Last reviewed June 2020
Last reviewed June 2020
Last reviewed June 2020
Mild
Moderate
Severe
*2 or more of: Temp greater than 38 °C or less than 36 °C; respiratory rate greater than 24 breaths/min; heart rate greater than 90 bpm; WBC greater than 12 or less than 4 x 109 /L
Last reviewed June 2020
• Antimicrobial choice and route of administration should be guided by severity of illness
* Higher dose (q12h) preferred for obese patients, significant inflammation, or bacteremic
1. 1st line in patients with IgE mediated penicillin allergy
2. Can transition to oral therapy when systemic symptoms resolved for at least 24 hours
3. Dose adjustment required for renal dysfunction; refer to NSHA Spectrum app for guidance
Last reviewed June 2020
Last reviewed June 2020
1. Antibiotics Why and Why Not 2018 Dalhousie CPD Academic Detailing Service, November 2018.
2. Stevens DL, Bisno AL, Chambers HF, et al. Practice Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections: 2014 Update by the Infectious Diseases Society of America. Clinical Infectious Diseases 2014;59(2): e10–52.
3. Raff AB, Kroshinsky D. Clinical Review and Education: Cellulitis. JAMA. 2016;316(3):325-337.
Last reviewed June 2020
Last reviewed July 2020
Last reviewed July 2020
Last reviewed July 2020
Last reviewed July 2020
TREATMENT
Antibiotic recommendations in table are empiric, should tailor antibiotics to microbiology results, clinical syndrome, and clinical response | ||
Mild |
S. aureus, beta-hemolytic streptococci | Duration |
|
7-14 days | |
Moderate |
S. aureus, Streptococcus spp., anaerobes, Gram-negative bacilli | |
|
Skin or subcutaneous tissue: 7-14d Deep tissue infections: 14-21d |
|
If osteomyelitis or septic arthritis: consult an expert in managing bone and joint infections. | ||
Severe |
S. aureus, Streptococcus spp., anaerobes, Gram-negative bacilli | |
|
Skin or subcutaneous tissue: 7-14d
Deep tissue infections: 14-21d |
|
|
||
If osteomyelitis or septic arthritis: consult an expert in managing bone and joint infections. | ||
If MRSA suspected, add the following to above regimens: known MRSA colonization, previous MRSA infection |
||
Mild or Moderate |
|
|
Severe |
|
a. requires dose adjustment in renal dysfunction. Refer to NS health Firstline app
b. can be used in patients with IgE mediated penicillin allergy
c. 2 g dose of ceftriaxone should be used for treating septic arthritis or osteomyelitis, otherwise 1 g is sufficient
Last reviewed June 2023
1. Lipsky BA, Berendt AR, Cornia PB, Pile JC, et al. 2012 Infectious Diseases Society of America Clinical Practice Guideline for the Diagnosis and Treatment of Diabetic Foot Infections. Clin Infect Dis. 2012 Jun 15;54(12):132-173.
2. Grigoropoulou P, Eleftheriadou I, Jude EB, Tentolouris N. Diabetic Foot Infections: An Update in Diagnosis and Management. Curr Diab Rep 2017 17(3): doi: 10.1007/s11892-017-0831-1.
3. Antimicrobial Stewardship Treatment Guidelines for Common Infections. Vancouver General Hospital University of British Columbia. (March 2016)
Last reviewed July 2020
Last reviewed April 2022
Last reviewed April 2022
Last reviewed April 2022
Last reviewed April 2022
Last updated April 2022
Last updated April 2022
Last reviewed April 2022
Last reviewed April 2022
1. Infectious Diseases Society of America. (2014). Practice Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections: 2014 Update by the Infectious Diseases Society of America. Clinical Infectious Diseases, 59(2), e10–e52. https://doi.org/10.1093/cid/ciu296
Last reviewed April 2022
Rapidly progressing, life-threatening infection along the fascial plane with gas formation.
Type I: Polymicrobial infection
Type II: Monomicrobial
Last reviewed January 2023
Last reviewed January 2023
Last reviewed January 2023
Last reviewed January 2023
Last reviewed January 2023
Last reviewed January 2023
Last reviewed January 2023
Last reviewed January 2023
Last reviewed January 2023
1. Alberta Health Services (2021). Necrotizing fasciitis/myositis in Adults – Culture proven in Bugs & Drugs [Mobile app]. Retrieved January 11, 2021 from http://bugsanddrugs.ca/
2. Stevens DL, Bisno AL, Chambers HF et al. Practice Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections: 2014 Update by the Infectious Diseases Society of America. Clin Infect Dis. 2014;59(2):147-59.
3. Stevens DL, Bryant AE. Necrotizing soft-tissue infections. N Engl J Med 377(23):2253–2265, 2017.
Last reviewed January 2023
Last reviewed January 2021
Last reviewed January 2021
Last reviewed January 2021
Last reviewed January 2021
Last reviewed January 2021
Last reviewed January 2021
Usually 6 weeks of intravenous therapy and then reassessment
Last reviewed January 2021
1. Berbari EF, Kanj SS, Kowalski TJ, et al. 2015 Infectious Diseases Society of America (IDSA) Clinical Practice Guidelines for the Diagnosis and Treatment of Native Vertebral Osteomyelitis in Adults. Clin Infect Dis. 2015;61(6):e26-e46.
2. Park KH, Cho OH, Lee JH, et al. Optimal Duration of Antibiotic Therapy in Patients With Hematogenous Vertebral Osteomyelitis at Low Risk and High Risk of Recurrence. Clin Infect Dis. 2016;62(10):1262-1269.
3. An HS, Seldomridge JA. Spinal infections: diagnostic tests and imaging studies. Clin Orthop Relat Res. 2006 Mar;444:27-33.
Last reviewed January 2021