Sandbox/Alejandro
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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
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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
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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.