Extremities
Elevation of affected limb essential:
lower extremity – elevate higher than hip joint
upper extremity – elevate higher than shoulder.
- Check between toes for fissures +/- tinea pedis → common portal of entry.
Usual Pathogens
Group A Streptococci
S. aureus
Group B,C,G Streptococci
Mild
| Empiric Therapy | Duration | |
|---|---|---|
| Cloxacillin | 500mg PO qid | 5 days |
| or | ||
| Cephalexin | 500-1000mg PO qid |
Penicillin and cephalexin allergy
| Empiric Therapy | Duration | |
|---|---|---|
| Cefuroxime axetil | 500mg PO bid |
Cefuroxime allergy
| Empiric Therapy | Duration | |
|---|---|---|
| Clindamycin | 300mg PO qid |
Moderate-severe
| Empiric Therapy | Duration | |
|---|---|---|
| Cloxacillin | 2g IV q6h | 5-10 days |
| or | ||
| Cefazolin | 2g IV q8h | 5-10 days |
Outpatient IV therapy
| Empiric Therapy | Duration | |
|---|---|---|
| Cefazolin | 2g IV daily | 5-10 days |
| + | ||
|
Probenecid (give 30 min. prior to cefazolin) |
2g PO daily or 1g PO bid |
Penicillin and cefazolin allergy
| Empiric Therapy | Duration | |
|---|---|---|
| Ceftriaxone | 2g IV daily | 5-10 days |
Ceftriaxone allergy
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Clindamycin IV/PO | 600mg IV q8h/300mg PO qid | 5-10 days |