Sandbox/Alejandro: Difference between revisions
< Sandbox
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| 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''''' | ||
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| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Cefotaxime]]''''' <br> OR <br> ▸ '''''[[Ciprofloxacin]]''''' | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Cefotaxime]] 1-2 g IV/IM q8-12 (up to 2 g q4-6h)''''' <br> OR <br> ▸ '''''[[Ciprofloxacin]] 400 mg IV q8-12h x 7-14 days'''''<br> OR <br> ▸ '''''[[Ciprofloxacin]] 500-750 mg PO q8-12h x 7-14 days''''' | ||
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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 | ▸ '''''[[Ciprofloxacin]] 400mg IV q12h''''' <br> OR <br> ▸ '''''[[Ceftazidime]]''''' <BR> PLUS <BR> | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Ciprofloxacin]] 400mg IV q12h''''' <br> OR <br> ▸ '''''[[Ceftazidime]] 0.5 -2 g IV q8h''''' <BR> PLUS <BR> | ||
▸ '''''[[Gentamicin]]''''' | ▸ '''''[[Gentamicin]]''''' | ||
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| 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''''' | ||
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| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Meropenem]]''''' <br> OR <br> ▸ '''''[[Imipenem]]-cilastatin''''' | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Meropenem]] 0.5-1 g IV q8h (infuse over 15-30 min or in bolus over 3-5 min)''''' <br> OR <br> ▸ '''''[[Imipenem]]-cilastatin 250-1000 mg IV (max: 50mg/kg/day)''''' | ||
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| 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 | ▸ '''''[[Ciprofloxacin]]''''' <br> OR <br> ▸ '''''[[ | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left |▸ '''''[[Cefotaxime]] 1-2 g IV/IM q8-12 (up to 2 g q4-6h)''''' <br> OR <br> ▸ '''''[[Ciprofloxacin]] 400 mg IV q8-12h x 7-14 days'''''<br> OR <br> ▸ '''''[[Ciprofloxacin]] 500-750 mg PO q8-12h x 7-14 days''''' <br> OR <br> ▸ '''''[[Imipenem]]-cilastatin 250-1000 mg IV (max: 50mg/kg/day)''''' | ||
|} | |} | ||
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Revision as of 14:04, 29 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.