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Impetigo
Mupirocin; (bacitracin and neomycin, are less effective.) numerous lesions or not responding to topical agents: oral antimicrobials effective against both S. aureus and S. pyogenes.
Furuncles and Carbuncles
Most furuncles: moist heat.
carbuncle, a furuncle with surrounding cellulitis or fever, or a furuncle located about the midface: an antistaphylococcal antibiotic (e.g., dicloxacillin). In a penicillin-allergic adult: clindamycin, or co-trimoxazole.
Patients with moderate to severe disease are best treated with initial parenteral therapy (e.g., vancomycin, linezolid, or daptomycin)
Erysipelas
Mild early: oral penicillin V (500 mg every 6 hours) or initial IM procaine penicillin (600,000 units once or twice daily). Erythromycin (250 to 500 mg orally every 6 hours) or other macrolides are suitable alternatives.
More extensive: hospitalization and parenteral aqueous penicillin G (2,000,000 units every 6 hours).
If differentiation from cellulitis is difficult: a PRP (nafcillin or oxacillin), a cephalo 1, or therapy against MRSA.
cellulitis
Outpatient: PRP (nafcillin or oxacillin), cephalo 1 MRSA is suspected: clindamycin, TMP-SMX, doxycycline or
minocycline + B-lactam (eg, amoxicillin), linezolid.
Inpatient:PRP, cephalo 1MRSA is suspected: vancomycin, linezolid, daptomycin,
clindamycin
Diabetic Ulcers
Mild: POcephalexin, dicloxacillin, clindamycin
Moderate to severe: IVclindamycin plus a cephalo 3, clindamycin plus a fluoroquinolone, piperacillin-tazobactam, carbapenem, ampicillin-sulbactam, ticarcillin-clavulanate.
CNS Infections (Subdural Empyema, Epidural Abscess)
vancomycin plus cefepime or ceftazidime + metronidazole or meropenem
In spinal cases, anaerobic coverage is not required.
CNS Infections (Suppurative Intracranial
Thrombophlebitis)
vancomycin plus cephalo 3 or 4 + metronidazole or meropenem