Sandbox/Alejandro: Difference between revisions
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▸ '''Adults''' | ▸ '''Adults''' | ||
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▸ '''Children age >28 days''' | ▸ '''Children age >28 days''' | ||
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'''Complicated | '''Complicated Cellulitis†''' | ||
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▸ '''Adults''' | ▸ '''Adults''' | ||
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▸ '''Children age >28 days''' | ▸ '''Children age >28 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 | ▸ '''''[[Vancomycin]] | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Vancomycin]] 15-20 mg/kg IV q8-12h'''''<BR> OR <BR>▸ '''''[[Linezolid]] 600 mg IV q12h'''''<BR> OR <BR> ▸ '''''[[Daptomycin]] 4mg/kg IV q24h''''' <BR> OR <BR> ▸ '''''[[Telavancin]] 10mg/kg IV q24h''''' | ||
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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 | | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Clindamycin]] 600 mg IV q8h''''' | ||
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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 | ▸ '''''[[Linezolid]] | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Linezolid]] 600 mg PO q12h''''' | ||
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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 | ▸ '''''[[Clindamycin]] | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Clindamycin]]'' 600 mg PO q8h''' | ||
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| style="padding: 0 5px; font-size: 90%; background: #F5F5F5" align=left | <SMALL> <sup>†</sup> Complicated cellulitis refers to a deeper soft-tissue infections and the association with necrotizing fasciitis, septic arthritis, or osteomyelitis</SMALL> | |||
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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''''' | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Vancomycin]] 15 | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Vancomycin]] 15 mg/kg IV q6h'''''<BR> OR <BR>▸ '''''[[Linezolid]] 10 mg/kg IV q8h (max: 600mg/dose)''''' | ||
|- | |- | ||
| 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 | ▸ '''''[[Clindamycin]] | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Clindamycin]] 10-13 mg/kg IV q6-8h (max:40 mg/kg/day)''''' | ||
|- | |- | ||
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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''''' | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Linezolid]] | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Linezolid]] 10 mg/kg PO q8h (max: 600mg/dose)''''' <br> OR <br> ▸ '''''[[Clindamycin]] 10-13 mg/kg PO q6-8h (max:40 mg/kg/day)''''' | ||
|- | |- | ||
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5" align=left | <SMALL> <sup>†</sup> Complicated cellulitis refers to a deeper soft-tissue infections and the association with necrotizing fasciitis, septic arthritis, or osteomyelitis<SMALL> | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5" align=left | <SMALL> <sup>†</sup> Complicated cellulitis refers to a deeper soft-tissue infections and the association with necrotizing fasciitis, septic arthritis, or osteomyelitis</SMALL> | ||
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Revision as of 19:06, 23 May 2014
Empiric TherapyAdapted from Clinical Practice Guidelines CID 2011[1] and Guidelines for Skin and Soft-Tissue Infections CID 2005[2]
▸ Click on the following categories to expand treatment regimens.
Cellulitis Non-purulent Cellulitis ▸ Adults ▸ Children age >28 days Purulent Cellulitis ▸ Adults ▸ Children age >28 days Complicated Cellulitis† ▸ Adults ▸ Children age >28 days
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Note:
- Treatment of cellulitis in neonates usually requires hospitalization and parenteral therapy. Oral therapy is given for completion of the treatment when the patogen is unknown.
- Optimal dose should be based on determination of serum concentrations.
- The above antibiotic regimen is NOT for initial empirical treatment of infections involving the face.
- Dose alteration for renal insufficiency may be needed 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.[3]
- ↑ Mathews, CJ.; Weston, VC.; Jones, A.; Field, M.; Coakley, G. (2010). "Bacterial septic arthritis in adults". Lancet. 375 (9717): 846–55. doi:10.1016/S0140-6736(09)61595-6. PMID 20206778. Unknown parameter
|month=
ignored (help) - ↑ Dennis L. Stevens, Alan L. Bisno, Henry F. Chambers, E. Dale Everett, Patchen Dellinger, Ellie J. C. Goldstein, Sherwood L. Gorbach, Jan V. Hirschmann, Edward L. Kaplan, Jose G. Montoya & James C. Wade (2005). "Practice guidelines for the diagnosis and management of skin and soft-tissue infections". Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 41 (10): 1373–1406. doi:10.1086/497143. PMID 16231249. Unknown parameter
|month=
ignored (help) - ↑ 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.