Washington Manual of Medical Therapeutics
Complicated Skin and Soft-Tissue Infections
General Principles
Deep soft-tissue infections, surgical and traumatic wound infections, large abscesses, complicated cellulitis, and infected ulcers and burns fall under this classification.
Diagnosis
Cultures of abscesses and surgical debridement specimens should be obtained to guide antibiotic therapy.
Treatment
Patients should be hospitalized to receive IV antibiotics (including MRSA coverage) and undergo surgical intervention as necessary. Vancomycin 15–20 mg/kg IV q12h, linezolid 600 mg PO/IV q12h, daptomycin 4 mg/kg IV qday, clindamycin 900 mg IV q8h, and ceftaroline 600 mg IV q12h are all acceptable antibiotic options.1
References
- Stevens DL, Bisno AL, Chambers HF, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis. 2014;59(2):147-159. [PMID:24947530]
Outline
- Chapter 14: Treatment of Infectious Diseases
- Principles of Therapy
- Toxin-Mediated Infections
- Toxic Shock Syndrome
- Skin, Soft-Tissue, and Bone Infections
- Purulent Skin and Soft-Tissue Infections (Furuncles, Carbuncles, Abscesses)
- Nonpurulent Skin and Soft-Tissue Infections (Erysipelas and Cellulitis)
- Complicated Skin and Soft-Tissue Infections
- Infected Decubitus Ulcers and Limb-Threatening Diabetic Foot Ulcers
- Necrotizing Fasciitis
- Anaerobic Myonecrosis (Gas Gangrene)
- Osteomyelitis
- Central Nervous System Infections
- Bloodstream Infections and Catheter-Related Bloodstream Infections
- Cardiovascular Infections
- Upper Respiratory Tract Infections
- Lower Respiratory Tract Infections
- Gastrointestinal and Abdominal Infections
- Genitourinary Infections
- Fungal and Atypical Organisms
- Tick-Borne Infections
- Mosquito-Borne Infections
- Zoonoses
- Bite Wounds
- Health Care-Associated Infections
- Bioterrorism and Emerging Infections
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