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Welcome to the Johns Hopkins Antibiotics Guide. Our goal with this site is to provide concise, clinically
useful, and up-to-date information about the evaluation and treatment of infectious diseases in adults.
There are several possible ways to use this site and multiple layers of material. We've provided the
FAQs below as a guide to the use of the site. If you don't find the answer to your question below, let
us know by sending us e-mail, and we will do our best to answer your question promptly. Since this
work represents a central repository of information, it is constantly a work in progress; please send
comments on specific content issues as well as areas that you think we could improve.
1. How is this site organized?
2. How do I find disease-specific information?
3. How do I find drug-specific information?
4. How do I find pathogen-specific information?
5. How is the information delivered?
6. How can I read more about a drug or diagnosis?
7. How often is information updated?
8. Does the material presented on this site adhere to any specific set of treatment
guidelines?
9. Who is this site designed for?
10. What should I be sure to notice about the navigation of the site?
11. Is there anything I need to know specifically about the structure of the site?
12. Are there any special editorial issues I should be aware of?
13. Why am I asked to indicate what drug or drugs I intend to use?
14. How does the expert question and answer forum work?
15. How current are the prices listed for each drug?
16. Does this site list all FDA-approved and non-FDA approved uses of drugs?
17. Why do I have to register to use the site?
18. What happens with the information I submit with my registration?
19. Are there additional features coming soon?
20. Does this guide cover pediatric care?
21. Is there a handheld version of this guide?
22. Will there be additions and changes to the handheld versions of the ABX Guide?
23. Why should I trust the material presented in the ABX Guide?
24. Why are the common pathogens in the diagnosis modules limited?
25. Are there any recent press releases/publications regarding the ABX Guide?
26. How do I move my ABX Guide (Palm version) to a memory card?
27. What is the new CME Center?
1. How is this site organized?
There are two main parts of the site: the antibiotic database, which is accessed by searching on
diagnosis, drug name, or pathogen, and the browsable areas of the site, which include news, features,
and other types of additional readings and information.
To find out about a specific drug and its use or about a specific diagnosis or pathogen, use the search
function accessible in the upper left corner of the page. You can use the pull-down menu to drill down
to the topic you are searching for, or you can enter the terms of your search in the space provided.
The results of your search will be presented in a concise and standard form designed to provide you
with fast, pithy treatment information that will be useful at your point of care. We designed this to be
a "just the facts" presentation accompanied by the opportunity to read more in-depth substantiating
information along the way if you are interested.
information along the way if you are interested.
2. How do I find disease-specific information?
Search by diagnosis. The results of your search will be presented as a page listing the basic diagnostic
criteria, common pathogens, treatment regimen(s) with comments, important points, and additional
details, including salient and authoritative references and pathogen specific therapies. At each step,
we provide you immediately with the information you need to treat the diagnosis and give you the
option to read more deeply if you choose. On the diagnosis page, you are also provided with links to
the information sheet for each drug that may be prescribed, and if you indicate which drug you intend
to use, you will be provided with the author's opinion on that choice. At each step, you can click on
"more" to read additional material about the topic.
3. How do I find drug-specific information?
Search by antibiotic. The results of your search will be presented as a page listing the FDA indications,
other uses of the drug referred to in the guide, usual adult dosing, adverse drug reactions, major drug
reactions, spectrum, forms (including brand name(s), manufacturer(s), route of administration,
dosage, and pricing range), and a comment providing a brief one sentence overview of the drug. You
are also able to access full pharmacological information (mechanism, absorption, Cmax, distribution,
protein binding, metabolism/excretion, t _, dosing for glomerular filtration of 50-80, dosing for
glomerular filtration of 10-50, dosing for glomerular filtration of less than 10 ml/min, dosing in
hemodialysis, dosing in peritoneal dialysis, dosing in cavh, dosing for decreased hepatic function,
pregnancy risk, and breast feeding compatibility). Supplemental information, such as elaboration on
adverse drug reactions and drug interactions, including management of ADRs and interactions is
accessed by clicking on "other".
4. How do I find pathogen-specific information?
Search by pathogen. The results of your search will be presented as a page listing the clinical
relevance, sites of infection, treatment regimen(s) with comments, important points, and additional
details, including references. At each step, we provide you immediately with the information you need
to treat the diagnosis and give you the option to read more or more deeply if you choose. On the
pathogen page, similar to the diagnosis page, you are also provided with links to the information sheet
for each drug that may be prescribed, and if you indicate which drug you intend to use, you will be
provided with the author's opinion on that choice. At each step, you can click on "more" to read
additional material about the topic.
5. How is the information delivered?
Whether searching for a drug, a bug, or a diagnosis, your search results will be delivered in a concise
and standard form designed to give you the most clinically useful information first, with the option to
go deeper if you choose.
If you search by diagnosis, you will receive a page listing common diagnostic criteria, common
pathogens, treatment regimen(s) with comments, important points, and additional details, including
references and pathogen specific therapy. At each step, we provide you immediately with the
information you need to treat the diagnosis and give you the option to read more or more deeply if
you choose. On the diagnosis page, you are also provided with links to the information sheet for each
drug that may be prescribed, and if you indicate which drug you intend to use, you will be provided
with the author¹s opinion on that choice. At each step, you can click on "more" to read additional
material about the topic.
If you search by drug, you will receive a page listing FDA indications, other uses of the drug referred
to in the guide, usual adult dosing, adverse drug reactions, drug interactions, spectrum, and forms.
You are also able to access full pharmacological information (mechanism, absorption, Cmax, volume of
distribution, protein binding, metabolism/excretion, t _, dosing for glomerular filtration of 50-80,
dosing for glomerular filtration of 10-50, dosing for glomerular filtration of <10 ml/min, dosing in
hemodialysisdosing in peritoneal dialysis, dosing in cavh, dosing for decreased hepatic function,
pregnancy risk, and breast feeding compatibility).
If you search by pathogen, you will receive a page listing clinical relevance, sites of infection,
treatment regimen(s) with comments, important points, and additional details, including references.
At each step, we provide you immediately with the information you need to treat the pathogen and
give you the option to read more or more deeply if you choose. On the pathogen page, similar to the
diagnosis page, you are also provided with links to the information sheet for each drug that may be
prescribed, and if you indicate which drug you intend to use, you will be provided with the author¹s
opinion on that choice. At each step, you can click on "more" to read additional material about the
opinion on that choice. At each step, you can click on "more" to read additional material about the
topic.
6. How can I read more about a drug or diagnosis?
If you click on "more" wherever it appears on a page, you will find more detailed material about the
topic at hand. In addition, the "Features" section and the "News" section contain reviews and articles
about pertinent topics. You may also find lectures and conference summaries under features.
7. How often is information updated?
The authors review and update their material at least monthly, and all material posted on this site is
subject to a multi-layered system of peer review. The work of each author is reviewed by a designated
Hopkins faculty peer.A national panel of experts in infectious diseases is being assembled to review all
material.
8. Does the material presented on this site adhere to any specific set of treatment
guidelines?
The material presented on this site represents the considered opinion of the Hopkins expert who is
listed as the author of the page as of the date indicated on the page. If an author relied on a particular
set of guidelines in crafting his/her recommendations, that information/reference appears as the first
item under "Important Points." Otherwise, the references section will contain an annotated list of
those articles that the author considers to be the best on the topic. Where authoritative guidelines
exist, such as CDC or ISDA guidelines or The Medical Letter Reports, such guidelines serve as the basis
for all recommendations presented on this site [Link to disclaimer].
9. Who is this site designed for?
This site is designed for primary care providers and other non-infectious disease specialists as a tool
that can be used at the point of care to assist in prescribing antibiotics. It should also be useful for
the infectious diseases expert seeking more in depth material.
10. What should I be sure to notice about the navigation of the site?
If you submit your choice of drug(s), you will be provided with the author¹s opinion of your
choices.
If an entry under "Common Pathogens" appears as a link, it will link to a "Pathogen Specific
Therapy" page.
Clicking on "More Info" next to a drug name will direct you to the information sheet about that
drug. You can also get to that information page by entering the drug name in the search space at
the top of the site.
The corporate sponsors of this website are listed in the "Sponsors" section of the site. We
provide a link to their sites as a courtesy only, and those links do not constitute either
advertisement or endorsement. Sponsors do not participate in editorial decisions about the site
and have no say over the material presented here. Please see our editorial policy.
11. Is there anything I need to know specifically about the structure of the pages?
Clicking on "More" under any section will yield additional information or a continuation of a
discussion begun on the search results page.
The adverse drug reactions and drug interactions listed on the search results page represent a
brief overview. If additional information is available, you¹ll find it by clicking on "Other."
Management of drug interactions is discussed under "Other" in the "Detailed Information"
section.
Pregnancy classification is to be found on the Pharmacology page, accessible by clicking on
"Pharmacology" in the "Detailed Information" section of the drug search results page.
News articles are archived and can be reached through the link to the "News" section.
The "Expert Q & A" section is available once you have completed our long form questionnaire.
Once you have completed that longer survey, you will have full access to both browse the q/a
forum and submit questions to our panel of experts yourself.
12. Are there any special editorial issues I should be aware of?
"Important Points" are critical bits of information regarding the topic at hand that either 1. do
not fit neatly into the other major categories on the main page, or 2. represent major changes to
the traditional thinking about diagnosis and treatment, such as the addition of new categories of
drugs, significant changes in diagnosis, or critical recent research that significantly impacts
clinical care. The first important point identifies the major source that the guidance is based on,
clinical care. The first important point identifies the major source that the guidance is based on,
such as authoritative guidelines from the IDSA, CDC, etc. If no such authoritative guidelines exist,
the first important point states that the material is the considered opinion of the author.
References are not meant to be an exhaustive list they are a compilation of the most
authoritative sources with brief annotations by the author of the section.
Prices listed on the drug information pages are based on "Average Wholesale Price" (AWP) and
are current within the prior three months.
If a generic drug has many manufacturers, we don¹t list them all, just a sampling.
We present only the ten most common FDA indications and indications "referenced within this
guide" for any drug; there may be more.
A drug is listed as the 1st line of treatment for a specific pathogen if there is a good in vivo
study showing efficacy; a drug is listed as second line if there is in vitro data, and it is not listed
at all if there is no data. Currently, this spectrum information is available on the website and on
the PocketPC; the Palm application will soon also present the same material.
13. Why am I asked to indicate what drug or drugs I intend to use?
Behind the scenes on the site we are attempting to follow or track our visitors¹ paths through the site
to discern information about how they think about prescribing antibiotics. Our reasons for doing this
are two fold: one is economics pure and simple, but the other, more interesting reason is that we are
hoping to be able to gain new insights into prescribing practices and clinical approaches by tapping
into the expertise of the wide variety of care providers who use this site. We expect to be able to do
several things with that information: 1. We¹ll share some of our data with the clinicians who use the
site look for periodic data reports on the homepage; 2. We hope to use the data to support research
and publication; 3. We hope that we can see and respond to trends in prescribing and, therefore,
patterns of disease that will allow for improved patient care; 4. And we are hoping that we may be
able to assist in the widespread effort to address antibiotic resistance.
14. How does the expert question and answer forum work?
If you have a question pertaining to a specific antibiotic, the evaluation and/or treatment of an
infectious disease, or current events and recent developments in ID, you can submit your question on
line to a panel of experts who answer questions for forum. The forum director, Dr. William Bishai, will
direct your question to the best person to answer it, and that expert will respond to your question
and post it live on the site. Keep in mind, though, that we reserve all editorial rights in choosing which
questions to answer and when to answer them, although if you submit a question it will most likely be
answered within two weeks, and often in much less time than that. Please note that the forum is not
a substitute for formal consultation [link to forum disclaimer].
15. How current are the prices listed for each drug?
Prices listed on the drug information pages are based on "Average Wholesale Price" (AWP) and are
current within the prior three months.
16. Does this site list all FDA-approved and non-FDA approved uses of drugs?
We have listed the 10 most common FDA-approved indications. There may be more, but for the sake
of brevity, we've chosen the most important. We also include a list of disease states for which a drug
may be prescribed regardless of FDA approval (see "Also Referenced in this Guide").
17. Why do I have to register to use the site?
Frankly, because we are trying to learn something about how the clinicians who use this site think
about prescribing antibiotics. We are trying to uncover trends in both clinical thought and prescribing
practices. We require registration so we can track individual users' paths through the site. We are
looking for trends based on demographic and geographic categories and are considering the data in
aggregate form.
18. What happens with the information I submit with my registration?
Your responses to the registration questionnaire will be paired with the information gathered from
your use of the site. Our data analysis section will look at the aggregate data, observing for strong
trends in prescribing and evaluation by groups of providers. This information is valuable to the
pharmaceutical industry, so sale of the aggregate information will greatly assist us in the maintenance
of the Antibiotic Guide. These data will also serve as the basis for original research.
Sale of the information that we gather will also serve as a sustained funding source. We are currently
supported by generous unrestricted educational grants from our industry sponsors. However, to
sustain and further develop this complex and expensive project without charging individual users and
remaining advertising free, we plan to rely on the sale of aggregate data.
remaining advertising free, we plan to rely on the sale of aggregate data.
We will never distribute or sell personal identifying information, such as e-mail adresses.
Information is collected as follows: if you choose to access the core clinical database, you will be asked
to create a unique username and password to distinguish you from any other user who might access
the Abx Guide from the same computer terminal. You will also be asked to complete five brief multiple
choice questions in the "short form." After you register, we will keep track of which pages you view
and in what combinations. If you wish to access the "Expert Question and Answer Forum," we ask you
to complete approximately 20 additional questions, many of which are clinical scenarios with multiple
choices. We will add two to three questions to this "long form" every month and will ask you to
respond to these questions in order to maintain access to the Q&A Forum. We plan to follow how your
responses change over time in conjunction with the material that you have viewed in the Abx Guide.
From time to time, you will see analysis of these data presented in the "Features" section of the
Guide. When interesting and exciting trends are identified, we will share them with you as part of our
bi-directional communication directive.
19. Are there additional features coming soon?
Yes. We are in the process of adding graphic treatment algorithms to all the diagnosis/syndrome
modules. We are also finalizing detailed spectrum of activity for all antibiotics in the drug database. As
the authors continue to refine their material, you'll see more graphic images, helpful links, etc.
Additional diagnoses, pathogens, and drugs will be entered over time; specifically, there will be
information on infectious diseases used as biologic weapons, and additional GYN diagnoses in the
immediate future.
20. Does the antibiotic guide cover pediatric care?
Our goal with this site is to provide concise, clinically useful, and up-to-date information about the
evaluation and treatment of infectious diseases in adults. Currently, the guide does not address
pediatric care.
21. Is there a handheld version of this guide?
The Antibiotic Guide is constructed as a "decision support tool", consisting of digested and layered
information which quickly assists clinicians in making point-of-care decisions. The physical structure of
the Guide is an underlying database, which is ultimately platform independent. You may view the
contents of the database on this website by searching on diagnosis, pathogen, or antibiotic. The
handheld version of this guide is currenlty available for use on the iPAQ PocketPC, Hewlett Packard
Jornada, Casio Cassiopeia, and on devices running Palm OS™ 3.2 or higher . Please check back
frequently for more information. Our goal is a PDA application which accesses the core database so
you can view the very same material truly at the "point of care", rather than having to locate and use
a desktop terminal.
22. Will there be additions and changes to the handheld versions of the ABX
Guide?
Both the PocketPC and Palm applications present a subset of the database that is viewable in its
entirety on the web. The first area of expansion for the Palm application will be addition of spectrum
of activity for each drug.
23. Why should I trust the material presented in the ABX Guide?
The ABX Guide first and foremost reflects Hopkins' missions of education, research, and patient care in
a non-profit environment, as well as the quality of work required of and produced by Hopkins' faculty.
Hopkins POC-IT, the production team for the ABX Guide, is not a commercial venture; its core mission
is to positively influence the delivery of health care. The work presented here for your use is evidencebased, as much as possible, and is rigorously reviewed by: 1. medical editing, 2. a peer review process,
3. senior faculty review, 4. cross-specialty review, where appropriate, and 5. review by a national
panel of thought leaders in the area of infectious disease.
24. Why are the common pathogens in the diagnosis modules limited?
In the current Palm and PocketPC applications, only pathogens with links to completed pathogen
modules are listed. We will repair this feature in the near future. At this point, if you'd like to view the
entire list of common pathogens for a diagnosis, consult this website.
25. Are there any recent press releases/publications regarding the ABX Guide?
Antibiotic Guide Q & A
Press Release for Antibiotic Guide
Service is free and available on World Wide Web
Experts Launch 'Antibiotic Guide' for Handheld PC
Bios of Antibiotic Guide Founders
Wireless Guide
Putting Therapeutic Information in the Palm of Your Hand
Johns Hopkins guide offers expert medical guidance
Online link to antibiotic information will help research use
Drugs in the Palm of Your Hand
Antibiotics database launched
Johns Hopkins Antibiotic Guide vs. Sanford Guide (scroll down)
Surf Watch in Popular Science
Hopkins to Publish Print Edition of Johns Hopkins Antibiotics (ABX) Guide
26. How do I move my ABX Guide (Palm version) to a memory card?
You can move the ABX Guide to a Flash memory card.
To move the application data to a memory card, select the "Memory Card" menu option while in the
ABX Guide program and click on "Move to Memory Card," as illustrated below.
You can move the ABX Guide data back to main memory using the same menu.
27. What is the new CME Center?
Featuring influenza related material, the ABX Guide has just launched a new CME Center on the site.
Covering topics ranging from the diagnosis, management and treatment of influenza patients
(including high risk groups) to the use of antivirals and influenza vaccine, the short POC-IT CME and
longer Hopkins Dialogues programs offer a unique opportunity to learn at the point of decision making.
http://www.hopkins-abxguide.org/show_pages.cfm?content=cme_content.html
Date updated: December 12, 2006
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Copyright 2000 - 2004 The Johns Hopkins University on behalf of its Division of Infectious Diseases. All rights reserved. Any work
produced by Noreen A. Hynes, M.D., M.P.H., and so designated on this site is not copyrighted and remains in the public domain.
Please contact us at [email protected] with any comments, questions or concerns about this site. This site is
advertising free.
This web site is provided as an information resource only, and not as a guide for recommendation of treatment, for physicians
and other health care professionals who are concerned with the appropriate treatment of infectious diseases, and who are
knowledgeable in the selection of antibiotics, as part of the care and treatment of patients. Recommendations for care and
treatment change rapidly and opinions can be controversial; therefore, physicians and other health care professionals are
encouraged to consult other sources and confirm the information contained within this site. This site is for informational purposes
only, and should not be relied upon for final treatment decisions. Johns Hopkins University makes no representations or
warranties concerning the accuracy or reliability of information contained within this site, and the Johns Hopkins University, and
the contributing authors, editors, production, and programming staff shall not be liable for errors, omissions or inaccuracies in
information or for any perceived harm to users of this site or their patients. By referring to this site you agree and understand that
the individual physician or other health care professional should use his/her best medical judgement in determining appropriate
patient care or treatment. Full Disclaimer >>