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| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Nafcillin]] 2 gm IV q4h''''' <br> OR <br> ▸ '''''[[Oxacillin]] 2 gm IV q4h'''''
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Nafcillin]] 2 gm IV q4h''''' <br> OR <br> ▸ '''''[[Oxacillin]] 2 gm IV q4h'''''
|-
|-
|}
|}
|}
|}
|}


<br><br><br><br>
<br>
<br><br><br><br>
===Specific Therapy===
<br><br><br><br>
 


<SMALL><font color="#FF4C4C">'''▸ Click on the following categories to expand treatment regimens.'''</font></SMALL>


{|
| valign=top |
<!--THIS ONE IS THE PSEUDOBUTTON WITH CURVED BORDER-->
<div style="border-radius: 5px 5px 0 0; border: solid 1px #20538D; border-bottom: 0px; text-shadow: 0 -1px 0 rgba(5, 5, 0, 0); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(5, 5, 0, 0); height: 30px; line-height: 30px; width: 225px; background: #A1BCDD; text-align: center;">
<font color="#FFF">
'''Specific Etiology'''
</font>
</div>
<!--THIS IS THE 1ST BUTTON THAT TRIGGERS THE 1ST BOX NAMED TABLE01.-->
<div class="mw-customtoggle-table04" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
<font color="#FFF">
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Methicillin-sensitive S.aureus'''
</font>
</div>
<!--THIS IS THE 2ND BUTTON THAT TRIGGERS THE 2ND BOX NAMED TABLE02.-->
<div class="mw-customtoggle-table05" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
<font color="#FFF">
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Methicillin-resistant S.aureus'''
</font>
</div>
<!--THIS IS THE 3RD BUTTON THAT TRIGGERS THE 3RD BOX NAMED TABLE03.-->
<div class="mw-customtoggle-table06" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
<font color="#FFF">
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Salmonella; GN bacilli''' </font>
</div>


<!--COLLECT ALL THE BOXES BELOW-->
| valign=top |
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table04" style="background: #FFFFFF;"
| valign=top |
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|MSSA}}
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | Preferred Regimen
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Nafcillin]] 2 gm IV q4h''''' <br> OR <br> ▸ '''''[[Oxacillin]] 2 gm IV q4h''''' <br> OR <br> ▸ '''''[[Cefazolin]] IV q8h'''''
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | Alternative Regimen
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Vancomycin]] 1 gm q12h IV; if over 100 kg, 1.5 gm IV q12h'''''
|-
|}
|}
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table05" style="background: #FFFFFF;"
| valign=top |
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|MRSA}}
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | Preferred Regimen
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Vancomycin]] 1 gm q12h IV'''''
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | Alternative Regimen
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''Linezolid 600 mg q12h IV/po''''' <br> ± <br> ▸ '''''[[Rifampin]] 300 mg po/IV bid'''''
|-
|}
|}
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table06" style="background: #FFFFFF;"
| valign=top |
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Salmonella (Gram-negative bacilli)}}
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | Preferred Regimen
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Ciprofloxacin]] 400 mg IV q12h'''''
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5; font-weight: bold; font-style: italic;" align=center | Alternative Regimen
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Levofloxacin]] 750 mg IV q24h
|-
|}
|}
|}




==Hematogenous Osteomyelitis==
<br>
===Specific Therapy===
==Contiguous Osteomyelitis Without Vascular Insufficiency==
===Empiric Therapy===


<SMALL><font color="#FF4C4C">'''▸ Click on the following categories to expand treatment regimens.'''</font></SMALL>
<SMALL><font color="#FF4C4C">'''▸ Click on the following categories to expand treatment regimens.'''</font></SMALL>
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</div>
</div>
<!--THIS IS THE 1ST BUTTON THAT TRIGGERS THE 1ST BOX NAMED TABLE01.-->
<!--THIS IS THE 1ST BUTTON THAT TRIGGERS THE 1ST BOX NAMED TABLE01.-->
<div class="mw-customtoggle-table01" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
<div class="mw-customtoggle-table04" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
<font color="#FFF">
<font color="#FFF">
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Methicillin-sensitive S.aureus'''
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Methicillin-sensitive S.aureus'''
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</div>
</div>
<!--THIS IS THE 2ND BUTTON THAT TRIGGERS THE 2ND BOX NAMED TABLE02.-->
<!--THIS IS THE 2ND BUTTON THAT TRIGGERS THE 2ND BOX NAMED TABLE02.-->
<div class="mw-customtoggle-table02" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
<div class="mw-customtoggle-table05" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
<font color="#FFF">
<font color="#FFF">
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Methicillin-resistant S.aureus'''  
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Methicillin-resistant S.aureus'''  
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</div>
</div>
<!--THIS IS THE 3RD BUTTON THAT TRIGGERS THE 3RD BOX NAMED TABLE03.-->
<!--THIS IS THE 3RD BUTTON THAT TRIGGERS THE 3RD BOX NAMED TABLE03.-->
<div class="mw-customtoggle-table03" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
<div class="mw-customtoggle-table06" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
<font color="#FFF">
<font color="#FFF">
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Salmonella; GN bacilli''' </font>
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Salmonella; GN bacilli''' </font>
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<!--COLLECT ALL THE BOXES BELOW-->
<!--COLLECT ALL THE BOXES BELOW-->
| valign=top |
| valign=top |
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table01" style="background: #FFFFFF;"
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table04" style="background: #FFFFFF;"
| valign=top |
| valign=top |
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
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|}
|}
|}
|}
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table02" style="background: #FFFFFF;"
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table05" style="background: #FFFFFF;"
| valign=top |
| valign=top |
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
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|}
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table03" style="background: #FFFFFF;"
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table06" style="background: #FFFFFF;"
| valign=top |
| valign=top |
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
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| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Levofloxacin]] 750 mg IV q24h
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Levofloxacin]] 750 mg IV q24h
|-
|-
|}
|}
|}
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Latest revision as of 13:33, 22 May 2014

Hematogenous Osteomyelitis

Empiric Therapy

▸ Click on the following categories to expand treatment regimens.

Age

  ▸  Newborn (<4 months)

  ▸  Children (>4 months) - Adults

  ▸  Adult (>21 years)

Staph aureus, gram-negative bacilli, group B strept
Preferred Regimen
Vancomycin 40 mg divided q6-8 hours
PLUS
Ceftazidime 50 mg IV q8h
OR
Cefepime 150 mg IV q8h
Alternative Regimen
Nafcillin
OR
Oxcacillin 37 mg q6h
PLUS
Ceftazidime 2 gm IV q8h
OR
Cefepime 2 gm IV q12h
Staph aureus, group A strept, gram-negative bacilli
Preferred Regimen
Vancomycin 40 mg divided q6-8 hours
PLUS
Ceftazidime 50 mg IV q8h
OR
Cefepime 150 mg IV q8h
Alternative Regimen
Nafcillin
OR
Oxcacillin 37 mg q6h
PLUS
Ceftazidime 2 gm IV q8h
OR
Cefepime 2 gm IV q12h
Staph aureus (most common)
Preferred Regimen
Vancomycin 1 gm IV q12h, if over 100 kg, 1.5 gm IV q12h
Alternative Regimen
Nafcillin 2 gm IV q4h
OR
Oxacillin 2 gm IV q4h


Specific Therapy

▸ Click on the following categories to expand treatment regimens.

Specific Etiology

  ▸  Methicillin-sensitive S.aureus

  ▸  Methicillin-resistant S.aureus

  ▸  Salmonella; GN bacilli

MSSA
Preferred Regimen
Nafcillin 2 gm IV q4h
OR
Oxacillin 2 gm IV q4h
OR
Cefazolin IV q8h
Alternative Regimen
Vancomycin 1 gm q12h IV; if over 100 kg, 1.5 gm IV q12h
MRSA
Preferred Regimen
Vancomycin 1 gm q12h IV
Alternative Regimen
Linezolid 600 mg q12h IV/po
±
Rifampin 300 mg po/IV bid
Salmonella (Gram-negative bacilli)
Preferred Regimen
Ciprofloxacin 400 mg IV q12h
Alternative Regimen
Levofloxacin 750 mg IV q24h



Contiguous Osteomyelitis Without Vascular Insufficiency

Empiric Therapy

▸ Click on the following categories to expand treatment regimens.

Specific Etiology

  ▸  Methicillin-sensitive S.aureus

  ▸  Methicillin-resistant S.aureus

  ▸  Salmonella; GN bacilli

MSSA
Preferred Regimen
Nafcillin 2 gm IV q4h
OR
Oxacillin 2 gm IV q4h
OR
Cefazolin IV q8h
Alternative Regimen
Vancomycin 1 gm q12h IV; if over 100 kg, 1.5 gm IV q12h
MRSA
Preferred Regimen
Vancomycin 1 gm q12h IV
Alternative Regimen
Linezolid 600 mg q12h IV/po
±
Rifampin 300 mg po/IV bid
Salmonella (Gram-negative bacilli)
Preferred Regimen
Ciprofloxacin 400 mg IV q12h
Alternative Regimen
Levofloxacin 750 mg IV q24h