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Infection

Skin (Cellulitis, erysipelas)  Possible therapeutic alternatives
Cellulitis (extremities): No risk factors. Mild cases .

Treatment duration: 
7 - 10 days

Common pathogens
Early / Mild:
Penicillin VK 500mg orally every 6 hours OR
Cephalexin 500mg orally every 6 hours OR
Bactrim DS orally twice daily
OR
Cefadroxil 500mg-1g orally every 12 hours OR Cefuroxime 250-500mg orally every 12 hours
Moderate / Severe / Sudden Onset:
Vancomycin 1 gram  ivpb q12h (patient-specific dosing required)  OR
Daptomycin 4 mg/kg IV q 24h OR
Linezolid 600 mg orally or IV q 12h
Erysipelas (sharply demarcated borders)

 

Treatment duration: 
7 - 10 days

Common pathogens
Early / Mild:
Dicloxacillin 500mg orally four times daily OR
Clindamycin 300mg orally four times daily or if severe 600mg IV every 6 hours OR
Cephalexin (Keflex ®) 250-500mg orally every 6 hours OR
Azithromycin
500mg x 1, then 250mg once daily
OR
Augmentin 875/125 mg orally twice daily or  500/125mg three times daily

Hospitalized:

Penicillin G 2-4 million units IV q4-6h OR
Cefotaxime 1-2 grams IV every 8 hours OR
Clindamycin  600mg IV every 6 or 8 hours or 300mg orally four times daily  OR
Cefazolin 1 gram IVPB q8h
Cellulitis: (Risk factors), Diabetes mellitus, Immunosuppressed, ulcerated lesions. Common pathogens

Early/mild:

Penicillin VK 500mg orally every 6 hours OR
Cephalexin 500mg orally every 6 hours
PLUS
Bactrim DS orally twice daily


Hospitalized:
Ampicillin-sulbactam 1.5 - 3 grams  ivpb every 6 hours 

Severe / Hospitalized:

Vancomycin 1 gram  ivpb q12h (patient-specific dosing required)  OR
Daptomycin 4 mg/kg IV q 24h OR
Linezolid 600 mg orally or IV q 12h OR
Ceftaroline 600mg IV q12h.

PLUS - May consider
:
Ertapenem 1 gm IV q24h OR
Doripenem 500 mg IV q8h OR
Meropenem 1 gm IV q8h

Images

Cellulitis

Erysipelas 

References - Infectious Disease Section

Infectious Disease References

Disclaimer

The authors make no claims of the accuracy of the information contained herein; and these suggested doses are not a substitute for clinical judgement. Neither GlobalRPh Inc. nor any other party involved in the preparation of this program shall be liable for any special, consequential, or exemplary damages resulting in whole or part from any user's use of or reliance upon this material.PLEASE READ THE DISCLAIMER CAREFULLY BEFORE ACCESSING OR USING THIS SITE. BY ACCESSING OR USING THIS SITE, YOU AGREE TO BE BOUND BY THE TERMS AND CONDITIONS SET FORTH IN THE DISCLAIMER.   Read the disclaimer
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