Template:Cellulitis antibiotics: Difference between revisions
Spenceemmett (talk | contribs) |
Ostermayer (talk | contribs) (Prepared the page for translation) |
||
| Line 1: | Line 1: | ||
<languages/> | |||
<translate> | |||
''Tailor 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> | ''Tailor 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==== | ||
''[[MRSA]] coverage only necessary if cellulitis associated with: purulence, penetrating trauma, known MRSA colonization, IV drug use, or SIRS''<ref name="IDSA guidelines">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> | ''Coverage primarily for [[Special:MyLanguage/Strep|Strep]]''<br /> | ||
''[[Special:MyLanguage/MRSA|MRSA]] coverage only necessary if cellulitis associated with: purulence, penetrating trauma, known MRSA colonization, IV drug use, or SIRS''<ref name="IDSA guidelines">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> | |||
*5 day treatment duration, unless symptoms do not improve within that timeframe<ref name="IDSA guidelines" /> | *5 day treatment duration, unless symptoms do not improve within that timeframe<ref name="IDSA guidelines" /> | ||
**[[Cephalexin]] 500mg PO q6hrs '''OR''' | **[[Special:MyLanguage/Cephalexin|Cephalexin]] 500mg PO q6hrs '''OR''' | ||
***Add [[TMP/SMX]] DS 1 tab 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 | ***Add [[Special:MyLanguage/TMP/SMX|TMP/SMX]] DS 1 tab 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 [[Special:MyLanguage/MRSA|MRSA]] is suspected | ||
***Most cases of non-purulent cellulitis are 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> | ***Most cases of non-purulent cellulitis are 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 covers both Strep and Staph | **[[Special:MyLanguage/Clindamycin|Clindamycin]] 450mg PO TID covers both Strep and Staph | ||
**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> | **Tetracyclines (like [[Special:MyLanguage/Doxycycline|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==== | ||
*[[Vancomycin]] 20mg/kg IV q12hrs '''OR''' | |||
*[[Clindamycin]] 600mg IV q8hrs '''OR''' | *[[Special:MyLanguage/Vancomycin|Vancomycin]] 20mg/kg IV q12hrs '''OR''' | ||
*[[Linezolid]] 600mg IV q12hrs '''OR''' | *[[Special:MyLanguage/Clindamycin|Clindamycin]] 600mg IV q8hrs '''OR''' | ||
*[[Daptomycin]] 4mg/kg IV once daily | *[[Special:MyLanguage/Linezolid|Linezolid]] 600mg IV q12hrs '''OR''' | ||
*[[Special:MyLanguage/Daptomycin|Daptomycin]] 4mg/kg IV once daily | |||
====Saltwater related cellulitis==== | ====Saltwater related cellulitis==== | ||
''coverage extended for [[Vibrio vulnificus]]'' | |||
*[[Doxycycline]] 100mg PO/IV q12hrs daily + [[Cefepime]] 1g IV q12hrs x 10 days | ''coverage extended for [[Special:MyLanguage/Vibrio vulnificus|Vibrio vulnificus]]'' | ||
*[[Ciprofloxacin]] 400mg IV q12hrs x 10 days | *[[Special:MyLanguage/Doxycycline|Doxycycline]] 100mg PO/IV q12hrs daily + [[Special:MyLanguage/Cefepime|Cefepime]] 1g IV q12hrs x 10 days | ||
*[[Ciprofloxacin]] 750mg PO q12hrs x 10 days | *[[Special:MyLanguage/Ciprofloxacin|Ciprofloxacin]] 400mg IV q12hrs x 10 days | ||
*[[Special:MyLanguage/Ciprofloxacin|Ciprofloxacin]] 750mg PO q12hrs x 10 days | |||
====Freshwater related cellulitis==== | ====Freshwater related cellulitis==== | ||
''coverage extended for [[Aeromonas sp]]'' | |||
*[[Ciprofloxacin]] 400mg IV q12hrs x 10 days | ''coverage extended for [[Special:MyLanguage/Aeromonas sp|Aeromonas sp]]'' | ||
*[[Ciprofloxacin]] 500mg PO q12hrs x 10 days | *[[Special:MyLanguage/Ciprofloxacin|Ciprofloxacin]] 400mg IV q12hrs x 10 days | ||
*[[TMP/SMX]] 2 DS tablets (5mg/kg) PO q12hrs x 10 days | *[[Special:MyLanguage/Ciprofloxacin|Ciprofloxacin]] 500mg PO q12hrs x 10 days | ||
*[[Ceftriaxone]] 1g (50mg/kg) IV q24hrs | *[[Special:MyLanguage/TMP/SMX|TMP/SMX]] 2 DS tablets (5mg/kg) PO q12hrs x 10 days | ||
*[[Special:MyLanguage/Ceftriaxone|Ceftriaxone]] 1g (50mg/kg) IV q24hrs | |||
</translate> | |||
Revision as of 15:57, 27 January 2026
Tailor 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]
- 5 day treatment duration, unless symptoms do not improve within that timeframe[2]
- Cephalexin 500mg PO q6hrs OR
- Clindamycin 450mg PO TID covers both Strep and Staph
- Tetracyclines (like Doxycycline) should be avoided in non-purulent cellulitis due to high rates of Strep resistance[5]
Inpatient
- Vancomycin 20mg/kg IV q12hrs OR
- Clindamycin 600mg IV q8hrs OR
- Linezolid 600mg IV q12hrs OR
- Daptomycin 4mg/kg IV once daily
coverage extended for Vibrio vulnificus
- Doxycycline 100mg PO/IV q12hrs daily + Cefepime 1g IV q12hrs x 10 days
- Ciprofloxacin 400mg IV q12hrs x 10 days
- Ciprofloxacin 750mg PO q12hrs x 10 days
coverage extended for Aeromonas sp
- Ciprofloxacin 400mg IV q12hrs x 10 days
- Ciprofloxacin 500mg PO q12hrs x 10 days
- TMP/SMX 2 DS tablets (5mg/kg) PO q12hrs x 10 days
- Ceftriaxone 1g (50mg/kg) IV q24hrs
- ↑ 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
- ↑ 2.0 2.1 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
- ↑ 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.
- ↑ 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
- ↑ 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.