SSTI: Antibiotic Dosing
Abscess:
- PO:
- Clindamycin 10 mg/kg/dose PO TID (max 450 mg/dose).
- Alternative therapy:
- TMP-SMX 4-6 mg/kg/dose (trimethoprim component) PO BID (max 160 mg TMP/dose).
- IV:
- Clindamycin.
Cellulitis or Erysipelas:
- PO:
- Cephalexin 17 mg/kg/dose PO TID (max 500 mg/dose).
- Alternative therapy:
- Amoxicillin-clavulanate 22.5 mg/kg/dose (amoxicillin component) PO BID (max 875 mg/dose) (Utilize the amoxicillin-clavulanate 400 mg/57 mg/5 mL formulation).
- Severe cephalosporin allergy or MRSA risk factors:
- Clindamycin 10 mg/kg/dose PO TID (max 450 mg/dose).
- IV:
- Cefazolin.
- Severe cephalosporin allergy or MRSA risk factors:
- Clindamycin.
Impetigo:
- PO:
- Cephalexin 17 mg/kg/dose PO TID (max 500 mg/dose).
- Severe cephalosporin allergy or MRSA risk factors:
- Clindamycin 10 mg/kg/dose PO TID (max 450 mg/dose).
- OR TMP-SMX 4-6 mg/kg/dose (trimethoprim component) PO BID (max 160 mg TMP/dose).
- IV:
- Cefazolin.
- Severe cephalosporin allergy or MRSA risk factors:
- Clindamycin.
IV drugs:
- Clindamycin: 30-40 mg/kg/day divided q 6-8 hours (Max dose is 3600 mg/day).
- Cefazolin: 50-150 mg/kg/day divided q 8 hours (Max dose is 6 g/day).
These pathways do not establish a standard of care to be followed in every case. It is recognized that each case is different, and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare a pathway for each. Accordingly, these pathways should guide care with the understanding that departures from them may be required at times.
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