Action
Add antibiotics (Class III)
IDSA Antibiotic Dosages for Nonpurulent Cellulitis, Purulent Cellulitis, and Complicated Skin and Soft-Tissue Infections
Disease and
Pathogen | Drug Choices | Comments |
Nonpurulent cellulitis: Streptococcus (more likely than Staphylococcus) | Cephalexin PO 500 mg qid | No MRSA coverage. Consider alternate regimen if not responding to beta- lactam therapy |
Clindamycin PO 450 mg tid | Covers Streptococcus and MRSA; useful if severe penicillin allergy | |
Purulent cellulitis:
Staphylococcus (more likely than Streptococcus), MRSA | Trimethoprim- sulfamethoxazole PO double strength 1-2 tabs bid | Category C/D in pregnancy |
Clindamycin PO 450 mg tid | Clostridioides difficile
disease may occur more frequently | |
Doxycycline PO 100 mg bid | Not recommended for children aged <8 years | |
Linezolid PO 600 mg bid | More expensive, may not be readily available | |
Complicated SSTI: Inpatients, Staphylococcus, Streptococcus, MRSA | Vancomycin IV 15-20 mg/kg q8-12hr | |
Clindamycin IV 600 mg tid | Clostridioides difficile
disease may occur more frequently | |
Linezolid IV 600 mg bid | More expensive, may not be readily available | |
Daptomycin IV 4 mg/kg qd |
