-
Erysipelas Txn
- Pen G Procaine IM or
- Pen VK PO
- Severe: Pen G IV
- PNC allergy: Clindamycin or erythromycin
- 7-10 days
-
Impetigo Txn
- Mupirocin (Bactroban) oint.
- Dicloxacillin or cloxacillin or first gen cephalosporins
- PCN allergy: Clindamycin
- 7-10 days
-
Cellulitis Txn
- Mild-moderate:
- Dicloxacillin 500mg PO QID
- PCN allergy: Cephalexin, Clindamycin
- Severe or unable to take PO:
- Nafcillin/oxacillin IV
- Cefazolin IV
- PCN allergy: Clindamycin, Vancomycin
- 5-10 days
-
Cellulitis MRSA Txn
- PO: doxycycline, clindamycin, bactrim
- IV: linezolid, daptomycin, vancomycin
-
Necrotizing Fasciitis Txn
- Hydration!
- Type I
- Unasyn OR Zosyn + Clindamycin + Ciprofloxacin
- PCN allergic: Clinda or metro + AMG or FQs
- Type II
- Clindamycin + PCN
- PCN allergy: Vanco, linezolid, dapto, quinu/dalfopristin
-
DFI Txn PEDIS 2
- Augmentin(no pseudo, cover anaerobe), Levo, Doxy(MRSA), Dicloxacillin, Clinda(MRSA), Cephalexin, Bactrim (CA-MRSA)
- 1-2 wks
-
DFI Txn PEDIS 3,4
- Anaerobic: Cefoxitin, Moxi, Ertapenem
- P. aeruginosa: Zosyn
- MRSA: Tigecycline, Linezolid, Dapto, Vanco
- No P. aeruginosa: Unasyn, Ertapenem
- 2-4 wks
-
Animal Bites Txn
- Augmentin
- IV: Unasyn, Ertapenem
- PCN allergy: Cefoxitin, carbapenem
- PCN allergy: doxy, bactrim, FQ+Clinda
- 5-10 days for cellulitis and abscesses
- 3-5 days for prophylactic
- >10 days for infection
-
Human Bites Txn
- Irrigation, tetanus, prophylactic ABt with Dicloxacillink Pen VK
- Infected bite: Augmentin
-
Human Bites (Clenched fist) Txn
- Cefoxitin, Unasyn, ertapenem
- PCN allergy: FQ + Clinda or Bactrim + metro
-
Osteomyelitis (Hematogenous)
- Empiric ATB: Nafcillin + Cefotaxime OR Ceftriaxone
- 4-6wks
-
Osteomyelitis (Chronic)
- Empiric ATB: Not recommended
- Surgical debridement + ATB (IV) based off culture results
- Long-tern IV catheters (4-6wks IV, 6 months of PO or indefinate)
-
Osteomyelitis Empiric selection
- NewBorn: S. aureus, strep, E.coli: Nafcillin and Cetazidime
- <5: S. aureus, S. pyogenes: Nafcillin of cefazolin or Cefuroxime for H. flu
- >5: S. aureus, S. pyogenes: Nafcillin or cefazolin
- Adult: S. aureus and epidermidis: Naf cillin, cefazolin, Vanco
- IVDA: Pseudomonas: Cipro or ceftazidime +AMG
- Vascular insufficiency: GM+,GM-: AMG + Unasyn
-
Osteomyelitis Bacteria Based
- S. aureus: Nafcillin (MSSA), Clinda, Vanco (MRSA)
- Strep: Pen G IV, Cefotaxime(intermediate) or Vanco(resistant)
- Entero: Ampicillin or Vanco
- GM- rods: FQs
- Serratia or P. aeruginosa: Ceftazadime + AMG
- Anaerobe: Clinda
- Aerobic/anaerobic: Augmentin
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