Template:Cellulitis antibiotics: Difference between revisions

(Created page with "''taylor antibiotics by regional antibiogram''<ref>Stevens D, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by th...")
 
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''taylor antibiotics by regional antibiogram''<ref>Stevens D, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis. 2014;59(2):e10-e52</ref>
''taylor antibiotics by regional antibiogram''<ref>Stevens D, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis. 2014;59(2):e10-e52</ref>
====Outpatient====
====Outpatient====
''Coverage for Staph and Strep''
*Coverage primarily for Strep
*[[Clindamycin]] 450mg PO TID x 10 days OR
*[[MRSA]] coverage only necessary if cellulitis associated with: purulence, penetrating trauma, known MRSA colonization, IV drug use, or SIRS<ref>Stevens D, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clinical infectious diseases 59.2 (2014): e10-52.</ref>
*[[Cephalexin]] 500mg PO q6hrs x 10 days OR
*IDSA guidelines recommend a 5 day treatment duration, unless symptoms do not improve within that timeframe<ref>Stevens D, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clinical infectious diseases 59.2 (2014): e10-52.</ref>
**Add[[TMP/SMX]] 1DS PO BID x 7 days<ref>Cadena J, et al. Dose of trimethoprim-sulfamethoxazole to treat skin and skin structure infections caused by methicillin-resis- tant Staphylococcus aureus. Antimicrobial agents and chemo- therapy 55.12 (2011): 5430-5432.</ref> if [[MRSA]] is suspected
**[[Cephalexin]] 500mg PO q6hrs OR
*[[Doxycycline]] or [[Minocycline]] 100mg PO BID x 10 days
***Add [[TMP/SMX]] 1DS PO BID<ref>Cadena J, et al. Dose of trimethoprim-sulfamethoxazole to treat skin and skin structure infections caused by methicillin-resistant Staphylococcus aureus. Antimicrobial agents and chemotherapy 55.12 (2011): 5430-5432.</ref> if [[MRSA]] is suspected
***Most cases of non-purulent cellulitis are likely caused by Strep. In these cases, the addition of TMP/SMX has been demonstrated to offer no clinical benefit over cephalexin alone.<ref>Pallin D, et al. Clinical trial: comparative effectiveness of cephalexin plus trimethoprim-sulfamethoxazole versus cephalexin alone for treatment of uncomplicated cellulitis: a randomized controlled trial. Clinical infectious diseases 56.12 (2013): 1754-1762</ref>
**[[Clindamycin]] 450mg PO TID
**Tetracyclines (like [[Doxycycline]]) should be avoided in non-purulent cellulitis, due to high rates of Strep resistance<ref>Traub, W and Leonhard, B. Comparative susceptibility of clinical group A, B, C, F, and G beta-hemolytic streptococcal isolates to 24 antimicrobial drugs. Chemotherapy 43.1 (1997):10-20.</ref>


====Inpatient====
====Inpatient====

Revision as of 21:34, 29 October 2015

taylor antibiotics by regional antibiogram[1]

Outpatient

  • Coverage primarily for Strep
  • MRSA coverage only necessary if cellulitis associated with: purulence, penetrating trauma, known MRSA colonization, IV drug use, or SIRS[2]
  • IDSA guidelines recommend a 5 day treatment duration, unless symptoms do not improve within that timeframe[3]
    • Cephalexin 500mg PO q6hrs OR
      • Add TMP/SMX 1DS PO BID[4] if MRSA is suspected
      • Most cases of non-purulent cellulitis are likely caused by Strep. In these cases, the addition of TMP/SMX has been demonstrated to offer no clinical benefit over cephalexin alone.[5]
    • Clindamycin 450mg PO TID
    • Tetracyclines (like Doxycycline) should be avoided in non-purulent cellulitis, due to high rates of Strep resistance[6]

Inpatient

Saltwater related cellulitis

coverage extended for Vibrio vulnificus

Freshwater related cellulitis

coverage extended for Aeromonas sp

  1. ↑ Stevens D, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis. 2014;59(2):e10-e52
  2. ↑ Stevens D, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clinical infectious diseases 59.2 (2014): e10-52.
  3. ↑ Stevens D, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clinical infectious diseases 59.2 (2014): e10-52.
  4. ↑ Cadena J, et al. Dose of trimethoprim-sulfamethoxazole to treat skin and skin structure infections caused by methicillin-resistant Staphylococcus aureus. Antimicrobial agents and chemotherapy 55.12 (2011): 5430-5432.
  5. ↑ Pallin D, et al. Clinical trial: comparative effectiveness of cephalexin plus trimethoprim-sulfamethoxazole versus cephalexin alone for treatment of uncomplicated cellulitis: a randomized controlled trial. Clinical infectious diseases 56.12 (2013): 1754-1762
  6. ↑ Traub, W and Leonhard, B. Comparative susceptibility of clinical group A, B, C, F, and G beta-hemolytic streptococcal isolates to 24 antimicrobial drugs. Chemotherapy 43.1 (1997):10-20.
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