Diferencia entre revisiones de «Environmental exposure antibiotics»
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Revisión actual - 20:22 15 abr 2019
Mammalian bites
====Cat and Dog Bites==== Coverage for Pasteurella, Strep, and Staph
- Consider for high-risk wounds
- wounds reaching the level of the muscle/tendon, wounds to the hand[1], violation of bone or joint capsule, immunocompromised hosts, wounds associated with significant local edema
- Amoxicillin/Clavulanate 875mg PO BID x 5-7 days OR[2]
- Doxycycline 100mg PO BID x 14 days if penicillin allergic [3]
- Clindamycin 450mg (5mg/kg) PO q8hrs x 7 days PLUS
- Ciprofloxacin 500mg PO q12hrs x 7 days OR
- TMP/SMX 2 DS tabs (5mg/kg) PO q12hrs
====Human Bites==== All human bites should be strongly considered for antibiotic therapy.[4]
Requires polymicrobial coverage for: S. aureus, Strep Viridans, Bacteroides, Coagulase-neg Staph, Eikenella, Fusobacterium, Cornebacterium, peptostreptococus
- Amoxicillin/Clavulanate 875mg PO BID x 5-7 days OR
- Clindamycin 450mg (5mg/kg) PO q8hrs x 7 days PLUS
- Ciprofloxacin 500mg PO q12hrs x 7 days OR
- TMP/SMX 2 DS tabs (5mg/kg) PO q12hrs
Pediatric:
- Amoxicillin/Clavulanate 25-45mg/kg/day PO divided BID x 5-7 days OR
- Clindamycin 30mg/kg/day PO divided TID (max 1.8g/day) + TMP/SMX 8-12mg/kg/day (TMP) PO divided BID
====Mammalian Bites Severe Infections==== *Ampicillin/Sulbactam 3g IV (50mg/kg) q6hrs OR
- Cefoxitin 1g IV q8hrs (25mg/kg q6hrs) OR
- Piperacillin/Tazobactam 4.5g IV (80mg/kg) q8hrs OR
- Ceftriaxone 1g (50mg/kg) IV once + Metronidazole 500mg IV q8hrs OR
- Clindamycin 600mg IV q8hrs PLUS
- TMP/SMX 5mg/kg IV q12hrs OR
- Ciprofloxacin 400mg IV q12hrs OR
Pediatric Cat and Dog Bites
- Amoxicillin/Clavulanate 25-45mg/kg/day PO divided BID x 5-7 days OR
- Clindamycin 30mg/kg/day PO divided TID (max 1.8g/day) + TMP/SMX 8-12mg/kg/day (TMP) PO divided BID
Pediatric Severe Bite Infections
- Ampicillin/Sulbactam 50mg/kg IV q6hrs (max 3g/dose) OR
- Piperacillin/Tazobactam 80mg/kg IV q8hrs (max 4.5g) OR
- Ceftriaxone 50mg/kg IV daily (max 2g) + Metronidazole 7.5mg/kg IV q8hrs (max 500mg)
Tetanus (Acute)
- Metronidazole 500mg IV (7.5mg/kg) q6hrs OR
- Clindamycin 600mg IV (7.5mg/kg) q6hrs
Penicillin
- Although once the drug of choice it is now no longer recommended since it may potentiate the effect of tetanus toxin by inhibiting the GABA receptors[5]
Pediatric
- Metronidazole 7.5mg/kg IV q6hrs (max 500mg/dose) x 7-10 days OR
- Clindamycin 10-13mg/kg IV q8hrs (max 900mg/dose)
See Also
Antibiotics by diagnosis
- Bone and joint antibiotics
- Cardiovascular antibiotics
- ENT antibiotics
- Eye antibiotics
- GI antibiotics
- GU antibiotics
- Neuro antibiotics
- OB/GYN antibiotics
- Pulmonary antibiotics
- Skin and soft tissue antibiotics
- Bioterrorism antibiotics
- Environmental exposure antibiotics
- Immunocompromised antibiotics
- Post exposure prophylaxis antibiotics
- Pediatric antibiotics
- Sepsis antibiotics
- Arthropod and parasitic antibiotics
For antibiotics by organism see Microbiology (Main)
References
- ↑ EBQ:Antibiotic prophylaxis for mammalian bites
- ↑ Griego RD, Rosen T, Orengo IF, Wolf JE. Dog, cat, and human bites: a review. J Am Acad Dermatol. 1995;33:1019–29.
- ↑ Talan DA, Citron DM, Abrahamian FM, Moran GJ, Goldstein EJ. Bacteriologic analysis of infected dog and cat bites. Emergency Medicine Animal Bite Infection Study Group. N Engl J Med. 1999;340:85–92.
- ↑ EBQ:Antibiotic prophylaxis for mammalian bites
- ↑ Ganesh Kumar AV. Benzathine penicillin, metronidazole and benzyl penicillin in the treatment of tetanus: a randomized, controlled trial .Ann Trop Med Parasitol. 2004 Jan;98(1):59-63 PMID 15000732