The choice of agent should take into account the patient’s risk for C. difficile infection
Duration of therapy 2- 4 weeks guided by clinical response
Common Pathogen(s)
Staphylococcus aureus.
Antibiotic – 1st line
Flucloxacillin 2g q6h IV
2nd Line
Clindamycin 600mg q6h IV.
Comment
Clarithromycin should NOT be used.
Duration of therapy usually 6 weeks. All cases should be discussed Consultant to Consultant Microbiologist during work hours
Common Pathogen(s)
Staphylococcus aureus.
Antibiotic – 1st line
Flucloxacillin 2g q6h IV.
2nd Line
Clindamycin 600mg q6h IV.
Common Pathogen(s)
Staphylococcus aureus;
Occasionally coliforms.
Antibiotic – 1st line
Empiric treatment not indicated.
If acute exacerbation, treat as acute osteomyelitis.
Common Pathogen(s)
Staphylococcus;
Propionobacteria.
Antibiotic – 1st line
Discuss between primary consultant and Consultant Microbiologist
All cases should be discussed Consultant to Consultant Microbiologist. Common Pathogen(s)
Staphylococcus aureus.
Antibiotic – 1st line
Vancomycin IV (dosed as per trust vancomycin guideline)
2nd Line
Clindamycin 600mg q6h IV.
Comment
All cases should be discussed with microbiologist
Common Pathogen(s)
Antibiotic – 1st line
Flucloxacillin 1g q6h IV
plus
Metronidazole 500mg q8h IV
plus Gentamicin(click here for full gentamicin policy) Note: If serum creatinine is not yet known then 5mg/kg may still be initiated unless 70years or above or there is evidence of existing severe renal impairment. CrCl must still be calculated once U+Es are available. ALL SUBSEQUENT DOSES MUST BE ADJUSTED AS PER CrCl once known. Must check pre-dose level as per policy.
5mg/kg IV q24h (max 500mg): if <70 years and CrCl≥30mL/min or
3mg/Kg IV q24h (max 300mg): If ≥70 years or CrCl 10-29.9ml/min, known renal impairment, or clinician has concerns about higher dose (e.g. clinical signs of renal impairment)
Round to nearest 20mg for ease of administration
CrCl known to be under <10ml/min discuss with microbiology during working hours for gentamicin dosing/or alternative antibiotic recommendation. If patient is obese ie. 20% over ideal body weight – use adjusted body weight
If renal failure:
Co-amoxiclav IV 1.2g q8h or 625mg q8h PO if discharge
Continue 24hours after closure of wound
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