Suppurative thrombophlebitis medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Medical Therapy

Overview

The mainstay of therapy for suppurative thrombophlebitis is antimicrobial therapy. Empiric therapy includes anti-staphylococcal antibiotics plus antibiotics with coverage against enterobacteriaceae. The benefit of pharmacologic anticoagulation is uncertain in suppurative thrombophlebitis and is not routinely recommended.

Peripheral Vein Suppurative Thrombophlebitis

Till the blood culture results detect the targeted pathogen, empiric antibiotic therapy is given aiming to include an agent with activity against staphylococci plus an agent with activity against enterobacteriaceae.

Peripheral Vein Suppurative Thrombophlebitis ▸ Vancomycin 15 to 20 mg/kg/dose every 8 to 12 hours, not to exceed 2 g per dose x minimum of 2Wks PLUS ▸ Ceftriaxone 1 g IV daily x minimum of 2Wks

Jugular Vein Suppurative Thrombophlebitis

A beta-lactamase resistant beta-lactam antibiotic should be used in cases of jugular vein suppurative thrombophlebitis.

Jugular Vein Suppurative Thrombophlebitis ▸ Ampicillin-sulbactam 3 g every six hours x 4 Wks OR ▸ Piperacillin-tazobactam 4.5 g every six hours x 4 Wks OR ▸ Ticarcillin-clavulanate 3.1 g every six hours x 4 Wks PLUS ▸ Vancomycin 15 to 20 mg/kg/dose every 8 to 12 hours, not to exceed 2 g per dose x 4 Wks

Vena Cava Suppurative Thrombophlebitis

Vena Cava Suppurative Thrombophlebitis ▸ Vancomycin 15 to 20 mg/kg/dose every 8 to 12 hours, not to exceed 2 g per dose x 4 to 6 Wks PLUS ▸ Ceftriaxone 1 g IV daily x 4 to 6 Wks

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