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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+ | {| class="wikitable" |
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+ | !Organism |
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+ | !Antimicrobial Options |
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+ | |- |
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+ | | |
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+ | | |
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+ | |- |
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+ | | |
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+ | | |
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+ | |- |
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+ | | |
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+ | | |
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+ | |} |
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+ | |||
+ | === Oral Antimicrobials === |
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+ | {| class="wikitable" |
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+ | !Organism |
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+ | !Antibiotic Options |
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+ | |- |
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+ | | rowspan="4" |[[MSSA]] |
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+ | |[[cefadroxil]] 500 to 1000 mg PO bid |
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+ | |- |
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+ | |[[cephalexin]] 500 mg PO tid to qid, or 1000 mg PO bid to tid |
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+ | |- |
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+ | |[[dicloxacillin]] 500 mg PO tid to qid |
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+ | |- |
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+ | |[[flucloxaxillin]] 500 mg PO tid to qid |
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+ | |- |
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+ | | rowspan="4" |[[MRSA]] |
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+ | |[[TMP-SMX]] DS 1 tablet PO bid |
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+ | |- |
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+ | |[[doxycycline]] 100 mg PO bid |
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+ | |- |
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+ | |[[minocycline]] 100 mg PO bid |
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+ | |- |
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+ | |[[clindamycin]] 600 mg PO tid |
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+ | |- |
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+ | |[[Gram-negative bacteria]] |
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+ | |[[TMP-SMX]] DS 1 tablet PO bid |
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+ | |- |
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+ | | |
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+ | |[[ciprofloxacin]] 500 mg PO bid |
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+ | |- |
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+ | | |
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+ | |[[levofloxacin]] 500 mg PO daily |
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+ | |- |
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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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+ | |- |
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+ | |[[penicillin]] VK 500 mg PO bid to tid |
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+ | |- |
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+ | | rowspan="2" |[[Cutibacterium acnes]] |
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+ | |[[amoxicillin]] 500 mg PO bid to tid |
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+ | |- |
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+ | |[[penicillin]] VK 500 mg PO bid to tid |
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+ | |} |
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[[Category:Bone and joint infections]] |
[[Category:Bone and joint infections]] |
Revision as of 09:01, 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.