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IDSA Skin and Soft Tissue Infections Guidelines 2014 IDSA ...

Skin and Soft Tissue Infection Treatment AlgorithmMildSevereModerateExclusions: Neutropenia, malignancy, severe immunodeficiency, osteomyelitis, diabetic ulcers, bite wounds, animal contact, surgical site Infections , penetrating trauma, fresh or ocean water exposure, viral infection or severe sepsis or septic shock ,or fever with neutropenia Localized infection, no systemic area, or SIRS (HR >90, RR>24, Temp <36 or >38O ,WBC >12000 or <4000 cells/ul. Not IV vancomycinRx: Oral Penicillin or Cephalexin. Clindamycin if PCN : ( if PCN allergy) Blood cultures. Prompt surgical consultation for suspected necrotizing infection. MildModerateSevereI&DI&DWound CultureLocalized infection, no systemic Infections with SIRS ( HR> 90, T<36 or >38O, WBC>12000 or <4000, RR >24 without hypotension) Failed I &D /oral antibiotics, SIRS with hypotension and/or organ CultureEmpiric Rx:TMP/SMX or Doxycycline Empiric Rx: IV Vancomycin.)

MRSA: TMP/SMX MSSA: Cefazolin or po cephalexin or po dicloxacillin Purulent ( MRSA, MSSA) Carbuncles/furuncles/ abscess Defined Rx: MRSA: IV vancomycin or TMP/SMX or Linezolid MSSA: Cefazolin or po cephalexin or po dicloxacillin Defined Rx for Necrotizing Infection: Strep or Clostridium • Penicillin + Clindamycin Vibrio vulnificus (marine ...

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