SSTI: Antibiotic Dosing

Abscess:

• PO:
  • Clindamycin 10 mg/kg/dose PO TID (max 450 mg/dose).
  • Alternative therapy:
    • TMP-SMX 4-6 mg/kg/dose (trimethoprim component) PO BID (max 160 mg TMP/dose).
• IV:
  • Clindamycin.

Cellulitis or Erysipelas:

• PO:
  • Cephalexin 17 mg/kg/dose PO TID (max 500 mg/dose).
  • Alternative therapy:
    • Amoxicillin-clavulanate 22.5 mg/kg/dose (amoxicillin component) PO BID (max 875 mg/dose) (Utilize the amoxicillin-clavulanate 400 mg/57 mg/5 mL formulation).
  • Severe cephalosporin allergy or MRSA risk factors:
    
    • Clindamycin 10 mg/kg/dose PO TID (max 450 mg/dose).
• IV:
  • Cefazolin.
  • Severe cephalosporin allergy or MRSA risk factors:
    • Clindamycin.

Impetigo:

• PO:
  • Cephalexin 17 mg/kg/dose PO TID (max 500 mg/dose).
  • Severe cephalosporin allergy or MRSA risk factors:
    
    • Clindamycin 10 mg/kg/dose PO TID (max 450 mg/dose). 
    • OR TMP-SMX 4-6 mg/kg/dose (trimethoprim component) PO BID (max 160 mg TMP/dose).
•  IV:
  • Cefazolin.
  • Severe cephalosporin allergy or MRSA risk factors:
    • Clindamycin.

IV drugs:

• Clindamycin: 30-40 mg/kg/day divided q 6-8 hours (Max dose is 3600 mg/day).
• Cefazolin: 50-150 mg/kg/day divided q 8 hours (Max dose is 6 g/day).