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IDSA MRSA Guidelines

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Comments Pediatric Dose 10-13 mg/kg/dose PO q6-8h Max: 40 mg/kg/day Trimethoprim 4-6 mg/kg/dose, sulfamethoxazole 20-30 mg/kg/dose PO q12h < 45 kg: 2 mg/kg/dose PO q12h > 45 kg: adult dose 4 mg/kg PO/IV x 1, then 2 mg/kg/dose PO/IV q12h 10 mg/kg/dose PO q8h Max: 600 mg/dose (Adult/Child) Class A-II A-II Clostridium difficile-associated disease may occur more frequently compared to other oral agents. TMP-SMX‡ not recommended for women in the third trimester of pregnancy and for children less than 2 months. A-II A-II Tetracyclines are not recommended for children under 8 years old (A-II) and are pregnancy category D. A-II Please refer to Red Book A-II More expensive compared to other alternatives. For non-purulent cellulitis, empiric therapy for β-hemolytic streptococci is recommended (A-II). The role of CA-MRSA is unknown. Empiric coverage for CA-MRSA is recommended in patients who fail to respond to β-lactam therapy and may be considered in those with systemic toxicity. Please refer to Red Book See above for TMP- SMX‡ dosing and tetracycline 10 mg/kg/dose PO q8h Max: 600 mg/dose 10-13 mg/kg/dose PO q6-8h Max: 40 mg/kg/day A-II A-II Provide coverage for both β-hemolytic streptococci and CA-MRSA. A-II is pregnancy category C/D and * Cultures from abscesses and other purulent SSTI are recommended in patients treated with anti- biotic therapy, those with severe local infection or signs of systemic illness, patients who have not responded adequately to initial treatment, and if there is concern for a cluster or outbreak (A-III). † Based on the extent of disease and the patient's clinical response. ‡ Adjust dose for renal impairment – see Prescribing Information for renal dosing. 3

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