Sandbox/Bites

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mugilan Poongkunran M.B.B.S [2]

Cellulitis Microchapters
Home
Patient Information
Overview
Historical perspective
Classification
Pathophysiology
Causes
Differentiating Cellulitis from other Diseases
Epidemiology and Demographics
Risk Factors
Natural History, Complications and Prognosis
Diagnosis
Diagnostic study of choice
History and Symptoms
Physical Examination
Laboratory Findings
Chest X Ray
CT
MRI
Ultrasound
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Sandbox/Bites On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Sandbox/Bites All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Sandbox/Bites
CDC on Sandbox/Bites
Sandbox/Bites in the news
Blogs on Sandbox/Bites
Directions to Hospitals Treating Cellulitis
Risk calculators and risk factors for Sandbox/Bites

Empiric Therapy

▸ Click on the following categories to expand treatment regimens.

Human Bites   ▸  Adults   ▸  Children   ▸  Animal Bites   ▸  Insect Bites

Early (not yet infected) Preferred Regimen ▸ Amoxicillin-clavulanate 875/125 mg orally q12h X 5 days Alternative Regimen (beta-lactam allergy) ▸ Moxifloxacin 400 mg orally q6h AND Clindamycin 300 mg orally q6h OR ▸ Trimethoprim-sulfamethoxazole 1 double-strength tablet orally q12h AND metronidazole 250 to 500 mg orally q6h Late (infected) Preferred Regimen ▸ Ampicillin sulbactam 1.5 gm IV q6h OR ▸ Cefoxitin 2 gm IV q8h OR ▸ Ticarcillin clavulanate 3.1 gm IV q6h OR ▸ Piperacillin-tazobactam 3.375 gm IV q6h or 4.5 gm q8h or 4-hr infusion of 3.375 gm q8h Alternative Regimen (beta-lactam allergy) ▸ Clindamycin 1.5 gm IV q6h PLUS ▸ Moxifloxacin 400 mg IV q6h Early (not yet infected) Preferred Regimen ▸ Amoxicillin-clavulanate (> 12weeks) 45 mg/kg/day orally in 2 divided doses for 5 days Late (infected) Preferred Regimen ▸ Ampicillin sulbactam 100 to 300 mg/kg/day IV q6h OR ▸ Cefoxitin 80 to 160 mg/kg/day IV in 4 divided doses OR ▸ Ertapenem (3months - 12years) 15 mg/kg IV twice daily (maximum 1 g/day) OR Ertapenem (>13years) 1 g IV once daily Rat Preferred Regimen ▸ Amoxicillin-clavulanate 875/125 mg orally q12h X 5 days Pig (Swine) Preferred Regimen ▸ Amoxicillin-clavulanate 875/125 mg orally q12h X 5 days Alternative Regimen ▸ Ampicillin sulbactam OR ▸ Imipenem OR ▸ Cephalosporin Monkey bite Preferred Regimen (without CNS symptoms) ▸ Acyclovir 12.5–15 mg per kg IV q8h OR ▸ Ganciclovir 5 mg per kg IV q12h Preferred Regimen (with CNS symptoms) ▸ Ganciclovir 5 mg per kg IV q12h Oral Regimen ▸ Clindamycin 5 mg/kg orally q8h OR ▸ Linezolid 10 mg/kg orally q8-12h Parental Regimen ▸ Vancomycin 10 to 15 mg/kg IV q8-12h PLUS ▸ Cefotaxime 50 mg/kg IV q8h OR ▸ Gentamicin 2.5 mg/kg IV q8-12h Oral Regimen ▸ Clindamycin 5 mg/kg orally q8h OR ▸ Linezolid 10 mg/kg orally q8h Parental Regimen ▸ Vancomycin 10 to 15 mg/kg IV q6-8h PLUS ▸ Cefotaxime 50 mg/kg IV q6-8h OR ▸ Gentamicin 2.5 mg/kg IV q8h Oral Regimen ▸ Clindamycin 5 mg/kg orally q6h OR ▸ Linezolid 10 mg/kg orally q8h

References

Template:WikiDoc Sources