Medication Summary
The goals of pharmacotherapy are to treat infections and prevent further complications.
Antibiotics
Class Summary
Empirical coverage for S aureus and streptococcal organisms should be provided. Given the rapid emergence of community-acquired methicillin-resistant S aureus, treatment with a drug more likely to be effective against this agent should be considered. Coverage for E corrodens may be indicated for immunosuppressed patients.
Dicloxacillin (Dycill, Dynapen)
Bactericidal antibiotic that inhibits cell wall synthesis; DOC to treat infections caused by penicillinase-producing staphylococci. May be used to initiate therapy when staphylococcal infection is suspected.
Erythromycin (EES, E-Mycin, Ery-Tab)
An alternative antibiotic that inhibits RNA-dependent protein synthesis, possibly by stimulating dissociation of peptidyl tRNA from ribosomes, which inhibits bacterial growth.
Indicated for the treatment of infections caused by susceptible strains, including streptococci and S aureus.
In children, age, weight, and severity of infection determine proper dosage. When twice a day dosing is desired, half-total daily dose may be taken every 12 h. For more severe infections, double dose.
Cephalexin (Keflex, Biocef)
Another alternative antibiotic. First-generation cephalosporin that inhibits bacterial replication by inhibiting bacterial cell wall synthesis. Bactericidal and effective against rapidly growing organisms forming cell walls.
Nafcillin (Unipen)
Indicated for severe infections.
Treats infections caused by penicillinase-producing staphylococci. Used to initiate therapy in any patients with possible penicillin G-resistant staphylococcal infection. Do not use for treatment of penicillin G-susceptible staphylococcal organisms.
Use parenteral therapy initially in severe infections. Severe infections may require very high doses.
Change to oral therapy as condition improves.
Because of occasional occurrence of thrombophlebitis associated with the parenteral route, particularly in elderly patients, administer parenterally only for a short term (24-48 h) and change to oral route if clinically possible.
Trimethoprim/sulfamethoxazole
Inhibits bacterial growth by inhibiting synthesis of dihydrofolic acid.
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