Sandbox/Alejandro: Difference between revisions
< Sandbox
Line 12: | Line 12: | ||
==Therapy based on Anatomical Location<SMALL><SMALL><SMALL><SMALL><SMALL>Adapted from </SMALL></SMALL></SMALL></SMALL></SMALL>== | ==Therapy based on Anatomical Location<SMALL><SMALL><SMALL><SMALL><SMALL>Adapted from </SMALL></SMALL></SMALL></SMALL></SMALL>== | ||
A specific therapy should be given for the following anatomical location due to an increase predisposition of certain bacteria. | |||
<SMALL><font color="#FF4C4C">'''▸ Click on the following categories to expand treatment regimens.'''</font></SMALL> | <SMALL><font color="#FF4C4C">'''▸ Click on the following categories to expand treatment regimens.'''</font></SMALL> | ||
Line 58: | Line 60: | ||
| valign=top | | | valign=top | | ||
{| 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|Buccal Cellulitis}} | ! 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|Buccal Cellulitis <br> ''(H. influenzae)''}} | ||
|- | |- | ||
| 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''''' | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Ceftriaxone]] 1-2 g IV q24h''''' | ||
|- | |- | ||
| 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 | ▸ '''''[[ | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Meropenem]]''''' <br> OR <br> ▸ '''''[[Imipenem-cilastatin]]''''' | ||
|} | |} | ||
|} | |} | ||
Line 100: | Line 102: | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | PLUS | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | PLUS | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[ | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Metronidazole]] 1g IV q12h''''' | ||
|- | |- | ||
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen 2''''' | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen 2''''' |
Revision as of 14:19, 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
A specific therapy should be given for the following anatomical location due to an increase predisposition of certain bacteria.
▸ Click on the following categories to expand treatment regimens.
Location ▸ Buccal ▸ Periorbital ▸ Orbital ▸ Perianal ▸ Facial
|
|
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
|
|
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.