Page 48 - HPP ANTIMICROBIAL GUIDELINE 2018

Suggested Treatment
Infection/ Condition Comments
Preferred Alternative

Muscular, skeletal and soft tissue trauma Cefazolin 2gm IV q8hrly Cefuroxime 1.5gm IV q8hly Duration: 3- 5 days

Compound Fractures/ Open Fractures

Gustilo 1 & 2 fractures Cefazolin 1gm IV q8h Amoxicillin/clavulanate 1.2gm Pre-debridement and post
IV q8h debridement cultures are not
OR representative of actual infection
Cefuroxime 1.5gm IV q8h
Duration of antibiotics for open
fractures:
Gustilo type I - stop after 24 hrs
Gustilo 3 fractures Cefazolin 1gm IV q8h Amoxicillin/clavulanate 1.2gm
IV q8h Gustilo type II - discontinue after 24
OR hours to 48 hrs
Cefuroxime 1.5gm IV q8h PLUS
Gentamicin 5mg/kg IV q24h Gustilo type III - 24 hrs after wound
PLUS closure or up to a maximum of 72 hrs

Gentamicin 5mg/kg IV q24h (whichever is earlier)

References:
1. IDSA guidelines, Clinical Infectious Diseases ; 2012 ; 54 : 132 -173 2012
2. Luca L.et al.International Journal of Infectious Diseases (2005) 9, 127
3. Michealis et al.. EFORT Open Rev 2016;1:128
4. Dennis L et al. N engl j med 377;23
5. Katie A. et.al. Curr Rheumatol Rep (2013) 15:332
6. Mathews CJ et al Lancet 2010 375(9717): 846
7. Barberi et al . CID2015
8. Michales pentali.EFORT Open Rev 2016

HPP AMG Bone & Joints Infections 19