Involving perineum, GI tract, female genital tract, axilla
- Surgical drainage may be indicated.
- Anaerobic coverage is recommended.
- Cephalosporins and clindamycin do not cover Enterococcus spp.
Usual Pathogens
Polymicrobial:
S. aureus/MRSA
Group A Streptococci
Enterobacteriaceae
Anaerobes
Occasionally:
Enterococcus spp
Pseudomonas spp
Mild
| Empiric Therapy | Duration | |
|---|---|---|
| Amoxicillin-clavulanate | 40mg/kg/d PO div tid | 10-14 days |
Moderate-severe
| Empiric Therapy | Dose | Duration |
|---|---|---|
| [Clindamycin | 20-40mg/kg/d IV div q8h | 10-14 days |
| +/- | ||
| Gentamicin] | 7mg/kg IV q24h | |
| or | ||
| [Cefazolin | 75mg/kg/d IV div q8h | 10-14 days |
| + | ||
| Metronidazole] | 30mg/kg/d IV div q12h |
Severe
| Empiric Therapy | Duration | |
|---|---|---|
| Piperacillin-tazobactam | 240-300mg piperacillin/kg/d IV div q6-8h | 10-14 days |
Severe and MRSA suspected
| Empiric Therapy | Duration | |
|---|---|---|
| Piperacillin-tazobactam | 240-300mg piperacillin/kg/d IV div q6-8h | 10-14 days |
| + | ||
| Vancomycin | 60mg/kg/d IV div q6h |