Sandbox/Alejandro: Difference between revisions
< Sandbox
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▸ '''''' | ▸ '''Facial''' | ||
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{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;" | {| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;" | ||
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|## | ! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|## Facial}} | ||
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| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen''''' | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen''''' | ||
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| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[''''' < | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left |▸ '''''[[Vancomycin]] 15-20 mg/kg IV q8-12h'''''<small> (trough 15—20 μg/mL)</small> | ||
|- | |- | ||
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen''''' | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen''''' | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[''''' <br> OR <br> ▸ '''''[[''''' | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Daptomycin]] 4 mg/kg IV q24h''''' <br> OR <br> ▸ '''''[[Linezolid]] 600mg IV q12h''''' | ||
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Revision as of 20:37, 28 May 2014
Medical Therapy
- For patients with purulent cellulitis, cultures are recommended and empirical therapy for Community Associated-MRSA (CA-MRSA) should be started.
- For patients with non-purulent cellulitis, empirical therapy for β-hemolytic streptococci should be started.
- The duration of the therapy should be individualized for the clinical response of each patient; 5-10 days is usually recommended.
- The treatment of cellulitis in neonates usually requires hospitalization and parenteral therapy. Oral therapy is given for completion of the treatment when the pathogen is unknown.
- Optimal dose should be based on determination of serum concentrations.
- Patients with renal insufficiency may require dose adjustment in case of cephalosporins.
- Clindamycin is an alternate therapy for patients at risk of severe hypersensitivity reaction to penicillins and cephalosporins.
- Doxycycline is NOT recommended for children <8 years of age.
- Studies have shown an increase in treatment failure with TMP-SMX compared to other agents for cellulitis in children, reflecting TMP-SMX less action against Group A streptococcus.[1]
Therapy based on Anatomical LocationAdapted from
▸ Click on the following categories to expand treatment regimens.
Location ▸ Buccal ▸ Periorbital ▸ Orbital ▸ Perianal ▸ Facial ▸ ' ▸ '
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Special ConsiderationsAdapted from
For the following conditions, an additional antibiotic therapy should be added to the usual regimen in order to cover specific pathogens associated to those circumstances.
▸ Click on the following categories to expand treatment regimens.
Special Considerations ▸ Diabetic Foot Ulcer ▸ Neutropenic Patients ▸ Sal Water Wound Exposure ▸ Fresh Water Wound Exposure ▸ Butcher, Fisherman, Veterinarian
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References
- ↑ Elliott DJ, Zaoutis TE, Troxel AB, Loh A, Keren R (2009). "Empiric antimicrobial therapy for pediatric skin and soft-tissue infections in the era of methicillin-resistant Staphylococcus aureus". Pediatrics. 123 (6): e959–66. doi:10.1542/peds.2008-2428. PMID 19470525.