Sandbox/osteo

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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 15 mg/kg IV q8—12h (trough 15—20 μg/mL)
PLUS
Cefotaxime 2 g IV q4—6h
OR
Ceftriaxone 2 g IV q12h
Alternative Regimen
Meropenem 2 g IV q8h
OR
Moxifloxacin 400 mg IV q24h
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

References