SSTIs, Osteomyelitis

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Author:
fallcloud13
ID:
170044
Filename:
SSTIs, Osteomyelitis
Updated:
2012-09-10 16:52:47
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SSTIs Osteomyelitis
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SSTIs, Osteomyelitis
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  1. Erysipelas Txn
    • Pen G Procaine IM or
    • Pen VK PO
    • Severe: Pen G IV
    • PNC allergy: Clindamycin or erythromycin
    • 7-10 days
  2. Impetigo Txn
    • Mupirocin (Bactroban) oint.
    • Dicloxacillin or cloxacillin or first gen cephalosporins
    • PCN allergy: Clindamycin
    • 7-10 days
  3. Cellulitis Txn
    • Mild-moderate:
    • Dicloxacillin 500mg PO QID
    • PCN allergy: Cephalexin, Clindamycin
    • Severe or unable to take PO:
    • Nafcillin/oxacillin IV
    • Cefazolin IV
    • PCN allergy: Clindamycin, Vancomycin
    • 5-10 days
  4. Cellulitis MRSA Txn
    • PO: doxycycline, clindamycin, bactrim
    • IV: linezolid, daptomycin, vancomycin
  5. Necrotizing Fasciitis Txn
    • Hydration!
    • Type I
    • Unasyn OR Zosyn + Clindamycin + Ciprofloxacin
    • PCN allergic: Clinda or metro + AMG or FQs
    • Type II
    • Clindamycin + PCN
    • PCN allergy: Vanco, linezolid, dapto, quinu/dalfopristin
  6. DFI Txn PEDIS 2
    • Augmentin(no pseudo, cover anaerobe), Levo, Doxy(MRSA), Dicloxacillin, Clinda(MRSA), Cephalexin, Bactrim (CA-MRSA)
    • 1-2 wks
  7. DFI Txn PEDIS 3,4
    • Anaerobic: Cefoxitin, Moxi, Ertapenem
    • P. aeruginosa: Zosyn
    • MRSA: Tigecycline, Linezolid, Dapto, Vanco
    • No P. aeruginosa: Unasyn, Ertapenem
    • 2-4 wks
  8. Animal Bites Txn
    • Augmentin
    • IV: Unasyn, Ertapenem
    • PCN allergy: Cefoxitin, carbapenem
    • PCN allergy: doxy, bactrim, FQ+Clinda
    • 5-10 days for cellulitis and abscesses
    • 3-5 days for prophylactic
    • >10 days for infection
  9. Human Bites Txn
    • Irrigation, tetanus, prophylactic ABt with Dicloxacillink Pen VK
    • Infected bite: Augmentin
  10. Human Bites (Clenched fist) Txn
    • Cefoxitin, Unasyn, ertapenem
    • PCN allergy: FQ + Clinda or Bactrim + metro
  11. Osteomyelitis (Hematogenous)
    • Empiric ATB: Nafcillin + Cefotaxime OR Ceftriaxone
    • 4-6wks
  12. Osteomyelitis (Chronic)
    • Empiric ATB: Not recommended
    • Surgical debridement + ATB (IV) based off culture results
    • Long-tern IV catheters (4-6wks IV, 6 months of PO or indefinate)
  13. Osteomyelitis Empiric selection
    • NewBorn: S. aureus, strep, E.coli: Nafcillin and Cetazidime
    • <5: S. aureus, S. pyogenes: Nafcillin of cefazolin or Cefuroxime for H. flu
    • >5: S. aureus, S. pyogenes: Nafcillin or cefazolin
    • Adult: S. aureus and epidermidis: Naf cillin, cefazolin, Vanco
    • IVDA: Pseudomonas: Cipro or ceftazidime +AMG
    • Vascular insufficiency: GM+,GM-: AMG + Unasyn
  14. Osteomyelitis Bacteria Based
    • S. aureus: Nafcillin (MSSA), Clinda, Vanco (MRSA)
    • Strep: Pen G IV, Cefotaxime(intermediate) or Vanco(resistant)
    • Entero: Ampicillin or Vanco
    • GM- rods: FQs
    • Serratia or P. aeruginosa: Ceftazadime + AMG
    • Anaerobe: Clinda
    • Aerobic/anaerobic: Augmentin

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