200 likes | 214 Views
به نام خدا. Impetigo. Mupirocin; (bacitracin and neomycin, are less effective.) numerous lesions or not responding to topical agents: oral antimicrobials effective against both S. aureus and S. pyogenes. Impetigo. Folliculitis.
E N D
Impetigo Mupirocin; (bacitracin and neomycin, are less effective.) numerous lesions or not responding to topical agents: oral antimicrobials effective against both S. aureus and S. pyogenes.
Folliculitis Local measures such as saline compresses and topical antibacterials (e.g., mupirocin)
Furuncles and Carbuncles Most furuncles: moist heat. carbuncle, a furuncle with surrounding cellulitis or fever, or a furuncle located about the midface: an antistaphylococcal antibiotic (e.g., dicloxacillin). In a penicillin-allergic adult: clindamycin, or co-trimoxazole. Patients with moderate to severe disease are best treated with initial parenteral therapy (e.g., vancomycin, linezolid, or daptomycin)
Erysipelas Mild early: oral penicillin V (500 mg every 6 hours) or initial IMprocaine penicillin (600,000 units once or twice daily). Erythromycin (250 to 500 mg orally every 6 hours) or other macrolides are suitable alternatives. More extensive: hospitalization and parenteral aqueous penicillin G (2,000,000 units every 6 hours). If differentiation from cellulitis is difficult: a PRP (nafcillin or oxacillin), a cephalo 1, or therapy against MRSA.
cellulitis • Outpatient: • PRP (nafcillin or oxacillin), cephalo 1 • MRSA is suspected: clindamycin, TMP-SMX, doxycycline or minocycline + B-lactam (eg, amoxicillin), linezolid. • Inpatient: • PRP, cephalo 1 • MRSA is suspected: vancomycin, linezolid, daptomycin, clindamycin
Diabetic Ulcers Mild: PO cephalexin, dicloxacillin, clindamycin Moderate to severe: IV clindamycin plus a cephalo 3, clindamycin plus a fluoroquinolone, piperacillin-tazobactam, carbapenem, ampicillin-sulbactam, ticarcillin-clavulanate.
Gastroenteritis ciprofloxacin, ofloxacin, levofloxacin, norfloxacin Azithromycin
CNS Infections (Shunt Infection) vancomycin plus either cefepime, ceftazidime, or meropenem
CNS Infections (Subdural Empyema, Epidural Abscess) vancomycin plus cefepime or ceftazidime + metronidazole or meropenem In spinal cases, anaerobic coverage is not required.
CNS Infections (Suppurative Intracranial Thrombophlebitis) vancomycin plus cephalo 3 or 4 + metronidazole or meropenem