Sandbox/osteo

Hematogenous Osteomyelitis

Empiric Therapy

▸ Click on the following categories to expand treatment regimens.

Age   ▸  Newborn (<4 months)   ▸  Children (>4 months) - Adults   ▸  Adult (>21 years)

Gram-Positive Cocci in Chains Preferred Regimen ▸ Vancomycin 40 mg divided q6-8 hours (trough 15—20 μg/mL) PLUS ▸ Ceftazidime 50 mg IV q8h OR ▸ Cefepime 150 mg IV q8h Alternative Regimen ▸ Nafcillin OR ▸ Oxcacillin 37mg q6h PLUS ▸ Ceftazidime 2 gm IV q8h OR Cefepime 2 gm IV q12h Gram-Positive Cocci in Pairs Preferred Regimen ▸ Ampicillin 2 g IV q4h OR ▸ Penicillin G 4 MU IV q4h PLUS ▸ Gentamicin 1.7 mg/kg IV q8h Alternative Regimen ▸ Cefotaxime 2 g IV q4—6h OR ▸ Ceftriaxone 2 g IV q12h Gram-Positive (Cocco-)Bacilli Preferred Regimen ▸ Ampicillin 2 g IV q4h OR ▸ Penicillin G 4 MU IV q4h PLUS ▸ Gentamicin 1.7 mg/kg IV q8h Alternative Regimen ▸ TMP/SMZ 5 mg/kg IV q6—12h (TMP component) OR ▸ Meropenem 2 g IV q8h 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 37mg q6h PLUS Ceftazidime 2 gm IV q8h OR Cefepime 2 gm IV q12h 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 oxcacillin37mg q6h PLUS Ceftazidime 2 gm IV q8h OR Cefepime 2 gm IV q12h Preferred regimen Vancomycin 1 gm IV q12h, if over 100 kg, 1.5 gm IV q12h Alternative regimen Nafcillin or oxacillin 2 gm IV q4h