Osteomyelitis: Difference between revisions
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*No clinically meaningful differences in bone penetration between classes of antibiotics exist[[CiteRef::landersdorfer2009pe]] |
*No clinically meaningful differences in bone penetration between classes of antibiotics exist[[CiteRef::landersdorfer2009pe]] |
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*Bioavailability likely still important |
*Bioavailability likely still important |
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*Empiric antimicrobials should generally cover MRSA, susceptible Gram-positives, and common Gram-negatives |
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**For example, [[vancomycin]] plus [[ceftriaxone]] |
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=== Parenteral Antimicrobials === |
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!Organism |
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!Antimicrobial Options |
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=== Oral Antimicrobials === |
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!Organism |
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!Antibiotic Options |
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| rowspan="4" |[[MSSA]] |
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|[[cefadroxil]] 500 to 1000 mg PO bid |
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|[[cephalexin]] 500 mg PO tid to qid, or 1000 mg PO bid to tid |
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|[[dicloxacillin]] 500 mg PO tid to qid |
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|[[flucloxaxillin]] 500 mg PO tid to qid |
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| rowspan="4" |[[MRSA]] |
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|[[TMP-SMX]] DS 1 tablet PO bid |
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|[[doxycycline]] 100 mg PO bid |
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|[[minocycline]] 100 mg PO bid |
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|[[clindamycin]] 600 mg PO tid |
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|[[Gram-negative bacteria]] |
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|[[TMP-SMX]] DS 1 tablet PO bid |
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|[[ciprofloxacin]] 500 mg PO bid |
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|[[levofloxacin]] 500 mg PO daily |
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| rowspan="2" |penicillin-susceptible [[Streptococcus species|streptococci]] and [[Enterococcus species|enterococci]] |
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|[[amoxicillin]] 500 mg PO bid to tid |
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|[[penicillin]] VK 500 mg PO bid to tid |
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| rowspan="2" |[[Cutibacterium acnes]] |
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|[[amoxicillin]] 500 mg PO bid to tid |
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|[[penicillin]] VK 500 mg PO bid to tid |
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[[Category:Bone and joint infections]] |
[[Category:Bone and joint infections]] |
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Revision as of 13:01, 14 January 2021
Management
- No clinically meaningful differences in bone penetration between classes of antibiotics exist1
- Bioavailability likely still important
- Empiric antimicrobials should generally cover MRSA, susceptible Gram-positives, and common Gram-negatives
- For example, vancomycin plus ceftriaxone
Parenteral Antimicrobials
| Organism | Antimicrobial Options |
|---|---|
Oral Antimicrobials
| Organism | Antibiotic Options |
|---|---|
| MSSA | cefadroxil 500 to 1000 mg PO bid |
| cephalexin 500 mg PO tid to qid, or 1000 mg PO bid to tid | |
| dicloxacillin 500 mg PO tid to qid | |
| flucloxaxillin 500 mg PO tid to qid | |
| MRSA | TMP-SMX DS 1 tablet PO bid |
| doxycycline 100 mg PO bid | |
| minocycline 100 mg PO bid | |
| clindamycin 600 mg PO tid | |
| Gram-negative bacteria | TMP-SMX DS 1 tablet PO bid |
| ciprofloxacin 500 mg PO bid | |
| levofloxacin 500 mg PO daily | |
| penicillin-susceptible streptococci and enterococci | amoxicillin 500 mg PO bid to tid |
| penicillin VK 500 mg PO bid to tid | |
| Cutibacterium acnes | amoxicillin 500 mg PO bid to tid |
| penicillin VK 500 mg PO bid to tid |
References
- ^ Cornelia B. Landersdorfer, Jürgen B. Bulitta, Martina Kinzig, Ulrike Holzgrabe, Fritz Sörgel. Penetration of Antibacterials into Bone. Clinical Pharmacokinetics. 2009;48(2):89-124. doi:10.2165/00003088-200948020-00002.
