IDS Treatment of Common Infections of the Skin

Question 2

Animal bite (prophylaxis or early infection)

Answer 2

Primary: Amoxicillin–clavulanate (875/125 mg PO bid) | Alternative: Doxycycline (100 mg PO bid)

Question 3

Animal bite (established infection)

Answer 3

Primary: Ampicillin–sulbactam (1.5–3 g IV q6h) | Alternative: Clindamycin (600–900 mg IV q8h) plus Ciprofloxacin (400 mg IV q12h) or cefoxitin (2 g IV q6h)

Question 4

Bacillary angiomatosis

Answer 4

Primary: Erythromycin (500 mg PO qid) | Alternative: Doxycycline (100 mg PO bid)

Question 5

Herpes simplex (primary genital)

Answer 5

Primary: Acyclovir (400 mg PO tid for 10 days) | Alternative: Famciclovir (250 mg PO tid for 5–10 days) or valacyclovir (1000 mg PO bid for 10 days)

Question 6

Herpes zoster (immunocompetent host >50 years of age)

Answer 6

Primary: Acyclovir (800 mg PO 5 times daily for 7–10 days) | Alternative: Famciclovir (500 mg PO tid for 7–10 days) or valacyclovir (1000 mg PO tid for 7 days)

Question 7

Cellulitis (staphylococcal or streptococcal)

Answer 7

Primary: Nafcillin or oxacillin (2 g IV q4–6h) | Alternative: Cefazolin (1–2 g q8h) or ampicillin/sulbactam (1.5–3 g IV q6h) or erythromycin (0.5–1 g IV q6h) or clindamycin (600–900 mg IV q8h)

Question 8

MRSA skin infection

Answer 8

Primary: Vancomycin (1 g IV q12h) | Alternative: Linezolid (600 mg IV q12h)

Question 9

Necrotizing fasciitis (Group A streptococcal)

Answer 9

Primary: Clindamycin (600–900 mg IV q6–8h) plus penicillin G (4 million units IV q4h) | Alternative: Clindamycin (600–900 mg IV q6–8h) plus a cephalosporin (first- or second-generation)

Question 10

Necrotizing fasciitis (mixed aerobes and anaerobes)

Answer 10

Primary: Ampicillin (2 g IV q4h) plus clindamycin (600–900 mg IV q6–8h) plus ciprofloxacin (400 mg IV q6–8h) | Alternative: Vancomycin (1 g IV q6h) plus metronidazole (500 mg IV q6h) plus ciprofloxacin (400 mg IV q6–8h)

Question 11

Gas gangrene

Answer 11

Primary: Clindamycin (600–900 mg IV q6–8h) plus penicillin G (4 million units IV q4–6h) | Alternative: Clindamycin (600–900 mg IV q6–8h) plus cefoxitin (2 g IV q6h)