Skin abscess +/- cellulitis
If systemic symptoms, do blood cultures.
Usual Pathogens
For severe infections or those unresponsive to listed empiric therapy, assess for additional risk factors.
See Recommended Empiric Therapy of Selected Infections in Adult Patients, Cellulitis, Extremities.
Group A Streptococci
S. aureus
Mild
| Empiric Therapy | Dose | Duration |
|---|---|---|
|
I&D If any of the following:
| ||
| Cephalexin | 40mg/kg/d PO div qid | 5 days |
ß-lactam allergy
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Clindamycin | 20-40mg/kg/d PO div qid | 5 days |
If above and risk factors for MRSA:
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Cephalexin | 40mg/kg/d PO div qid | 5 days |
| + | ||
| [TMP/SMX (if > 1 month old) | 8-12mg TMP /kg/d PO div bid | |
| or | ||
| Doxycycline (> 8 years old)] | 2-4mg/kg/d PO div bid |
Moderate-Severe
| Empiric Therapy | Dose | Duration |
|---|---|---|
| I&D | ||
| + | ||
| Vancomycin | 60mg/kg/d IV div q6h | 5-10 days |