriaxone plus macrolide) therapy. Uncomplicated UTIs are treated with short-course antibiotics (e.g., nitrofurantoin), while skin infections are bifurcated into non-purulent (cellulitis) and purulent (abscess) algorithms. Viral infection algorithms are often time-sensitive. Influenza treatment with neuraminidase inhibitors is most effective within 48 hours of onset. Human Immunodeficiency Virus (HIV) follows a "treat-all" algorithm, initiating antiretroviral therapy (ART) with a 2- or 3-drug regimen immediately upon diagnosis. Fungal infection algorithms differentiate between prophylaxis, empiric, and definitive therapy, with echinocandins being first-line for suspected invasive candidiasis in critically ill patients. Parasitic disease algorithms, such as for malaria, are strictly species- and region-dependent, utilizing artemisinin-based combination therapies (ACTs) for uncomplicated P. falciparum. Antimicrobial stewardship principles, including de-escalation based on culture data, are integral to all algorithms.
Keywords: Infectious Disease Algorithms, Antimicrobial Stewardship, Community-Acquired Pneumonia, HIV/ART, Sepsis, Empiric Therapy
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