| 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 |
|
