UCSF Benioff Children’s Hospital San Francisco: Empiric Antimicrobial Therapy Guidelines


These guidelines were developed to inform initial selection of empiric antimicrobial therapy for children at UCSF Benioff Children's Hospital San Francisco and affilitated outpatient sites. The guidelines were developed by the Pediatric Antimicrobial Stewardship Program in collaboration with multiple clinical groups. They represent consensus based on evidence-based guidelines and local microbiology and susceptibility patterns.

See QuickLinks for

Critical Illness/Life-Threatening Infections 

Neonatal Infections 

Outpatient Infections 

Guidelines by Infection Category: 

Bone and Joint Infections


Septic Arthritis

CNS Infections


Brain Abscess

Gastrointestinal Infections

Bacterial Gastroenteritis

Clostridium difficile Associated Diarrhea

Helicobacter pylori Infection

Fever in Oncology and BMT Patients

Management of Fever in Pediatric Oncology and BMT Patients

Fever Without a Source

Young Febrile Infant

Head and Neck Infections

Dental Infection

Peritonsillar/Retropharyngeal Abscess




Orbital Cellulitis/Abscess

Periorbital/Preseptal Cellulitis

Intra-Abdominal Infections

Appendicitis, Other Community-Onset Intra-Abdominal Infection

Healthcare-Associated Intra-Abdominal Infection

Necrotizing Enterocolitis

Liver Failure and/or Early Post-Liver Transplantation, Suspected Infection

Empiric Antimicrobial Treatment of Pediatric Patients with Liver Failure and/or Early Post-Liver Transplantation

Respiratory Infections

Community-Acquired Pneumonia

Aspiration Pneumonia

Healthcare-Associated Pneumonia


Acute Otitis Media

Streptococcal Pharyngitis

Acute Bacterial Sinusitis

Severe Sepsis

Previously Healthy Infant or Child

Hospitalized Neonate (ICN)

Child with Healthcare Exposure or Comorbidities

Skin and Soft Tissue Infections

Abscess or Purulent Cellulitis

Cellulitis, Non-Purulent

Necrotizing Fasciitis

Bite Wound

Sexually Transmitted Infections


Gonorrhea, Uncomplicated

Herpes Simplex Virus Infections (see "Mucocutaneous HSV")

Pelvic Inflammatory Disease



Urinary Tract Infections

Community-Onset Urinary Tract Infection

Hospital-Onset Urinary Tract Infection

Viral Infections


Herpes Simpex Virus Infections

Varicella-Zoster Virus Infections

Special Sections

Assessment of Antibiotic Allergies

Antibiotic Spectrum Guide


For questions or feedback about these guidelines, please email primary content owner Rachel Wattier ([email protected])

The guidelines were reviewed and approved by the UCSF Pharmacy and Therapeutics Committee, 06/2016