Table 7. Suggested Empirical Antibiotic Regimens Based on Clinical Severity for DFI*
Infection Severity
Mild (usually treated with oral agent[s])
Probable Pathogen(s)
Methicillin- sensitive Staphylococcus aureus (MSSA); Streptococcus spp.
Antibiotic Agent (Brand) Comments
Dicloxacillin (generic)
Clindamycina (Cleocin®
)
Requires qid dosing; narrow- spectrum; inexpensive
Usually active against community-associated MRSA, but check macrolide sensitivity and consider ordering a "D-test" before using for MRSA. Inhibits protein synthesis of some bacterial toxins
Cephalexina (Keflex®
Levofloxacina (Levaquin®
, generic) Requires qid dosing; , generic) Once daily dosing;
inexpensive suboptimal against S. aureus
Amoxicillin/ clavulanatea (Augmentin®
MRSA
Doxycycline (Vibramycin®
generic)
) ,
Trimethoprim/ sulfamethoxazole (Bactrim®
generic)
Moderate (may be treated with oral or initial parenteral agent[s]) or Severe (usually treated with parenteral agent[s])
MSSA;
Streptococcus spp.; Enterobacteriaceae; obligate anaerobes
Levofloxacina (Levaquin®
Cefoxitina (Mefoxin®
Relatively broad-spectrum oral agent that includes anaerobic coverage
Active against many MRSA & some Gram- negatives; uncertain against Streptococcus spp.
, Septra® ,
Active against many MRSA & some Gram-negatives; uncertain activity against streptococci
, generic) Once a day dosing; , generic) 2nd generation
cephalosporin with anaerobic coverage
Ceftriaxone (Rocephin®
) , generic) Once daily dosing, 3rd
Ampicillin/ sulbactama (Unasyn®
Moxifloxacina (Avelox®
)
Ertapenema (Invanz®
) generation cephalosporin
Adequate if low suspicion of P. aeruginosa
Once daily oral dosing. Relatively broad-spectrum, including most obligate anaerobic organisms
Once daily dosing. Relatively broad-spectrum including anaerobes, but not active against P. aeruginosa
Continued on next page. 9 suboptimal against S. aureus
