- Received > 48h of IV antibiotic Tx for this disease
- More than 24 hours have passed since admission to the intensive care unit
- Known hypersensitivity to all study antibiotic medications
- Specific antibiotic choice is indicated, for example:
- a. Suspected/proven concurrent infection such as meningitis
- b. Suspected/proven infection with resistant bacteria for which trial agents should not be active. This includes cystic fibrosis, bronchiectasis, or any other chronic suppurative lung disease where Pseudomonas infection may be suspected, but does not include patients with suspected MRSA infection
- c. Febrile neutropenia or significant immunosuppression (including organ/bone marrow transplantation, HIV infection with CD4 <200 cells/µL, systemic immunosuppression, systemic corticosteroids including prednisolone ≥ 20 mg/day or equivalent for > 4 weeks prior)
- d. Suspected melioidosis
- e. Specific microbiological information exists to guide specific antibacterial treatment
- Treating physician believes involvement in the trial would not be in the best interest of the patient
Specific Exclusions to Interventions
- Known non-severe hypersensitivity to penicillins = exclusion of piperacillin and amoxicillin
- Known non-severe hypersensitivity to cephalosporins = exclusion of ceftriaxone
- Known severe hypersensitivity to beta-lactams (penicillins or cephalosporins)
- Known hypersensitivity to levofloxacin
- Known severe hypersensitivity to macrolides = exclusion of all interventions except levofloxacin
- Known/suspected pregnancy = exclusion of levofloxacin intervention
