Lymphangitis medical therapy: Difference between revisions
No edit summary |
No edit summary |
||
Line 64: | Line 64: | ||
| 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="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Suspected Methicillin-Sensitive Staphylococcus Aureus (MSSA)''''' | ||
|- | |- | ||
| style=" | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Dicloxacillin]] 500 mg PO q6h'''''<BR> OR <BR> ▸ '''''[[Cephalexin]] 500 mg PO q6h''''' | ||
|- | |- | ||
| style="font-size: 90% | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Suspected Methicillin-Resistant Staphylococcus Aureus (MRSA)''''' | ||
|- | |- | ||
| style=" | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Clindamycin]] 300-450 mg PO q8h'''''<BR> OR <BR>▸ '''''[[TMP-SMZ]] 1 or 2 double-strength tablets ((sulfamethoxazole 800 mg; trimethoprim 160 mg) PO q12h'''''<BR> OR <BR>▸ '''''[[Doxycycline]] 100 mg PO q12h'''''<BR> OR <BR> ▸ '''''[[Minocycline]] 100 mg PO q12h'''''<BR> OR <BR> ▸ '''''[[Linezolid]] 600 mg PO q12h''''' | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[ | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Suspected Beta-Hemolytic Streptococci and Methicillin-Resistant Staphylococcus Aureus (MRSA)''''' | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Clindamycin]] 300-450 mg PO q8h'''''<BR> OR <BR>▸ '''''[[Amoxicillin]] 500 mg PO q8h plus [[TMP-SMZ]] 1 or 2 double-strength tablets ((sulfamethoxazole 800 mg; trimethoprim 160 mg) PO q12h'''''<BR> OR <BR>▸ '''''[[Amoxicillin]] 500 mg PO q8h plus [[Doxycycline]] 100 mg PO q12h'''''<BR> OR <BR> ▸ '''''[[Amoxicillin]] 500 mg PO q8h plus [[Minocycline]] 100 mg PO q12h'''''<BR> OR <BR> ▸ '''''[[Linezolid]] 600 mg PO q12h''''' | |||
|- | |- | ||
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Animal Bites''''' | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Animal Bites''''' | ||
Line 93: | Line 92: | ||
| 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="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Suspected Methicillin-Sensitive Staphylococcus Aureus (MSSA)''''' | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[ | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Dicloxacillin]] 25 mg/kg PO divided q6h '''''<BR> OR <BR> ▸ '''''[[Cephalexin]] 25 mg/kg PO divided q6h''''' | ||
|- | |- | ||
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Suspected | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Suspected Methicillin-Resistant Staphylococcus Aureus (MRSA)''''' | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[ | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Clindamycin]] 10-13 mg/kg PO q6-8h'''''<BR> OR <BR>'''''[[TMP-SMZ]] 8–12 mg/kg (based on trimethoprim component) PO q12h'''''<BR> OR <BR> ▸ '''''[[Doxycycline]] ≤45 kg: 2 mg/kg PO q12h; >45 kg: 100 mg PO q12h'''''<BR> OR <BR> ▸ '''''[[Minocycline]] 2 mg/kg PO q12h'''''<BR> OR <BR> ▸ '''''[[Linezolid]] 10 mg/kg PO q8h''''' | ||
|- | |- | ||
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Suspected MRSA''''' | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Suspected Beta-Hemolytic Streptococci and Methicillin-Resistant Staphylococcus Aureus (MRSA)''''' | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Clindamycin]] 10-13 mg/kg PO q6-8h'''''<BR> OR <BR>▸ '''''[[Amoxicillin]] 25-50 mg/kg PO q8h plus [[TMP-SMZ]] 8–12 mg/kg (based on trimethoprim component) PO q12h'''''<BR> OR <BR>▸ '''''[[Amoxicillin]] 25-50 mg/kg PO q8h plus [[Doxycycline]] ≤45 kg: 2 mg/kg PO q12h; >45 kg: 100 mg PO q12h'''''<BR> OR <BR> ▸ '''''25-50 mg/kg PO q8h plus [[Minocycline]] 2 mg/kg PO q12h'''''<BR> OR <BR> ▸ '''''[[Linezolid]] 10 mg/kg PO q8h''''' | |||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[ | |||
|- | |- | ||
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Animal Bites''''' | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Animal Bites''''' | ||
Line 126: | Line 124: | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Clindamycin]] 300-450 mg PO q8h'''''<BR> OR <BR> ▸ '''''[[Vancomycin]] 15-20 mg/kg IV q8-12h''''' | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Clindamycin]] 300-450 mg PO q8h'''''<BR> OR <BR> ▸ '''''[[Vancomycin]] 15-20 mg/kg IV q8-12h''''' | ||
|- | |- | ||
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Suspected MSSA''''' | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Suspected Methicillin-Sensitive Staphylococcus Aureus (MSSA)''''' | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[ | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Nafcillin]] or [[Oxacillin]] 1-2 g IV q4h'''''<BR> OR <BR> ▸ '''''[[Cefazolin]] 1 g IV q8h'''''<BR> OR <BR> ▸ '''''[[Clindamycin]] 300-450 mg PO q8h'''''<BR> OR <BR> ▸ '''''[[Erythromycin]] 500 mg PO q6h''''' | ||
|- | |- | ||
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Suspected MRSA''''' | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Suspected Methicillin-Resistant Staphylococcus Aureus (MRSA)''''' | ||
|- | |- | ||
| 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 | | 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> ▸ '''''[[Clindamycin]] 600 mg IV/PO q8h'''''<BR> OR <BR> ▸ '''''[[Telavancin]] 10 mg/kg IV q12h''''' | ||
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Suspected Beta-Hemolytic Streptococci and Methicillin-Resistant Staphylococcus Aureus (MRSA)''''' | |||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Clindamycin]] 300-450 mg PO q8h'''''<BR> OR <BR>▸ '''''[[Amoxicillin]] 500 mg PO q8h plus [[TMP-SMZ]] 1 or 2 double-strength tablets ((sulfamethoxazole 800 mg; trimethoprim 160 mg) PO q12h'''''<BR> OR <BR>▸ '''''[[Amoxicillin]] 500 mg PO q8h plus [[Doxycycline]] 100 mg PO q12h'''''<BR> OR <BR> ▸ '''''[[Amoxicillin]] 500 mg PO q8h plus [[Minocycline]] 100 mg PO q12h'''''<BR> OR <BR> ▸ '''''[[Linezolid]] 600 mg PO q12h | |||
|- | |- | ||
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Animal Bites''''' | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Animal Bites''''' | ||
Line 155: | Line 155: | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Clindamycin]] 10-13 mg/kg IV q6-8h'''''<BR> OR <BR> ▸ '''''[[Vancomycin]] 15 mg/kg IV q6h''''' | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Clindamycin]] 10-13 mg/kg IV q6-8h'''''<BR> OR <BR> ▸ '''''[[Vancomycin]] 15 mg/kg IV q6h''''' | ||
|- | |- | ||
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Suspected MSSA''''' | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Suspected Methicillin-Sensitive Staphylococcus Aureus (MSSA)''''' | ||
|- | |||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Nafcillin]] or [[Oxacillin]] 100–150 mg/kg IV q6h'''''<BR> OR <BR> ▸ '''''[[Cefazolin]] 50 mg/kg IV q8h'''''<BR> OR <BR> ▸ '''''[[Clindamycin]] 10-13 mg/kg IV q6-8h'''''<BR> OR <BR> ▸ '''''[[Erythromycin]] 10 mg/kg PO q6h''''' | |||
|- | |- | ||
| style="font-size: 90% | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Suspected Methicillin-Resistant Staphylococcus Aureus (MRSA)''''' | ||
|- | |- | ||
| style=" | | 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/PO q8h'''''<BR> OR <BR> ▸ '''''[[Daptomycin]] 5-9 mg/kg IV q24h'''''<BR> OR <BR> ▸ '''''[[Clindamycin]] 10-13 mg/kg IV/PO q6-8h (max:40 mg/kg/day)''''' | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[ | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Suspected Beta-Hemolytic Streptococci and Methicillin-Resistant Staphylococcus Aureus (MRSA)''''' | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Clindamycin]] 10-13 mg/kg PO q6-8h'''''<BR> OR <BR>▸ '''''[[Amoxicillin]] 25-50 mg/kg PO q8h plus [[TMP-SMZ]] 8–12 mg/kg (based on trimethoprim component) PO q12h'''''<BR> OR <BR>▸ '''''[[Amoxicillin]] 25-50 mg/kg PO q8h plus [[Doxycycline]] ≤45 kg: 2 mg/kg PO q12h; >45 kg: 100 mg PO q12h'''''<BR> OR <BR> ▸ '''''25-50 mg/kg PO q8h plus [[Minocycline]] 2 mg/kg PO q12h'''''<BR> OR <BR> ▸ '''''[[Linezolid]] 10 mg/kg PO q8h''''' | |||
|- | |- | ||
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Animal Bites''''' | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Animal Bites''''' | ||
Line 240: | Line 243: | ||
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Life-Threatening Penicillin Allergies''''' | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Life-Threatening Penicillin Allergies''''' | ||
|- | |- | ||
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=left | ''''' | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=left | '''''Adults''''' | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Clindamycin]] 300-450 mg PO q8h'''''<BR> OR <BR> ▸ '''''[[Vancomycin]] 15-20 mg/kg IV q8-12h''''' | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Clindamycin]] 300-450 mg PO q8h'''''<BR> OR <BR> ▸ '''''[[Vancomycin]] 15-20 mg/kg IV q8-12h''''' | ||
Line 254: | Line 257: | ||
| 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|Methicillin Sensitive Staphylococcus Aureus}} | ! 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|Methicillin-Sensitive Staphylococcus Aureus (MSSA)}} | ||
| 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="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=left | ''''' | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=left | '''''Adults''''' | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Nafcillin]] or [[Oxacillin]] 1-2 g IV q4h'''''<BR> OR <BR> ▸ '''''[[Cefazolin]] 1 g IV q8h'''''<BR> OR <BR> ▸ '''''[[Clindamycin]] 300-450 mg PO q8h or 600 mg/kg IV q8h'''''<BR> OR <BR> ▸ '''''[[Erythromycin]] 500 mg PO q6h'''''<BR> OR <BR> ▸ '''''[[Dicloxacillin]] 500 mg PO q6h'''''<BR> OR <BR> ▸ '''''[[Cephalexin]] 500 mg PO q6h'''''<BR> OR <BR> ▸ '''''[[Doxycycline]] or [[Minocycline]] 100 mg PO q12h'''''<BR> OR <BR> ▸ '''''[[TMP-SMZ]] 1 or 2 double-strength tablets ((sulfamethoxazole 800 mg; trimethoprim 160 mg) PO q12h''''' | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Nafcillin]] or [[Oxacillin]] 1-2 g IV q4h'''''<BR> OR <BR> ▸ '''''[[Cefazolin]] 1 g IV q8h'''''<BR> OR <BR> ▸ '''''[[Clindamycin]] 300-450 mg PO q8h or 600 mg/kg IV q8h'''''<BR> OR <BR> ▸ '''''[[Erythromycin]] 500 mg PO q6h'''''<BR> OR <BR> ▸ '''''[[Dicloxacillin]] 500 mg PO q6h'''''<BR> OR <BR> ▸ '''''[[Cephalexin]] 500 mg PO q6h'''''<BR> OR <BR> ▸ '''''[[Doxycycline]] or [[Minocycline]] 100 mg PO q12h'''''<BR> OR <BR> ▸ '''''[[TMP-SMZ]] 1 or 2 double-strength tablets ((sulfamethoxazole 800 mg; trimethoprim 160 mg) PO q12h''''' | ||
Line 270: | Line 273: | ||
| 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|Methicillin Resistant Staphylococcus Aureus}} | ! 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|Methicillin-Resistant Staphylococcus Aureus (MRSA)}} | ||
| 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''''' | ||
|- | |- |
Revision as of 16:13, 2 June 2014
Lymphangitis Microchapters |
Diagnosis |
---|
Treatment |
Case Studies |
Lymphangitis medical therapy On the Web |
American Roentgen Ray Society Images of Lymphangitis medical therapy |
Risk calculators and risk factors for Lymphangitis medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vendhan Ramanujam M.B.B.S [2]
Overview
Lymphangitis most often is an acute complication following an extension from the skin infection with the potential of a systemic spread. It has to be promptly treated with appropriate antibiotics along with analgesics, anti-inflammatory medications, warm and moist compresses. Certain conditions like nodular lymphagitis that is complicated by abscess and lymphedema with significant lymphatic obstruction may require surgical intervention.
Principles of Therapy
Therapy Based on Clinical Form
Acute Lymphangitis
Empiric Therapy
▸ Click on the following categories to expand treatment regimens.[1]
Mild - Moderate Acute Lymphangitis ▸ Adults ▸ Children age >28 days Severe Acute Lymphangitis ▸ Adults ▸ Children age >28 days |
|
Pathogen Based Therapy
▸ Click on the following categories to expand treatment regimens.[1]
Bacteria ▸ Streptococcus Pyogenes ▸ Methicillin Sensitive Staphylococcus Aureus ▸ Methicillin Resistant Staphylococcus Aureus ▸ Spirillum Minus
|
References
- ↑ 1.0 1.1 Moran GJ, Abrahamian FM, Lovecchio F, Talan DA (2013). "Acute bacterial skin infections: developments since the 2005 Infectious Diseases Society of America (IDSA) guidelines". J Emerg Med. 44 (6): e397–412. doi:10.1016/j.jemermed.2012.11.050. PMID 23466022.