Peds ID Abx QOTW #20 Answer
b) Vancomycin
e) Clindamycin
Severe Cellulitis with circumferential lesion
- Based the fever and tachycardia and rapid spread
- Best answers are Vancomycin for MRSA coverage +/- Clindamycin
- Vancomycin alone is more than enough for MSSA and GAS in skin infections
- No need to add Cephalexin/Cefazolin/Oxacillin
- Addition of Clindamycin for toxin blocking for 48hrs is also reasonable
- Reasonable alternative would be clindamycin alone*
- No need to add Ceftriaxone as GNR not a common player
- No need for Vancomycin and Piperacillin/tazobactam
- This is common combination for Necrotizing fascitis of lower extremities, however, which are polymicrobial
- Also would be reasonable with a patient with “shooters abscess” with cellulitis