SSTI Flashcards
Treatment for superficial Impetigo
Mupirocin Topical antibiotic BD x 5 days
Empiric treatment for impetigo and ecthyma (with and without allergies)
Without allergies
Cephalexin 250mg QDS for 7 days
Cloxacillin 250mg QDS for 7 days
With beta-lactam allergy
Clindamycin 300mg PO QDS for 7 days
Culture-directed treatment for S. pyogenes for impetigo and ecthyma
PO Penicillin VK 250mg QDS for 7 days
Culture-directed treatment for S. aureus for impetigo and ecthyma
Cephalexin 250mg QDS for 7 days
Cloxacillin 250mg QDS for 7 days
What are the SIRS criteria?
Temperature >38 or <36 degree celcius
Heart rate > 90bpm
Respiratory rate > 24 breaths per minute
WBC count > 12 x 10^9/L or <4 x 10^9/L
Patient has non-purulent cellulitis with 1 SIRS criteria; what empiric treatment to give?
PO Penicillin VK 500mg QDS 5 days
PO Cloxacillin 500mg QDS 5 days
PO Cephalexin 500mg QDS 5 days
PO Clindamycin 300mg QDS 5 days
Patient has non-purulent cellulitis with 2 or more SIRS criteria, what empiric treatment to give?
IV Penicillin G, 4million units q4-6h
IV Cefazolin 1-2g q8h
IV Clindamycin 600mg q8h
Patient has non-purulent cellulitis with 2 SIRS criteria AND hypotension
IV Piperacillin/Tazobactam 4.5g q6-8h
IV Cefepime 2g q8h
IV Meropenem 1g q8h
If MRSA risk factor, add:
Vancomycin 15mg/kg q8-12h
Daptomycin
Linezolid
Whats the difference between purulent and non-purulent cellulitis treatment for patient with no SIRS or 1 SIRS criteria?
Cannot use Penicillin G or VK anymore as we must cover for S. aureus in the empiric treatment.
First line will become Cephalexin 500mg PO QDS or Cloxacillin 500mg PO QDS
Patient with diabetic foot infection (mild), what antibiotics to give?
PO Cephalexin 250-500mg QDS
PO Cloxacillin 250-500mg QDS
PO Clindamycin 300mg QDS
If MRSA risk factor:
PO Cotrimoxazole 960mg BD
PO Clindamycin 300mg QDS
PO doxycycline 100mg BD
Duration when no bone involved: 1 to 2 weeks
Patient with diabetic foot infection (moderate), what antibiotics to give
IV Augmentin 1.2g q8h
IV Ceftriaxone (must give IV metronidazole 500mg TDS or IV Clindamycin 600mg q8h for anaerobic coverage)
IV ertapenem
If MRSA Risk factor:
IV Vancomycin 15mg/kg q8-12h
IV daptomycin
IV linezolid
Duration when no bone involved is 1 to 3 weeks
Patient with diabetic foot infection (Severe), what antibiotics to give
IV Piperacillin/tazobactam 4.5g q6-8h
IV Cefepime 2g q8h (must give IV metronidazole 500mg TDS or IV Clindamycin 600mg q8h for anaerobic coverage)
IV Meropenem 1g q8h
If MRSA Risk factor
IV vancomycin 15mg/kg q8-12h
IV Daptomycin
IV Linezolid
Duration when no bone involved is 2 to 4 weeks
Antibiotics must be given until wound healing is done for DFI, true or false?
False, antibiotics only needed to resolve the infection. Wound healing take very long.
