Infection Protocols - Bacterial & Fungal

For recurrent resistance bacteria consider the following:\n\nMicroGenDx and they use PCR w genetic sequencing to detect antimicrobial resistance genes. They report a bacterial load which is a proxy for CFU on standard cultures. They have a whole host of options for various systems and I believe some insurance plans may cover it (Medicare does)- I think its probably an annoying "submit for reimbursement by the patient" situation with compelling clinical reasoning. Impt to note you'd have to add on STIs (but mycoplasma/ureaplasma is included). Heres the link to womens test and there's a similar one for men.\nhttps://microgendx.com/product/womens-complete-urine-vaginal-swabs-office-hospital/\n\n+actinomyces\nAmpicillin 500mg PO BID x 21 days with probiotics for patient and spouse. Then, ampicillin 500mg PO BID on CD1-10 of the subsequent 6 cycles for patient and spouse.\nDoxycyline 100 mg BID for 60 days for PCN allergy\n\n+Aerococcus/+Anaerococcus\n-Augmentin 875-125mg 1 tab PO BID x 21 days.\n\n+Alpha hemolytic strep\naugmentin x 21 days, followed by EMB with TOC 4 weeks after treatment complete. Consider treatment of husband and avoiding intercourse until both are done with antibiotics\n\n+Aspergillus in uterus (a fungus)\nRecommend Voriconazole 200 mg BID x 21 days and test of cure 3-4 weeks after treatment complete\n\n+Bacillus\n-Tetracycline x 21 d then repeat TOC 3-4 weeks after completion with EMB/ Cultures (Aerobic/anaerobic)\n\n+Bacterial vaginosis\n-Flagyl 500mg BID for 7 days\n-metrogel -1 applicator full vaginally at bedtime for 5 days\n\n+ Bifidobacterium:\nthis is typically susceptible to penicillin/ amoxicillin/ augmentin (augmentin likely best endometrial/ prostate penetration)\n\n+Candida Glabrata and non-aureus Staph\n-tx w/ Bactrim bid for 21 days& Diflucan 1 tab mondays and fridays during bactrim treatment for patient and spouse\n\n+Candida\nDiflucan every other day for 21 doses, then TOC 3-4 weeks after completion, consider candida diet (limiting sugar/carbs which can promote growth)\n\nCandida Parapsilosis\namphotereicin B for _ doses, then TOC 3-4 weeks after completion, consider candida diet (limiting sugar/carbs which can promote growth)\n\nYeast: Fusarium:\nPer my research, based on what was recently resulted: Fusarium: " The most active antifungal agents against Fusarium tend to be amphotericin B, voriconazole, and in some cases posaconazole or natamycin"\nSo new Rx sent for Voriconazole. I also messaged the lab to see if they can run sensitivities