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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