Template:Mastoiditis Antibiotics

Coverage against S. pneumoniae, S. pyogenes, S. aureus, H. influenzae

• Clindamycin 600mg IV q8 hours OR (if MRSA concern use Vancomycin regimen)
• Vancomycin 15-20mg/kg IV q12 hours PLUS
  • Ceftriaxone 1g (50mg/kg) IV once daily OR
  • Ampicillin/Sulbactam 3g (50mg/kg) IV q6 hours
• If chronic or severe, need pseudomonas coverage
  • Vancomycin + Piperacillin/Tazobactam 100mg/kg/dose piperacillin IV q6h (max 4g piperacillin/dose)

Pediatric

• Ceftriaxone 50mg/kg IV daily (max 2g) OR
• Ampicillin/Sulbactam 50mg/kg IV q6hrs (max 3g/dose)
• If MRSA concern: add Vancomycin 15mg/kg IV q6hrs
• If chronic/severe: Piperacillin/Tazobactam 100mg/kg IV q6hrs (max 4.5g/dose) + Vancomycin
• Clindamycin 10-13mg/kg IV q8hrs (max 900mg/dose) as alternative