Page 256 - HPP ANTIMICROBIAL GUIDELINE 2018

Infection/Condition Suggested Treatment Comments
Preferred Alternative

Impetigo
Staphylococcus aureus,
Streptococcus pyogenes

Localised Topical 2% fusidic acid q8-12h for 7 Penicillin V 15mg/kg PO q6h
days (outpatient)
OR
Generalised Cloxacillin 50-100 mg/kg/24h PO q6h Trimethoprim(TMP)/sulfamethoxazole
for 7 days 4-5mg/kg PO q12h

Necrotizing fasciitis Benzylpenicillin 50,000 units/kg IV q4h Piperacillin/tazobactam 100 Aggressive surgical debridement;
Group A Streptococcus mg/kg/dose IV q6h consider adding IVIG to bind toxin for
Polymicrobial: Gram +ve PLUS streptococcal infection with toxic shock.
cocci, Anaerobes , Gram-ve Clindamycin 15-20 mg/kg IV q6-8h PLUS Tissues should be gram stained and
rods Vancomycin 10-13 mg/kg/dose IV cultured.
q8h
Refer IDSA 2014 guidelines

Scalded skin syndrome Cloxacillin 150-200 mg/kg/24h IV in
Staphylococcus aureus q6h then, step down
to 50mg/kg/24h PO q6h for 7 days

HPP AMG Skin & Soft Tissue Infections 123