Lymphangitis medical therapy: Difference between revisions
No edit summary |
No edit summary |
||
Line 70: | Line 70: | ||
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Suspected Methicillin-Resistant Staphylococcus Aureus (MRSA)''''' | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Suspected Methicillin-Resistant Staphylococcus Aureus (MRSA)''''' | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Clindamycin]] 300-450 mg PO q8h'''''<BR> OR <BR>▸ '''''[[TMP- | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Clindamycin]] 300-450 mg PO q8h'''''<BR> OR <BR>▸ '''''[[TMP-SMX]] 1 or 2 double-strength tablets ((sulfamethoxazole 800 mg; trimethoprim 160 mg) PO q12h'''''<BR> OR <BR>▸ '''''[[Doxycycline]] 100 mg PO q12h'''''<BR> OR <BR> ▸ '''''[[Minocycline]] 100 mg PO q12h'''''<BR> OR <BR> ▸ '''''[[Linezolid]] 600 mg PO q12h''''' | ||
|- | |- | ||
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Suspected Beta-Hemolytic Streptococci and Methicillin-Resistant Staphylococcus Aureus (MRSA)''''' | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Suspected Beta-Hemolytic Streptococci and Methicillin-Resistant Staphylococcus Aureus (MRSA)''''' | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Clindamycin]] 300-450 mg PO q8h'''''<BR> OR <BR>▸ '''''[[Amoxicillin]] 500 mg PO q8h plus [[TMP- | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Clindamycin]] 300-450 mg PO q8h'''''<BR> OR <BR>▸ '''''[[Amoxicillin]] 500 mg PO q8h plus [[TMP-SMX]] 1 or 2 double-strength tablets ((sulfamethoxazole 800 mg; trimethoprim 160 mg) PO q12h'''''<BR> OR <BR>▸ '''''[[Amoxicillin]] 500 mg PO q8h plus [[Doxycycline]] 100 mg PO q12h'''''<BR> OR <BR> ▸ '''''[[Amoxicillin]] 500 mg PO q8h plus [[Minocycline]] 100 mg PO q12h'''''<BR> OR <BR> ▸ '''''[[Linezolid]] 600 mg PO q12h''''' | ||
|- | |- | ||
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Animal Bites''''' | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Animal Bites''''' | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Amoxicillin-clavulanate]] 875 mg PO q12h''''' | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=left | '''''Preferred Regimen''''' | ||
|- | |||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Amoxicillin-clavulanate]] 875 mg PO q12h''''' | |||
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen''''' | |||
|- | |||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Doxycycline]] 100 mg PO q12h'''''<BR> OR <BR> ▸ '''''[[TMP-SMX]] 1 double strength tablet (sulfamethoxazole 800 mg; trimethoprim 160 mg) PO q12h'''''<BR> OR <BR> ▸ '''''[[Moxifloxacin]] 400 mg PO q24h'''''<BR> PLUS <BR> ▸ '''''[[Clindamycin]] 450 mg PO q8h''''' | |||
|- | |- | ||
|} | |} | ||
Line 98: | Line 103: | ||
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Suspected Methicillin-Resistant Staphylococcus Aureus (MRSA)''''' | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Suspected Methicillin-Resistant Staphylococcus Aureus (MRSA)''''' | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Clindamycin]] 10-13 mg/kg PO q6-8h'''''<BR> OR <BR>'''''[[TMP- | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Clindamycin]] 10-13 mg/kg PO q6-8h'''''<BR> OR <BR>'''''[[TMP-SMX]] 8–12 mg/kg (based on trimethoprim component) PO q12h'''''<BR> OR <BR> ▸ '''''[[Doxycycline]] ≤45 kg: 2 mg/kg PO q12h; >45 kg: 100 mg PO q12h'''''<BR> OR <BR> ▸ '''''[[Minocycline]] 2 mg/kg PO q12h'''''<BR> OR <BR> ▸ '''''[[Linezolid]] 10 mg/kg PO q8h''''' | ||
|- | |- | ||
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Suspected Beta-Hemolytic Streptococci and Methicillin-Resistant Staphylococcus Aureus (MRSA)''''' | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Suspected Beta-Hemolytic Streptococci and Methicillin-Resistant Staphylococcus Aureus (MRSA)''''' | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Clindamycin]] 10-13 mg/kg PO q6-8h'''''<BR> OR <BR>▸ '''''[[Amoxicillin]] 25-50 mg/kg PO q8h plus [[TMP- | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Clindamycin]] 10-13 mg/kg PO q6-8h'''''<BR> OR <BR>▸ '''''[[Amoxicillin]] 25-50 mg/kg PO q8h plus [[TMP-SMX]] 8–12 mg/kg (based on trimethoprim component) PO q12h'''''<BR> OR <BR>▸ '''''[[Amoxicillin]] 25-50 mg/kg PO q8h plus [[Doxycycline]] ≤45 kg: 2 mg/kg PO q12h; >45 kg: 100 mg PO q12h'''''<BR> OR <BR> ▸ '''''25-50 mg/kg PO q8h plus [[Minocycline]] 2 mg/kg PO q12h'''''<BR> OR <BR> ▸ '''''[[Linezolid]] 10 mg/kg PO q8h''''' | ||
|- | |- | ||
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Animal Bites''''' | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Animal Bites''''' | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Amoxicillin-clavulanate]] 20 mg/kg PO divided q12h''''' | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=left | '''''Preferred Regimen''''' | ||
|- | |||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Amoxicillin-clavulanate]] 20 mg/kg PO divided q12h''''' | |||
|- | |||
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=left | '''''Alternative Regimen''''' | |||
|- | |||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | '''''[[TMP-SMX]] 4-5 mg/kg (trimethoprim component) PO q12h'''''<BR> PLUS <BR> ▸ '''''[[Clindamycin]] 10 mg/kg PO q8h''''' | |||
|- | |- | ||
|} | |} | ||
Line 119: | Line 130: | ||
|- | |- | ||
| 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''''' | ||
|- | |- | ||
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Suspected Methicillin-Sensitive Staphylococcus Aureus (MSSA)''''' | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Suspected Methicillin-Sensitive Staphylococcus Aureus (MSSA)''''' | ||
Line 131: | Line 138: | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Vancomycin]] 15-20 mg/kg IV q8-12h'''''<BR> OR <BR> ▸ '''''[[Linezolid]] 600 mg IV q12h'''''<BR> OR <BR> ▸ '''''[[Daptomycin]] 4mg/kg IV q24h '''''<BR> OR <BR> ▸ '''''[[Clindamycin]] 600 mg IV/PO q8h'''''<BR> OR <BR> ▸ '''''[[Telavancin]] 10 mg/kg IV q12h''''' | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Vancomycin]] 15-20 mg/kg IV q8-12h'''''<BR> OR <BR> ▸ '''''[[Linezolid]] 600 mg IV q12h'''''<BR> OR <BR> ▸ '''''[[Daptomycin]] 4mg/kg IV q24h '''''<BR> OR <BR> ▸ '''''[[Clindamycin]] 600 mg IV/PO q8h'''''<BR> OR <BR> ▸ '''''[[Telavancin]] 10 mg/kg IV q12h''''' | ||
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Suspected Beta-Hemolytic Streptococci and Methicillin-Resistant Staphylococcus Aureus (MRSA)''''' | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Clindamycin]] 300-450 mg PO q8h'''''<BR> OR <BR>▸ '''''[[Amoxicillin]] 500 mg PO q8h plus [[TMP- | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Suspected Beta-Hemolytic Streptococci and Methicillin-Resistant Staphylococcus Aureus (MRSA)''''' | ||
|- | |||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Clindamycin]] 300-450 mg PO q8h'''''<BR> OR <BR>▸ '''''[[Amoxicillin]] 500 mg PO q8h plus [[TMP-SMX]] 1 or 2 double-strength tablets ((sulfamethoxazole 800 mg; trimethoprim 160 mg) PO q12h'''''<BR> OR <BR>▸ '''''[[Amoxicillin]] 500 mg PO q8h plus [[Doxycycline]] 100 mg PO q12h'''''<BR> OR <BR> ▸ '''''[[Amoxicillin]] 500 mg PO q8h plus [[Minocycline]] 100 mg PO q12h'''''<BR> OR <BR> ▸ '''''[[Linezolid]] 600 mg PO q12h''''' | |||
|- | |- | ||
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Animal Bites''''' | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Animal Bites''''' | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Ampicillin sulbactam]] 3 g IV q6h''''' | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=left | '''''Preferred Regimen''''' | ||
|- | |||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Ampicillin sulbactam]] 3 g IV q6h''''' | |||
|- | |||
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=left | '''''Alternative Regimen''''' | |||
|- | |||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Ertapenem]] 1 g IM/IV q24h'''''<BR> OR <BR> ▸ '''''[[Cefoxitin]] 1 g IV q4h or 2 g IV q8h'''''<BR> OR <BR> ▸ '''''[[Meropenem]] 1 g IV q8h'''''<BR> OR <BR> ▸ '''''[[Imipenem cilastatin]] 500 mg IV q6h'''''<BR> OR <BR> '''''[[Doxycycline]] 100 mg IV q12h'''''<BR> OR <BR> ▸ '''''[[TMP-SMX]] 8-20 mg/kg IV divided q6-12h'''''<BR> OR <BR> ▸ '''''[[Moxifloxacin]] 400 mg IV q24h'''''<BR> PLUS <BR> ▸ '''''[[Clindamycin]] 600 mg IV q8h''''' | |||
|- | |- | ||
|} | |} | ||
Line 150: | Line 165: | ||
|- | |- | ||
| 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''''' | ||
|- | |- | ||
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Suspected Methicillin-Sensitive Staphylococcus Aureus (MSSA)''''' | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Suspected Methicillin-Sensitive Staphylococcus Aureus (MSSA)''''' | ||
Line 163: | Line 174: | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Vancomycin]] 15 mg/kg IV q6h'''''<BR> OR <BR> ▸ '''''[[Linezolid]] 10 mg/kg IV/PO q8h'''''<BR> OR <BR> ▸ '''''[[Daptomycin]] 5-9 mg/kg IV q24h'''''<BR> OR <BR> ▸ '''''[[Clindamycin]] 10-13 mg/kg IV/PO q6-8h (max:40 mg/kg/day)''''' | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Vancomycin]] 15 mg/kg IV q6h'''''<BR> OR <BR> ▸ '''''[[Linezolid]] 10 mg/kg IV/PO q8h'''''<BR> OR <BR> ▸ '''''[[Daptomycin]] 5-9 mg/kg IV q24h'''''<BR> OR <BR> ▸ '''''[[Clindamycin]] 10-13 mg/kg IV/PO q6-8h (max:40 mg/kg/day)''''' | ||
|- | |- | ||
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Suspected Beta-Hemolytic Streptococci and Methicillin-Resistant Staphylococcus Aureus (MRSA)''''' | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Suspected Beta-Hemolytic Streptococci and Methicillin-Resistant Staphylococcus Aureus (MRSA)''''' | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Clindamycin]] 10-13 mg/kg PO q6-8h'''''<BR> OR <BR>▸ '''''[[Amoxicillin]] 25-50 mg/kg PO q8h plus [[TMP- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Clindamycin]] 10-13 mg/kg PO q6-8h'''''<BR> OR <BR>▸ '''''[[Amoxicillin]] 25-50 mg/kg PO q8h plus [[TMP-SMX]] 8–12 mg/kg (based on trimethoprim component) PO q12h'''''<BR> OR <BR>▸ '''''[[Amoxicillin]] 25-50 mg/kg PO q8h plus [[Doxycycline]] ≤45 kg: 2 mg/kg PO q12h; >45 kg: 100 mg PO q12h'''''<BR> OR <BR> ▸ '''''25-50 mg/kg PO q8h plus [[Minocycline]] 2 mg/kg PO q12h'''''<BR> OR <BR> ▸ '''''[[Linezolid]] 10 mg/kg PO q8h''''' | |||
|- | |- | ||
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Animal Bites''''' | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''For Animal Bites''''' | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Ampicillin sulbactam]] 50 mg/kg IV q6h''''' | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=left | '''''Preferred Regimen''''' | ||
|- | |||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Ampicillin sulbactam]] 50 mg/kg IV 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 | ▸ '''''[[Ertapenem]] 15 mg/kg IM/IV q12h'''''<BR> OR <BR> ▸ '''''[[Cefoxitin]] 160 mg/kg IV divided q4-6h'''''<BR> OR <BR> ▸ '''''[[Meropenem]] 20 mg/kg IV q8h'''''<BR> OR <BR> ▸ '''''[[Imipenem cilastatin]] 25 mg/kg IV q6h'''''<BR> OR <BR> ▸ '''''[[TMP-SMX]] 4-5 mg/kg (trimethoprim component) IV q12h'''''<BR> PLUS <BR> ▸ '''''[[Clindamycin]] 10 mg/kg IV q8h''''' | |||
|- | |- | ||
|} | |} |
Revision as of 17:32, 2 June 2014
Lymphangitis Microchapters |
Diagnosis |
---|
Treatment |
Case Studies |
Lymphangitis medical therapy On the Web |
American Roentgen Ray Society Images of Lymphangitis medical therapy |
Risk calculators and risk factors for Lymphangitis medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vendhan Ramanujam M.B.B.S [2]
Overview
Lymphangitis most often is an acute complication following an extension from the skin infection with the potential of a systemic spread. It has to be promptly treated with appropriate antibiotics along with analgesics, anti-inflammatory medications, warm and moist compresses. Certain conditions like nodular lymphagitis that is complicated by abscess and lymphedema with significant lymphatic obstruction may require surgical intervention.
Principles of Therapy
Therapy Based on Clinical Form
Acute Lymphangitis
Empiric Therapy
▸ Click on the following categories to expand treatment regimens.[1][2]
Mild - Moderate Acute Lymphangitis ▸ Adults ▸ Children age >28 days Severe Acute Lymphangitis ▸ Adults ▸ Children age >28 days |
|
Pathogen Based Therapy
▸ Click on the following categories to expand treatment regimens.[1][2]
Bacteria ▸ Streptococcus Pyogenes ▸ Methicillin Sensitive Staphylococcus Aureus ▸ Methicillin Resistant Staphylococcus Aureus ▸ Pasteurella ▸ Spirillum Minus |
|
|
|
References
|