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{{Cellulitis}}
{{Cellulitis}}


====Empiric Therapy====
==Bites==
===Human Bites===
====Medical Therapy====


<SMALL><font color="#FF4C4C">'''▸ Click on the following categories to expand treatment regimens.'''</font></SMALL><div style="-webkit-user-select: none;"><ref name="pmid16231249">{{cite journal| author=Stevens DL, Bisno AL, Chambers HF, Everett ED, Dellinger P, Goldstein EJ et al.| title=Practice guidelines for the diagnosis and management of skin and soft-tissue infections. | journal=Clin Infect Dis | year= 2005 | volume= 41 | issue= 10 | pages= 1373-406 | pmid=16231249 | doi=10.1086/497143 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16231249  }} </ref>
<SMALL><font color="#FF4C4C">'''▸ Click on the following categories to expand treatment regimens.'''</font></SMALL><div style="-webkit-user-select: none;"><ref name="pmid16231249">{{cite journal| author=Stevens DL, Bisno AL, Chambers HF, Everett ED, Dellinger P, Goldstein EJ et al.| title=Practice guidelines for the diagnosis and management of skin and soft-tissue infections. | journal=Clin Infect Dis | year= 2005 | volume= 41 | issue= 10 | pages= 1373-406 | pmid=16231249 | doi=10.1086/497143 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16231249  }} </ref>
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<font color="#FFF">
<font color="#FFF">
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Children'''
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Children'''
</font>
</div>
<div class="mw-customtoggle-table02" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
<font color="#FFF">
&nbsp;&nbsp;▸&nbsp;&nbsp;''''''
</font>
</div>
<div class="mw-customtoggle-table02" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
<font color="#FFF">
&nbsp;&nbsp;▸&nbsp;&nbsp;''''''
</font>
</div>
<div class="mw-customtoggle-table03" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
<font color="#FFF">
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Insect Bites'''
</font>
</font>
</div>
</div>
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{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table02" style="background: #FFFFFF;"
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</div>
 
====Vaccination====
* Diphtheria, Tetanus, and Acellular Pertussis Vaccine:
** Adults (19 years and older, including pregnant women): 1 dose (0.5 mL) IM once to replace a single dose of tetanus and diphtheria (Td) for adults who have not received a prior dose of Tdap
** Pediatrics (13 to 18 years, catch-up): 1 dose (0.5 mL) IM to those who missed the 11- to 12-year Tdap booster dose if they have completed the recommended childhood DTP/DTaP vaccination series
** Pediatrics (11 to 12 years): 1 dose (0.5 mL) IM to those who have completed the recommended childhood DTP/DTaP vaccination series and have not received a Tdap booster dose
 
*Diphtheria and Tetanus Toxoids:
** Adults (19 years and older): 1 dose (0.5 mL) Td IM every 10 years for persons who previously received a one-time dose of Tdap
 
===Dog Bites===
====Medical Therapy====
 
<SMALL><font color="#FF4C4C">'''▸ Click on the following categories to expand treatment regimens.'''</font></SMALL><div style="-webkit-user-select: none;"><ref name="pmid16231249">{{cite journal| author=Stevens DL, Bisno AL, Chambers HF, Everett ED, Dellinger P, Goldstein EJ et al.| title=Practice guidelines for the diagnosis and management of skin and soft-tissue infections. | journal=Clin Infect Dis | year= 2005 | volume= 41 | issue= 10 | pages= 1373-406 | pmid=16231249 | doi=10.1086/497143 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16231249  }} </ref>
 
{|
| valign=top |
<div style="border-radius: 5px 5px 0 0; border: solid 1px #20538D; border-bottom: 0px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #A1BCDD; text-align: center;">
<font color="#FFF">
'''Dog Bites'''
</font>
</div>
 
<div class="mw-customtoggle-table12" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
<font color="#FFF">
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Adults'''
</font>
</div>
 
<div class="mw-customtoggle-table13" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
<font color="#FFF">
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Children'''
</font>
</div>
 
| valign=top |
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table12" style="background: #FFFFFF;"
| valign=top |
| valign=top |
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Rat}}
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Early (not yet infected)}}
|-
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Amoxicillin-clavulanate]] 875/125 mg orally q12h X 5 days'''''
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Amoxicillin-clavulanate]] 875/125 mg orally q12h'''''<BR> OR <BR> ▸ '''''[[Amoxicillin-clavulanate]] 500/125 mg orally q8h'''''
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen (beta-lactam allergy)'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Clindamycin]] 300 mg orally q6h'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | PLUS
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Ciprofloxacin]] 500 to 750 mg orally q12h'''''
|-
|-
|}
|}
|}
|}
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table02" style="background: #FFFFFF;"
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table12" style="background: #FFFFFF;"
| valign=top |
| valign=top |
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Pig (Swine)}}
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Late (infected)}}
|-
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Amoxicillin-clavulanate]] 875/125 mg orally q12h X 5 days'''''
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Ampicillin sulbactam]] 1.5 to 3 g IV q6-8h'''''<BR> OR <BR> ▸ '''''[[Piperacillin-tazobactam]] 3.375 gm IV q6-8h'''''<BR> OR <BR> ▸ '''''[[Ertapenem]] 1 gm IV q24h'''''<BR> OR <BR> ▸ '''''[[Imipenem]]-[[Cilastin]] 1 gm IV q6-8h'''''<BR> OR <BR> ▸ '''''[[Imipenem]]-[[Cilastin]] 1 gm IV q6-8h'''''<BR> OR <BR> ▸ '''''[[Meropenem]] 1 gm IV q8h'''''
|-
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen'''''
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen (beta-lactam allergy)'''''
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Ampicillin sulbactam]] '''''<BR> OR <BR> ▸ '''''[[Imipenem]]'''''<BR> OR <BR> ▸ '''''[[Cephalosporin]]'''''
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Cefazolin]] 1 gm IV q8h'''''<BR> OR <BR> ▸ '''''[[Cefuroxime]] 1 gm IV q24h'''''<BR> OR <BR> ▸ '''''[[Cefoxitin]] 1 gm IV q6-8h'''''<BR> OR <BR>▸ '''''[[Ceftriaxone sodium]] 1 gm IV q12h'''''<BR> OR <BR>▸ '''''[[Cefotaxime]] 2 gm IV q6h'''''<BR> OR <BR>▸ '''''[[Ciprofloxacin]] 400 mg IV q12h'''''<BR> OR <BR>▸ '''''[[Moxifloxacin]] 400 mg IV q24h'''''
|-
|-
|}
|}
|}
|}
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table02" style="background: #FFFFFF;"
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table13" style="background: #FFFFFF;"
| valign=top |
| valign=top |
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Monkey bite }}
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Early (not yet infected)}}
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Amoxicillin-clavulanate]] 45 mg/kg/day orally in two divided doses X 3-7 days'''''
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen (beta-lactam allergy)'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Clindamycin]] 20 to 30 mg/kg/day orally in 4 divided doses'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | PLUS
|-
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen (without CNS symptoms)'''''
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | '''''[[Trimethoprim]] component 8 mg/kg/day orally in 2 divided doses'''''
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Acyclovir]]  12.5–15 mg per kg IV q8h'''''<BR> OR <BR> ▸ '''''[[Ganciclovir]] 5 mg per kg IV q12h'''''
|}
|}
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table13" style="background: #FFFFFF;"
| valign=top |
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Late (infected)}}
|-
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen (with CNS symptoms)'''''
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Ganciclovir]] 5 mg per kg IV q12h'''''
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Ampicillin sulbactam]] 100 to 300 mg/kg/day IV q6h'''''<BR> OR <BR> ▸ '''''[[Cefoxitin]] 80 to 160 mg/kg/day IV in 4 divided doses'''''<BR> OR <BR> ▸ '''''[[Ertapenem]] (3months - 12years) 15 mg/kg IV twice daily (maximum 1 g/day) OR [[Ertapenem]] (>13years) 1 g IV once daily'''''
|-
|-
|}
|}
|}
|}
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table02" style="background: #FFFFFF;"
|}
</div>
 
====Vaccination====
* Unvaccinated patients exposed to an animal suspected of having [[rabies]]:
** Adults: Rabies immune globulin 20 International Units/kg IM; infiltrate as much as possible of the full dose around wound(s); give the remainder IM at an anatomic site distant from vaccine administration AND rabies vaccine 1 mL IM in deltoid region as soon as possible after exposure; repeat rabies vaccine dose on days 3, 7, 14, and 28
** Pediatrics: Rabies immune globulin 20 International Units/kg IM; infiltrate as much as possible of the full dose around wound(s); give the remainder IM at an anatomic site distant from vaccine administration AND rabies vaccine 1 mL IM in lateral thigh as soon as possible after exposure; repeat rabies vaccine dose on days 3, 7, 14, and 28
 
* Vaccinated patients exposed to animals suspected of having rabies:
** Adults: 1 mL rabies vaccine IM in deltoid region as soon as possible after exposure; repeat dose 3 days later
** Pediatrics: 1 mL rabies vaccine IM in lateral thigh as soon as possible after exposure; repeat dose 3 days later
 
===Cat Bites===
====Medical Therapy====
<SMALL><font color="#FF4C4C">'''▸ Click on the following categories to expand treatment regimens.'''</font></SMALL><div style="-webkit-user-select: none;"><ref name="pmid16231249">{{cite journal| author=Stevens DL, Bisno AL, Chambers HF, Everett ED, Dellinger P, Goldstein EJ et al.| title=Practice guidelines for the diagnosis and management of skin and soft-tissue infections. | journal=Clin Infect Dis | year= 2005 | volume= 41 | issue= 10 | pages= 1373-406 | pmid=16231249 | doi=10.1086/497143 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16231249  }} </ref>
 
{|
| valign=top |
<div style="border-radius: 5px 5px 0 0; border: solid 1px #20538D; border-bottom: 0px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #A1BCDD; text-align: center;">
<font color="#FFF">
'''Cat Bites'''
</font>
</div>
 
<div class="mw-customtoggle-table22" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
<font color="#FFF">
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Adults'''
</font>
</div>
 
<div class="mw-customtoggle-table23" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
<font color="#FFF">
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Children'''
</font>
</div>
 
| valign=top |
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table22" style="background: #FFFFFF;"
| valign=top |
| valign=top |
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|}}
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Early (not yet infected)}}
|-
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Oral Regimen'''''
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Clindamycin]] 5 mg/kg orally q8h'''''<BR> OR <BR> ▸ '''''[[Linezolid]] 10 mg/kg orally q8-12h'''''
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Amoxicillin-clavulanate]] 875/125 mg orally q12h'''''<BR> OR <BR> ▸ '''''[[Amoxicillin-clavulanate]] 500/125 mg orally q8h'''''
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen (beta-lactam allergy)'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Doxycycline]] 100 mg orally q12h'''''<BR> OR <BR> ▸ '''''[[Cefuroxime]] 500 mg orally q12h'''''
|-
|-
|}
|}
|}
|}
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table03" style="background: #FFFFFF;"
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table22" style="background: #FFFFFF;"
| valign=top |
| valign=top |
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|}}
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Late (infected)}}
|-
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Parental Regimen'''''
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Vancomycin]] 10 to 15 mg/kg IV q8-12h'''''
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Ampicillin sulbactam]] 1.5 to 3 g IV q6-8h'''''<BR> OR <BR> ▸ '''''[[Piperacillin-tazobactam]] 3.375 gm IV q6-8h'''''<BR> OR <BR> ▸ '''''[[Ertapenem]] 1 gm IV q24h'''''<BR> OR <BR> ▸ '''''[[Imipenem]]-[[Cilastin]] 1 gm IV q6-8h'''''<BR> OR <BR> ▸ '''''[[Imipenem]]-[[Cilastin]] 1 gm IV q6-8h'''''<BR> OR <BR> ▸ '''''[[Meropenem]] 1 gm IV q8h'''''
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | PLUS
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen (beta-lactam allergy)'''''
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Cefotaxime]] 50 mg/kg IV q8h'''''<BR> OR <BR> ▸ '''''[[Gentamicin]] 2.5 mg/kg IV q8-12h'''''
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Cefazolin]] 1 gm IV q8h'''''<BR> OR <BR> ▸ '''''[[Cefuroxime]] 1 gm IV q24h'''''<BR> OR <BR> ▸ '''''[[Cefoxitin]] 1 gm IV q6-8h'''''<BR> OR <BR>▸ '''''[[Ceftriaxone sodium]] 1 gm IV q12h'''''<BR> OR <BR>▸ '''''[[Cefotaxime]] 2 gm IV q6h'''''<BR> OR <BR>▸ '''''[[Ciprofloxacin]] 400 mg IV q12h'''''<BR> OR <BR>▸ '''''[[Moxifloxacin]] 400 mg IV q24h'''''
|-
|-
|}
|}
|}
|}
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table03" style="background: #FFFFFF;"
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table22" style="background: #FFFFFF;"
| valign=top |
| valign=top |
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|}}
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Cat scratch disease}}
|-
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Oral Regimen'''''
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Clindamycin]] 5 mg/kg orally q8h'''''<BR> OR <BR> ▸ '''''[[Linezolid]] 10 mg/kg orally q8h'''''
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Azithromycin]] 500 mg orally on day 1, then 250 mg orally once daily X 4 days'''''
|-
|-
|}
|}
|}
|}
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table03" style="background: #FFFFFF;"
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table23" style="background: #FFFFFF;"
| valign=top |
| valign=top |
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|}}
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Early (not yet infected)}}
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Amoxicillin-clavulanate]] 45 mg/kg/day orally in two divided doses X 3-7 days'''''
|-
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Parental Regimen'''''
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen'''''
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Vancomycin]] 10 to 15 mg/kg IV q6-8h'''''
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Cefuroxime]] 10 to 15 mg/kg orally q12h'''''
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | PLUS
|}
|}
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table23" style="background: #FFFFFF;"
| valign=top |
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Cat scratch disease}}
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Cefotaxime]] 50 mg/kg IV q6-8h'''''<BR> OR <BR> ▸ '''''[[Gentamicin]] 2.5 mg/kg IV q8h'''''
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Azithromycin]] 10 mg/kg orally on day 1, then 5 mg/kg orally X 4 days'''''
|-
|-
|}
|}
|}
|}
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table03" style="background: #FFFFFF;"
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table13" style="background: #FFFFFF;"
| valign=top |
| valign=top |
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|}}
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Late (infected)}}
|-
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Oral Regimen'''''
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Clindamycin]] 5 mg/kg orally q6h'''''<BR> OR <BR> ▸ '''''[[Linezolid]] 10 mg/kg orally q8h'''''
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Ampicillin sulbactam]] 100 to 300 mg/kg/day IV q6h'''''<BR> OR <BR> ▸ '''''[[Cefoxitin]] 80 to 160 mg/kg/day IV in 4 divided doses'''''<BR> OR <BR> ▸ '''''[[Ertapenem]] (3months - 12years) 15 mg/kg IV twice daily (maximum 1 g/day) OR [[Ertapenem]] (>13years) 1 g IV once daily'''''
|-
|-
|}
|}
Line 209: Line 306:
</div>
</div>


==Vaccination==
===Monkey Bites===
===Human Bites===
====Medical Therapy====
<SMALL><font color="#FF4C4C">'''▸ Click on the following categories to expand treatment regimens.'''</font></SMALL><div style="-webkit-user-select: none;"><ref name="pmid16231249">{{cite journal| author=Stevens DL, Bisno AL, Chambers HF, Everett ED, Dellinger P, Goldstein EJ et al.| title=Practice guidelines for the diagnosis and management of skin and soft-tissue infections. | journal=Clin Infect Dis | year= 2005 | volume= 41 | issue= 10 | pages= 1373-406 | pmid=16231249 | doi=10.1086/497143 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16231249  }} </ref>
 
{|
| valign=top |
<div style="border-radius: 5px 5px 0 0; border: solid 1px #20538D; border-bottom: 0px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #A1BCDD; text-align: center;">
<font color="#FFF">
'''Monkey Bites'''
</font>
</div>
 
<div class="mw-customtoggle-table32" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
<font color="#FFF">
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Adults'''
</font>
</div>


* Diphtheria, Tetanus, and Acellular Pertussis Vaccine:
<div class="mw-customtoggle-table33" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
** Adults (19 years and older, including pregnant women): 1 dose (0.5 mL) IM once to replace a single dose of tetanus and diphtheria (Td) for adults who have not received a prior dose of Tdap
<font color="#FFF">
** Pediatrics (13 to 18 years, catch-up): 1 dose (0.5 mL) IM to those who missed the 11- to 12-year Tdap booster dose if they have completed the recommended childhood DTP/DTaP vaccination series
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Children'''
** Pediatrics (11 to 12 years): 1 dose (0.5 mL) IM to those who have completed the recommended childhood DTP/DTaP vaccination series and have not received a Tdap booster dose
</font>
</div>


*Diphtheria and Tetanus Toxoids:
| valign=top |
** Adults (19 years and older): 1 dose (0.5 mL) Td IM [7] every 10 years for persons who previously received a one-time dose of Tdap
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table32" style="background: #FFFFFF;"
| valign=top |
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|High risk bites (deep bites, symptomatic animals}}
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen (without CNS symptoms)'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Acyclovir]]  12.5–15 mg per kg IV q8h'''''<BR> OR <BR> ▸ '''''[[Ganciclovir]] 5 mg per kg IV q12h'''''
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen (with CNS symptoms)'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Ganciclovir]] 5 mg per kg IV q12h'''''
|-
|}
|}
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table33" style="background: #FFFFFF;"
| valign=top |
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|High risk bites (deep bites, symptomatic animals}}
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen (without CNS symptoms)'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Acyclovir]]  12.5–15 mg per kg IV q8h'''''<BR> OR <BR> ▸ '''''[[Ganciclovir]] 5 mg per kg IV q12h'''''
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen (with CNS symptoms)'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Ganciclovir]] 5 mg per kg IV q12h'''''
|-
|}
|}
|}
</div>


===Rat Bites===
====Medical Therapy====
<SMALL><font color="#FF4C4C">'''▸ Click on the following categories to expand treatment regimens.'''</font></SMALL><div style="-webkit-user-select: none;"><ref name="pmid16231249">{{cite journal| author=Stevens DL, Bisno AL, Chambers HF, Everett ED, Dellinger P, Goldstein EJ et al.| title=Practice guidelines for the diagnosis and management of skin and soft-tissue infections. | journal=Clin Infect Dis | year= 2005 | volume= 41 | issue= 10 | pages= 1373-406 | pmid=16231249 | doi=10.1086/497143 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16231249  }} </ref>
<SMALL><font color="#FF4C4C">'''▸ Click on the following categories to expand treatment regimens.'''</font></SMALL><div style="-webkit-user-select: none;"><ref name="pmid16231249">{{cite journal| author=Stevens DL, Bisno AL, Chambers HF, Everett ED, Dellinger P, Goldstein EJ et al.| title=Practice guidelines for the diagnosis and management of skin and soft-tissue infections. | journal=Clin Infect Dis | year= 2005 | volume= 41 | issue= 10 | pages= 1373-406 | pmid=16231249 | doi=10.1086/497143 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16231249  }} </ref>


Line 226: Line 372:
<div style="border-radius: 5px 5px 0 0; border: solid 1px #20538D; border-bottom: 0px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #A1BCDD; text-align: center;">
<div style="border-radius: 5px 5px 0 0; border: solid 1px #20538D; border-bottom: 0px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #A1BCDD; text-align: center;">
<font color="#FFF">
<font color="#FFF">
'''Dog Bites'''
'''Rat Bites'''
</font>
</font>
</div>
</div>


<div class="mw-customtoggle-table12" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
<div class="mw-customtoggle-table42" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
<font color="#FFF">
<font color="#FFF">
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Adults'''
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Adults'''
Line 236: Line 382:
</div>
</div>


<div class="mw-customtoggle-table13" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
<div class="mw-customtoggle-table43" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
<font color="#FFF">
<font color="#FFF">
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Children'''
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Children'''
Line 243: Line 389:


| valign=top |
| valign=top |
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table12" style="background: #FFFFFF;"
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table42" style="background: #FFFFFF;"
| valign=top |
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Uncomplicated}}
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Amoxicillin-clavulanate]] 875/125 mg orally q12h'''''
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen (beta-lactam allergy)'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Doxycycline]] 100 mg orally q12h'''''
|-
|}
|}
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table42" style="background: #FFFFFF;"
| valign=top |
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Rat bite fever}}
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Penicillin G benzathine]] 600,000 to 1,000,000 units/day IM X 10-14 days'''''<BR> OR <BR> ▸ '''''[[Tetracycline]]  250 to 500 mg orally q6h'''''
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Streptomycin]] 15 mg/kg/day IM in a single dose or in 2 divided doses X 10-14 days'''''
|-
|}
|}
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table43" style="background: #FFFFFF;"
| valign=top |
| valign=top |
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
Line 250: Line 426:
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Amoxicillin-clavulanate]] 875/125 mg orally q12h'''''<BR> OR <BR> ▸ '''''[[Amoxicillin-clavulanate]] 500/125 mg orally q8h'''''
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Amoxicillin-clavulanate]] 45 mg/kg/day orally in two divided doses X 3-7 days'''''
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen'''''
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Cefuroxime]] 10 to 15 mg/kg orally q12h'''''
|-
|}
|}
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table43" style="background: #FFFFFF;"
| valign=top |
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Rat bite fever}}
|-
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen (beta-lactam allergy)'''''
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Clindamycin]] 300 mg orally q6h'''''
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Penicillin G benzathine]] 25,000 to 50,000 units/day IM X 10-14 days'''''<BR> OR <BR> ▸ '''''[[Tetracycline]] (>8 years) 25 to 50 mg/kg/day orally in 4 divided doses X 10-14 days'''''
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | PLUS
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen'''''
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Ciprofloxacin]] 500 to 750 mg orally q12h'''''
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Streptomycin]] 15 mg/kg/day IM in a single dose or in 2 divided doses X 10-14 days'''''
|-
|-
|}
|}
|}
|}
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table12" style="background: #FFFFFF;"
|}
</div>
 
===Pig Bites===
====Medical Therapy====
<SMALL><font color="#FF4C4C">'''▸ Click on the following categories to expand treatment regimens.'''</font></SMALL><div style="-webkit-user-select: none;"><ref name="pmid16231249">{{cite journal| author=Stevens DL, Bisno AL, Chambers HF, Everett ED, Dellinger P, Goldstein EJ et al.| title=Practice guidelines for the diagnosis and management of skin and soft-tissue infections. | journal=Clin Infect Dis | year= 2005 | volume= 41 | issue= 10 | pages= 1373-406 | pmid=16231249 | doi=10.1086/497143 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16231249  }} </ref>
 
{|
| valign=top |
<div style="border-radius: 5px 5px 0 0; border: solid 1px #20538D; border-bottom: 0px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #A1BCDD; text-align: center;">
<font color="#FFF">
'''Pig Bites'''
</font>
</div>
 
<div class="mw-customtoggle-table52" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
<font color="#FFF">
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Adults'''
</font>
</div>
 
<div class="mw-customtoggle-table53" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
<font color="#FFF">
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Children'''
</font>
</div>
 
| valign=top |
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table52" style="background: #FFFFFF;"
| valign=top |
| valign=top |
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Late (infected)}}
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Pig (Swine)}}
|-
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Ampicillin sulbactam]] 1.5 to 3 g IV q6-8h'''''<BR> OR <BR> ▸ '''''[[Piperacillin-tazobactam]] 3.375 gm IV q6-8h'''''<BR> OR <BR> ▸ '''''[[Ertapenem]] 1 gm IV q24h'''''<BR> OR <BR> ▸ '''''[[Imipenem]]-[[Cilastin]] 1 gm IV q6-8h'''''<BR> OR <BR> ▸ '''''[[Imipenem]]-[[Cilastin]] 1 gm IV q6-8h'''''<BR> OR <BR> ▸ '''''[[Meropenem]] 1 gm IV q8h'''''
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Amoxicillin-clavulanate]] 875/125 mg orally q12h X 5 days'''''
|-
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen (beta-lactam allergy)'''''
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen'''''
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Cefazolin]] 1 gm IV q8h'''''<BR> OR <BR> ▸ '''''[[Cefuroxime sodium]] 1 gm IV q24h'''''<BR> OR <BR> ▸ '''''[[Cefoxitin sodium]] 1 gm IV q6-8h'''''<BR> OR <BR>▸ '''''[[Ceftriaxone sodium]] 1 gm IV q12h'''''<BR> OR <BR>▸ '''''[[Cefotaxime sodium]] 2 gm IV q6h'''''<BR> OR <BR>▸ '''''[[Ciprofloxacin]] 400 mg IV q12h'''''<BR> OR <BR>▸ '''''[[Moxifloxacin]] 400 mg IV q24h'''''
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Ampicillin sulbactam]] '''''<BR> OR <BR> ▸ '''''[[Imipenem]]'''''<BR> OR <BR> ▸ '''''[[Cephalosporin]]'''''
|-
|-
|}
|}
|}
|}
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table13" style="background: #FFFFFF;"
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table53" style="background: #FFFFFF;"
| valign=top |
| valign=top |
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Early (not yet infected)}}
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Pig (Swine)}}
|-
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Amoxicillin-clavulanate]] 45 mg/kg/day orally in two divided doses X 3-7 days'''''
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Amoxicillin-clavulanate]] 875/125 mg orally q12h X 5 days'''''
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen'''''
|-
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen (beta-lactam allergy)'''''
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Ampicillin sulbactam]] '''''<BR> OR <BR> ▸ '''''[[Imipenem]]'''''<BR> OR <BR> ▸ '''''[[Cephalosporin]]'''''
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Clindamycin]] 20 to 30 mg/kg/day orally in 4 divided doses'''''
|}
|}
|}
</div>
 
===Tick Bites===
====Medical Therapy====
<SMALL><font color="#FF4C4C">'''▸ Click on the following categories to expand treatment regimens.'''</font></SMALL><div style="-webkit-user-select: none;"><ref name="pmid16231249">{{cite journal| author=Stevens DL, Bisno AL, Chambers HF, Everett ED, Dellinger P, Goldstein EJ et al.| title=Practice guidelines for the diagnosis and management of skin and soft-tissue infections. | journal=Clin Infect Dis | year= 2005 | volume= 41 | issue= 10 | pages= 1373-406 | pmid=16231249 | doi=10.1086/497143 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16231249  }} </ref>
 
{|
| valign=top |
<div style="border-radius: 5px 5px 0 0; border: solid 1px #20538D; border-bottom: 0px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #A1BCDD; text-align: center;">
<font color="#FFF">
'''Tick Bites'''
</font>
</div>
 
<div class="mw-customtoggle-table62" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
<font color="#FFF">
&nbsp;&nbsp;&nbsp;&nbsp;'''Adults'''
</font>
</div>
 
<div class="mw-customtoggle-table63" style="cursor: pointer; border-radius: 0 0 0 0; border: solid 1px #20538D; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); height: 30px; line-height: 30px; width: 225px; background: #4479BA;">
<font color="#FFF">
&nbsp;&nbsp;▸&nbsp;&nbsp;'''Children'''
</font>
</div>
 
| valign=top |
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table62" style="background: #FFFFFF;"
| valign=top |
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Suspected Leptospirosis}}
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | PLUS
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Trimethoprim]] component 8 mg/kg/day orally in 2 divided doses'''''
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Doxycycline]] 200 mg orally once within 72 hours of tick removal '''''
|-
|-
|}
|}
|}
|}
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table13" style="background: #FFFFFF;"
{| class="mw-collapsible mw-collapsed" id="mw-customcollapsible-table63" style="background: #FFFFFF;"
| valign=top |
| valign=top |
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
{| style="float: left; cellpadding=0; cellspacing= 0; width: 400px;"
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Late (infected)}}
! style="height: 30px; line-height: 30px; background: #4479BA; border: 0px; font-size: 100%; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5);" align=center | {{fontcolor|#FFF|Suspected Leptospirosis}}
|-
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen'''''
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Ampicillin sulbactam]] 100 to 300 mg/kg/day IV q6h'''''<BR> OR <BR> ▸ '''''[[Cefoxitin]] 80 to 160 mg/kg/day IV in 4 divided doses'''''<BR> OR <BR> ▸ '''''[[Ertapenem]] (3months - 12years) 15 mg/kg IV twice daily (maximum 1 g/day) OR [[Ertapenem]] (>13years) 1 g IV once daily'''''
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Doxycycline]] (≥8 years) 4 mg/kg (maximum 200 mg) orally once within 72 hours tick removal'''''
|-
|-
|}
|}
Line 309: Line 559:
|}
|}
</div>
</div>


==References==
==References==
Line 314: Line 565:


[[Category:Disease]]
[[Category:Disease]]
[[Category:Infectious disease]]
 
[[Category:Dermatology]]
[[Category:Dermatology]]
[[Category:Emergency medicine]]
[[Category:Emergency medicine]]

Latest revision as of 18:42, 18 September 2017

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mugilan Poongkunran M.B.B.S [2]

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Bites

Human Bites

Medical Therapy

▸ Click on the following categories to expand treatment regimens.

[1]

Human Bites

  ▸  Adults

  ▸  Children

Early (not yet infected)
Preferred Regimen
Amoxicillin-clavulanate 875/125 mg orally q12h X 5 days
Alternative Regimen (beta-lactam allergy)
Moxifloxacin 400 mg orally q6h AND Clindamycin 300 mg orally q6h
OR
Trimethoprim-sulfamethoxazole 1 double-strength tablet orally q12h AND metronidazole 250 to 500 mg orally q6h
Late (infected)
Preferred Regimen
Ampicillin sulbactam 1.5 gm IV q6h
OR
Cefoxitin 2 gm IV q8h
OR
Ticarcillin clavulanate 3.1 gm IV q6h
OR
Piperacillin-tazobactam 3.375 gm IV q6h or 4.5 gm q8h or 4-hr infusion of 3.375 gm q8h
Alternative Regimen (beta-lactam allergy)
Clindamycin 1.5 gm IV q6h
PLUS
Moxifloxacin 400 mg IV q6h
Early (not yet infected)
Preferred Regimen
Amoxicillin-clavulanate (> 12weeks) 45 mg/kg/day orally in 2 divided doses for 5 days
Late (infected)
Preferred Regimen
Ampicillin sulbactam 100 to 300 mg/kg/day IV q6h
OR
Cefoxitin 80 to 160 mg/kg/day IV in 4 divided doses
OR
Ertapenem (3months - 12years) 15 mg/kg IV twice daily (maximum 1 g/day) OR Ertapenem (>13years) 1 g IV once daily

Vaccination

  • Diphtheria, Tetanus, and Acellular Pertussis Vaccine:
    • Adults (19 years and older, including pregnant women): 1 dose (0.5 mL) IM once to replace a single dose of tetanus and diphtheria (Td) for adults who have not received a prior dose of Tdap
    • Pediatrics (13 to 18 years, catch-up): 1 dose (0.5 mL) IM to those who missed the 11- to 12-year Tdap booster dose if they have completed the recommended childhood DTP/DTaP vaccination series
    • Pediatrics (11 to 12 years): 1 dose (0.5 mL) IM to those who have completed the recommended childhood DTP/DTaP vaccination series and have not received a Tdap booster dose
  • Diphtheria and Tetanus Toxoids:
    • Adults (19 years and older): 1 dose (0.5 mL) Td IM every 10 years for persons who previously received a one-time dose of Tdap

Dog Bites

Medical Therapy

▸ Click on the following categories to expand treatment regimens.

[1]

Dog Bites

  ▸  Adults

  ▸  Children

Early (not yet infected)
Preferred Regimen
Amoxicillin-clavulanate 875/125 mg orally q12h
OR
Amoxicillin-clavulanate 500/125 mg orally q8h
Alternative Regimen (beta-lactam allergy)
Clindamycin 300 mg orally q6h
PLUS
Ciprofloxacin 500 to 750 mg orally q12h
Late (infected)
Preferred Regimen
Ampicillin sulbactam 1.5 to 3 g IV q6-8h
OR
Piperacillin-tazobactam 3.375 gm IV q6-8h
OR
Ertapenem 1 gm IV q24h
OR
Imipenem-Cilastin 1 gm IV q6-8h
OR
Imipenem-Cilastin 1 gm IV q6-8h
OR
Meropenem 1 gm IV q8h
Alternative Regimen (beta-lactam allergy)
Cefazolin 1 gm IV q8h
OR
Cefuroxime 1 gm IV q24h
OR
Cefoxitin 1 gm IV q6-8h
OR
Ceftriaxone sodium 1 gm IV q12h
OR
Cefotaxime 2 gm IV q6h
OR
Ciprofloxacin 400 mg IV q12h
OR
Moxifloxacin 400 mg IV q24h
Early (not yet infected)
Preferred Regimen
Amoxicillin-clavulanate 45 mg/kg/day orally in two divided doses X 3-7 days
Alternative Regimen (beta-lactam allergy)
Clindamycin 20 to 30 mg/kg/day orally in 4 divided doses
PLUS
Trimethoprim component 8 mg/kg/day orally in 2 divided doses
Late (infected)
Preferred Regimen
Ampicillin sulbactam 100 to 300 mg/kg/day IV q6h
OR
Cefoxitin 80 to 160 mg/kg/day IV in 4 divided doses
OR
Ertapenem (3months - 12years) 15 mg/kg IV twice daily (maximum 1 g/day) OR Ertapenem (>13years) 1 g IV once daily

Vaccination

  • Unvaccinated patients exposed to an animal suspected of having rabies:
    • Adults: Rabies immune globulin 20 International Units/kg IM; infiltrate as much as possible of the full dose around wound(s); give the remainder IM at an anatomic site distant from vaccine administration AND rabies vaccine 1 mL IM in deltoid region as soon as possible after exposure; repeat rabies vaccine dose on days 3, 7, 14, and 28
    • Pediatrics: Rabies immune globulin 20 International Units/kg IM; infiltrate as much as possible of the full dose around wound(s); give the remainder IM at an anatomic site distant from vaccine administration AND rabies vaccine 1 mL IM in lateral thigh as soon as possible after exposure; repeat rabies vaccine dose on days 3, 7, 14, and 28
  • Vaccinated patients exposed to animals suspected of having rabies:
    • Adults: 1 mL rabies vaccine IM in deltoid region as soon as possible after exposure; repeat dose 3 days later
    • Pediatrics: 1 mL rabies vaccine IM in lateral thigh as soon as possible after exposure; repeat dose 3 days later

Cat Bites

Medical Therapy

▸ Click on the following categories to expand treatment regimens.

[1]

Cat Bites

  ▸  Adults

  ▸  Children

Early (not yet infected)
Preferred Regimen
Amoxicillin-clavulanate 875/125 mg orally q12h
OR
Amoxicillin-clavulanate 500/125 mg orally q8h
Alternative Regimen (beta-lactam allergy)
Doxycycline 100 mg orally q12h
OR
Cefuroxime 500 mg orally q12h
Late (infected)
Preferred Regimen
Ampicillin sulbactam 1.5 to 3 g IV q6-8h
OR
Piperacillin-tazobactam 3.375 gm IV q6-8h
OR
Ertapenem 1 gm IV q24h
OR
Imipenem-Cilastin 1 gm IV q6-8h
OR
Imipenem-Cilastin 1 gm IV q6-8h
OR
Meropenem 1 gm IV q8h
Alternative Regimen (beta-lactam allergy)
Cefazolin 1 gm IV q8h
OR
Cefuroxime 1 gm IV q24h
OR
Cefoxitin 1 gm IV q6-8h
OR
Ceftriaxone sodium 1 gm IV q12h
OR
Cefotaxime 2 gm IV q6h
OR
Ciprofloxacin 400 mg IV q12h
OR
Moxifloxacin 400 mg IV q24h
Cat scratch disease
Preferred Regimen
Azithromycin 500 mg orally on day 1, then 250 mg orally once daily X 4 days
Early (not yet infected)
Preferred Regimen
Amoxicillin-clavulanate 45 mg/kg/day orally in two divided doses X 3-7 days
Alternative Regimen
Cefuroxime 10 to 15 mg/kg orally q12h
Cat scratch disease
Preferred Regimen
Azithromycin 10 mg/kg orally on day 1, then 5 mg/kg orally X 4 days
Late (infected)
Preferred Regimen
Ampicillin sulbactam 100 to 300 mg/kg/day IV q6h
OR
Cefoxitin 80 to 160 mg/kg/day IV in 4 divided doses
OR
Ertapenem (3months - 12years) 15 mg/kg IV twice daily (maximum 1 g/day) OR Ertapenem (>13years) 1 g IV once daily

Monkey Bites

Medical Therapy

▸ Click on the following categories to expand treatment regimens.

[1]

Monkey Bites

  ▸  Adults

  ▸  Children

High risk bites (deep bites, symptomatic animals
Preferred Regimen (without CNS symptoms)
Acyclovir 12.5–15 mg per kg IV q8h
OR
Ganciclovir 5 mg per kg IV q12h
Preferred Regimen (with CNS symptoms)
Ganciclovir 5 mg per kg IV q12h
High risk bites (deep bites, symptomatic animals
Preferred Regimen (without CNS symptoms)
Acyclovir 12.5–15 mg per kg IV q8h
OR
Ganciclovir 5 mg per kg IV q12h
Preferred Regimen (with CNS symptoms)
Ganciclovir 5 mg per kg IV q12h

Rat Bites

Medical Therapy

▸ Click on the following categories to expand treatment regimens.

[1]

Rat Bites

  ▸  Adults

  ▸  Children

Uncomplicated
Preferred Regimen
Amoxicillin-clavulanate 875/125 mg orally q12h
Alternative Regimen (beta-lactam allergy)
Doxycycline 100 mg orally q12h
Rat bite fever
Preferred Regimen
Penicillin G benzathine 600,000 to 1,000,000 units/day IM X 10-14 days
OR
Tetracycline 250 to 500 mg orally q6h
Alternative Regimen
Streptomycin 15 mg/kg/day IM in a single dose or in 2 divided doses X 10-14 days
Early (not yet infected)
Preferred Regimen
Amoxicillin-clavulanate 45 mg/kg/day orally in two divided doses X 3-7 days
Alternative Regimen
Cefuroxime 10 to 15 mg/kg orally q12h
Rat bite fever
Preferred Regimen
Penicillin G benzathine 25,000 to 50,000 units/day IM X 10-14 days
OR
Tetracycline (>8 years) 25 to 50 mg/kg/day orally in 4 divided doses X 10-14 days
Alternative Regimen
Streptomycin 15 mg/kg/day IM in a single dose or in 2 divided doses X 10-14 days

Pig Bites

Medical Therapy

▸ Click on the following categories to expand treatment regimens.

[1]

Pig Bites

  ▸  Adults

  ▸  Children

Pig (Swine)
Preferred Regimen
Amoxicillin-clavulanate 875/125 mg orally q12h X 5 days
Alternative Regimen
Ampicillin sulbactam
OR
Imipenem
OR
Cephalosporin
Pig (Swine)
Preferred Regimen
Amoxicillin-clavulanate 875/125 mg orally q12h X 5 days
Alternative Regimen
Ampicillin sulbactam
OR
Imipenem
OR
Cephalosporin

Tick Bites

Medical Therapy

▸ Click on the following categories to expand treatment regimens.

[1]

Tick Bites

  ▸  Adults

  ▸  Children

Suspected Leptospirosis
Preferred Regimen
Doxycycline 200 mg orally once within 72 hours of tick removal
Suspected Leptospirosis
Preferred Regimen
Doxycycline (≥8 years) 4 mg/kg (maximum 200 mg) orally once within 72 hours tick removal


References

  1. 1.0 1.1 1.2 1.3 1.4 1.5 1.6 Stevens DL, Bisno AL, Chambers HF, Everett ED, Dellinger P, Goldstein EJ; et al. (2005). "Practice guidelines for the diagnosis and management of skin and soft-tissue infections". Clin Infect Dis. 41 (10): 1373–406. doi:10.1086/497143. PMID 16231249.


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