Carbuncles

- Recommend incision and drainage and C&S of pus, probing cavities to break up loculations, and covering with dry dressing.

 
Usual Pathogens

S. aureus

Limited disease

Empiric Therapy

Dose

Duration
Hot compresses + Antiseptic cleanser

Unresponsive to above or indication for systemic antibiotics

Empiric Therapy Dose Duration
Cloxacillin 40-50mg/kg/d PO div qid 7 days
or    
Cephalexin 40mg/kg/d PO div qid 7 days

ß-lactam allergy

Empiric Therapy

Dose

Duration
TMP/SMX (if > 1 month old) 8-12mg TMP/kg/d PO div bid 7 days
or    
Clindamycin 20mg/kg/d PO div qid 7 days

MRSA suspected

Empiric Therapy

Dose

Duration
TMP/SMX (if > 1 month old) 8-12mg TMP/kg/d PO div bid 7 days
or    
Doxycycline (if > 8 years old) 2-4mg/kg/d PO div bid 7 days