Template:Osteomyelitis Antibiotics: Difference between revisions

(Created page with "{|class="wikitable" |- | '''Risk Factor''' | '''Likely Organism''' | '''Initial Empiric Antibiotic Therapy'''' |- | Elderly, hematogenous spread | MRSA, MSSA, gram n...")
 
(Fix incomplete doses: add route/frequency for Vancomycin, Pip/Tazo, Imipenem)
 
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| Elderly, hematogenous spread
| Elderly, hematogenous spread
| [[MRSA]], [[MSSA]], [[gram neg]]
| [[MRSA]], [[MSSA]], [[gram neg]]
| [[Vancomycin]] 1gm + ([[Piperacillin/Tazobactam]] 3.375 grams OR [[imipenem]] 500mg)
| {{AntibioticDose|disease=Osteomyelitis|drug=Vancomycin|dose=1g IV q12h|context=Elderly/Hematogenous}} + ({{AntibioticDose|disease=Osteomyelitis|drug=Piperacillin/Tazobactam|dose=3.375g IV q6h|context=Elderly/Hematogenous}} OR {{AntibioticDose|disease=Osteomyelitis|drug=Imipenem|dose=500mg IV q6h|context=Elderly/Hematogenous}})
|-
|-
| [[Sickle Cell Disease]]
| [[Sickle Cell Disease]]
| Salmonella, gram-negative bacteria
| [[Salmonella]], [[gram-negative]] bacteria
| [[Ceftriaxone]] 50mg/kg IV once daily OR [[Cefotaxime]] 50mg/kg IV three times daily, PLUS<br>
| {{AntibioticDose|disease=Osteomyelitis|drug=Ceftriaxone|dose=50mg/kg IV once daily|context=Sickle Cell Disease|population=Pediatric}} OR {{AntibioticDose|disease=Osteomyelitis|drug=Cefotaxime|dose=50mg/kg IV three times daily|context=Sickle Cell Disease|population=Pediatric}}, PLUS<br>
*[[Vancomycin]] 15mg/kg IV four times daily OR
*{{AntibioticDose|disease=Osteomyelitis|drug=Vancomycin|dose=15mg/kg IV four times daily|context=Sickle Cell Disease|population=Pediatric}} OR
*[[Clindamycin]] 10mg/kg IV PO four times daily OR
*{{AntibioticDose|disease=Osteomyelitis|drug=Clindamycin|dose=10mg/kg IV PO four times daily|context=Sickle Cell Disease|population=Pediatric}} OR
*[[Nafcillin]] 50 mg/kg IV four times daily to cover K. Kingae (common in daycare population)
*{{AntibioticDose|disease=Osteomyelitis|drug=Nafcillin|dose=50 mg/kg IV four times daily|context=Sickle Cell Disease|population=Pediatric}} to cover K. Kingae (common in daycare population)
|-
|-
| [[DM]] or vascular insufficiency
| [[DM]] or vascular insufficiency
| Polymicrobial: Staph, strep, coliforms, [[anaerobes]]
| Polymicrobial: [[Staph]], [[strep]], coliforms, [[anaerobes]]
| [[Vancomycin]] 1gm + ([[Piperacillin/Tazobactam]] 3.375 grams OR [[imipenem]] 500mg)
| {{AntibioticDose|disease=Osteomyelitis|drug=Vancomycin|dose=1g IV q12h|context=DM/Vascular insufficiency}} + ({{AntibioticDose|disease=Osteomyelitis|drug=Piperacillin/Tazobactam|dose=3.375g IV q6h|context=DM/Vascular insufficiency}} OR {{AntibioticDose|disease=Osteomyelitis|drug=Imipenem|dose=500mg IV q6h|context=DM/Vascular insufficiency}})
|-
|-
| IV drug user
| [[IVDU|IV drug]] user
| [[MRSA]], [[MSSA]], pseudomonas
| [[MRSA]], [[MSSA]], [[pseudomonas]]
| [[Vancomycin]] 1gm&nbsp;
| {{AntibioticDose|disease=Osteomyelitis|drug=Vancomycin|dose=1g IV q12h|context=IVDU}}&nbsp;
|-
|-
| Newborn
| Newborn
| [[MRSA]], [[MSSA]], GBS, [[Gram Negative]]
| [[MRSA]], [[MSSA]], [[group B strep|GBS]], [[Gram Negative]]
| [[Vancomycin]] 15mg/kg load, then reduce dose, AND [[ceftazidime]] 30mg/kg IV q12 h
| {{AntibioticDose|disease=Osteomyelitis|drug=Vancomycin|dose=15mg/kg load, then reduce dose|context=Newborn|population=Pediatric}}, AND {{AntibioticDose|disease=Osteomyelitis|drug=Ceftazidime|dose=30mg/kg IV q12 h|context=Newborn|population=Pediatric}}
|-
|-
| Children
| Children
| [[MRSA]], [[MSSA]]
| [[MRSA]], [[MSSA]]
| [[Vancomycin]] 10mg/kg q6 h AND [[ceftazidime]] 50mg/kg q8hr
| {{AntibioticDose|disease=Osteomyelitis|drug=Vancomycin|dose=10mg/kg q6 h|context=Children|population=Pediatric}} AND {{AntibioticDose|disease=Osteomyelitis|drug=Ceftazidime|dose=50mg/kg q8hr|context=Children|population=Pediatric}}
|-
|-
| Postoperative (ortho)
| Postoperative (ortho)
| [[MRSA]], [[MSSA]]
| [[MRSA]], [[MSSA]]
| [[Vancomycin]] 1gm
| {{AntibioticDose|disease=Osteomyelitis|drug=Vancomycin|dose=1g IV q12h|context=Postoperative}}
|-
|-
| Human bite
| [[Human bite]]
| Strep, anaerobes, HACEK organism
| [[Strep]], [[anaerobes]], HACEK organism
| [[Piperacillin/Tazobactam]] 3.375gm OR [[imipenem]] 500mg
| {{AntibioticDose|disease=Osteomyelitis|drug=Piperacillin/Tazobactam|dose=3.375gm|context=Human bite}} OR {{AntibioticDose|disease=Osteomyelitis|drug=Imipenem|dose=500mg IV q6h|context=Human bite}}
|-
|-
| Animal bite
| [[Animal bites]]
| Pasteurella, Eikenella, HACEK organism  
| [[Pasteurella]], [[Eikenella]], HACEK organism
| [[Piperacillin/Tazobactam]] 3.375gm OR [[imipenem]] 500mg
| {{AntibioticDose|disease=Osteomyelitis|drug=Piperacillin/Tazobactam|dose=3.375gm|context=Animal bites}} OR {{AntibioticDose|disease=Osteomyelitis|drug=Imipenem|dose=500mg IV q6h|context=Animal bites}}
|-
| Foot puncture wound
| [[Pseudomonas]]
| Anti-pseudomonal, staph coverage
|}
|}
*{{AntibioticDose|drug=Dicloxacillin|dose=<40kg: 50-100mg/kg/day PO divided q6h; >40kg: 250-500mg PO q6h|context=Osteomyelitis|disease=Osteomyelitis|population=Pediatric}}

Latest revision as of 11:30, 20 March 2026

Risk Factor Likely Organism Initial Empiric Antibiotic Therapy'
Elderly, hematogenous spread MRSA, MSSA, gram neg Vancomycin 1g IV q12h + (Piperacillin/Tazobactam 3.375g IV q6h OR Imipenem 500mg IV q6h)
Sickle Cell Disease Salmonella, gram-negative bacteria Ceftriaxone 50mg/kg IV once daily OR Cefotaxime 50mg/kg IV three times daily, PLUS
  • Vancomycin 15mg/kg IV four times daily OR
  • Clindamycin 10mg/kg IV PO four times daily OR
  • Nafcillin 50 mg/kg IV four times daily to cover K. Kingae (common in daycare population)
DM or vascular insufficiency Polymicrobial: Staph, strep, coliforms, anaerobes Vancomycin 1g IV q12h + (Piperacillin/Tazobactam 3.375g IV q6h OR Imipenem 500mg IV q6h)
IV drug user MRSA, MSSA, pseudomonas Vancomycin 1g IV q12h 
Newborn MRSA, MSSA, GBS, Gram Negative Vancomycin 15mg/kg load, then reduce dose, AND Ceftazidime 30mg/kg IV q12 h
Children MRSA, MSSA Vancomycin 10mg/kg q6 h AND Ceftazidime 50mg/kg q8hr
Postoperative (ortho) MRSA, MSSA Vancomycin 1g IV q12h
Human bite Strep, anaerobes, HACEK organism Piperacillin/Tazobactam 3.375gm OR Imipenem 500mg IV q6h
Animal bites Pasteurella, Eikenella, HACEK organism Piperacillin/Tazobactam 3.375gm OR Imipenem 500mg IV q6h
Foot puncture wound Pseudomonas Anti-pseudomonal, staph coverage
  • Dicloxacillin <40kg: 50-100mg/kg/day PO divided q6h; >40kg: 250-500mg PO q6h
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