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Wound Infections

Wound infections  Possible therapeutic alternatives
Wound: Infected, post-op or trauma, without sepsis. (Not Gastrointestinal tract or female genital tract.) Common pathogens
Uncomplicated (mild or moderate)
Bactrim DS orally twice daily OR
Cephalexin 500mg orally 4 times daily OR
Augmentin 875/125 mg orally twice daily OR500/125mg three times daily or
Augmentin XR* 1000/62.5 mg 2 tablets orally twice daily  OR

*AUGMENTIN XR is contraindicated in patients with a creatinine clearance of < 30 mL/min. and in hemodialysis patients.

Doxycycline 100mg orally twice daily OR
Clindamycin  300mg to 450mg orally four times daily
Complicated (Severe)
Ticarcillin-clavulanic acid  3.1 grams  IV every 6 hours OR
Piperacillin-tazobactam
3.375 grams IV every 6 hours OR
Ertapenem
1 gram q24h

PLUS
Vancomycin 1 gram  ivpb q12h (patient-specific dosing required) 

Wound infection + sepsis. (does not include surgery involving GI or female genital tract) Common pathogens
Ampicillin-sulbactam 1.5 - 3 grams IV every 6 hours  OR
Ticarcillin-clavulanic acid  3.1 grams  IV every 6 hours OR
Piperacillin-tazobactam 3.375 grams IV every 6 hours OR
Cefazolin 1 gram  IV every 8 hours.
Postop wound (surgery involving gastrointestinal tract or female genital tract)  (all regimens must cover anaerobes) Common pathogens
Piperacillin-tazobactam 3.375 grams IV every 6 hours OR
Ticarcillin-clavulanic acid  3.1grams IV every 6 hours  OR
Ampicillin-sulbactam 1.5-3g ivpb q6h OR
[ (Cefotaxime 1g ivpb q8h or Ceftriaxone1-2g ivpb q24h ) +  Metronidazole 500mg ivpb q6-8h]  OR
Imipenem 500mg ivpb q6h.

Reference(s)

Wound infections