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Empiric SSTI algorithm

Empiric SSTI algorithm *This algorithm does NOT include: surgical site infections, diabetic foot ulcers, decubitus ulcers, insect, animal or human bites, or gangrene **Please see order form for guidance (including renal dosing adjustments).

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Empiric SSTI algorithm

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  1. Empiric SSTI algorithm *This algorithmdoes NOTinclude: surgical site infections, diabetic foot ulcers, decubitus ulcers, insect, animal or human bites, or gangrene **Please see order form for guidance (including renal dosing adjustments) If cephalosporin allergic: Vancomycin can be substituted for cefazolin 1 The preferred method of treatment is I&D Clinical Pearl: Treatment should continue for 48 hours prior to determination of clinical failure; SSTIs often appear worse during initial treatment period

  2. Antibiotic De-escalation Criteria • Culture susceptibilities • Clinical response • Clinically stable • Decreased erythema • Decreased edema • Decreased warmth • Resolving leukocytosis • Afebrile Total course of antibiotics is 5 days (i.e. 2 days of IV cefazolin + 3 days of PO cephalexin) Note: Renal dose adjustments are required for patients with CrCL less than 30 mL/min If sulfa allergic: Either tetracyclineor doxycycline can be substituted to replace TMP/SMX If beta-lactam anaphylaxis: Clindamycin (non-severe infection) can be substituted to replace cephalexin, or linezolid can be substituted to replace both TMP/SMX and cephalexin

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