What are the inpatient treatment recommendations for cellulitis with purulent drainage or abscess (purulent cellulitis)?

Updated: Sep 13, 2018
  • Author: Alfred Scott Lea, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Answer

Inpatient treatment recommendations (MRSA prevalent) are as follows:

  • Vancomycin 15 mg/kg IV q12h followed by dosage adjustment based on trough levels maintained between 10 and 20 µg/mL and serial renal function**

  • Daptomycin 4 mg/kg IV q24h (q48h if creatinine clearance [CrCl] < 30 mL/min)**

  • Linezolid 600 mg IV q12h**

  • Ceftaroline 600 mg IV q12h (dose reduction required if CrCl ≤50 mL/min)**

* Total duration of therapy is 7-14 days. Extend therapy if cellulitis is slow to respond. [1, 6]

** Parenteral antibiotics given 1-3 days until patient debrided, stabilized, and improving; then, transition to oral antibiotics for the duration of therapy. [1]

§ Expensive

∞ Requires special sensitivity testing (DTEST) to exclude hidden (inducible) resistance. [10]


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