Skin structure infections

Recognizing the presumed site of infection and most common pathogens associated with the infectious source should guide antimicrobial choice, dose, and route of administration. For example, community-acquired pneumonia is caused most commonly by S. pneumoniae, E. coli is the primary cause of uncomplicated UTIs, and staphylococci and streptococci are implicated most frequently in skin and skin-structure infections (e.g., cellulitis). 

Guay DR Treatment ofbacterial skin and skin structure infections. Expert Opin Pharmaco-ther 2003 4 1259-1275. 

SSSIs - skin and skin structure infections cSSSIs - complicated skin and skin structure infections RTIs - respiratory tract infections. G+ - Gram positive. 

A number of recent publications indicate that the antibacterial field has adopted the concept of comparing free drug concentration at the site of action to in vitro drug potency reported as MIC [24-26]. A study of the antibacterial ertapenem in healthy volunteers was carried out to provide support for its use in skin and skin-structure infections [27]. Using microdialysis techniques, unbound drug concentrations in muscle and subcutaneous tissues were sampled at... 

Even newer is the natural product daptomycin (Cubicin), a complex cyclic lipopeptide structure, approved for use in the United States in 2003. Daptomycin has a spectrum similar to that of linezolid and specifically includes MRSA and VRE. In contrast to linezolid, daptomycin is bactericidal for these Gram-positive organisms. It is, like vancomycin, a parenteral antibiotic and is given intravenously. It is indicated for treatment of complicated skin and skin structure infections and for some cases of bacteremia, including endocarditis. Daptomycin may be thought of as an alternative to vancomycin. 

Breed J, Teras J, Gardovskis J, Maritz FJ, Vaasna T, Ross DP, Gioud-Paquet M, Dartois N, Ellis-Grosse EJ, Loh E. (2005) Safety and efficacy of tigecycline in treatment of skin and skin structure infections Results of a double-blind phase 3 comparison study with vancomycin-aztreonam. Antimicrob Agents Chemother 49 4658 666. 

Noel GJ, Bush K, Bagchi P, lanus J, Strauss RS. (2008) A randomized, double-blind trial comparing ceftobiprole medocaril with vancomycin plus ceftazidime for the treatment of patients with complicated skin and skin-structure infections. Clin Infect Dis 46 647-655. 

Talbot GH, Thye D, Das A, Ge Y. (2007) Phase 2 study of ceftaroline versus standard therapy in treatment of complicated skin and skin structure infections. Antimicrob Agents Chemother 51 3612-3616. 

Uncomplicated skin and skin structure infections-375 mg/12 hours for 7 to 10 days. 

Skin and skin structure infections - 1 g/day in single or 2 divided doses. 

Urinary tract infections, skin and skin structure infections 30 mg/kg/day in divided doses every 12 hours. 

Moderate to severe uncomplicated skin and skin structure infections caused by Staphylococcus aureus or Streptococcus pyogenes. 2glV q 12 h 10... 

Pediatric patients (2 months to 16 years of age) - Treatment of uncomplicated and complicated urinary tract infections (including pyelonephritis), uncomplicated skin and skin structure infections, pneumonia, and as empiric therapy for febrile neutropenic patients. 

Treat K. pneumoniae skin and skin structure infections with 1 or 2 g every 12 hours IV or IM. 

Uncomplicated pneumonia mild skin and skin structure infections 500 mg to 1 g IV or IM q 8 h... 

Skin and skin structure infections Give 50 to 75 mg/kg once daily (or in equally divided doses twice daily), not to exceed 2 g. 

Monohydrate 25 to 50 mg/kg/day in divided doses. For streptococcal pharyngitis in patients older than 1 year of age and for skin and skin structure infections, divide total daily dose and give every 12 hours. In severe infections, double the dose. 

Skin and skin structure infections - E. faecalis, S. aureus (penicillinase-producing), S. epidermidis, E. coli, Klebsiella sp., Enterobacter sp., P. vulgaris, P. rettgeri, M. morganii, P. aeruginosa, Serratia sp., Citrobactersp., Acinetobacter sp., Bacteroides sp., Fusobacterium sp. Peptococcus sp., Peptostreptococcus sp. 

Skin and skin structure infections- Skin and skin structure infections, including abscesses, cellulitis, infected skin ulcers, and wound infections caused by S. aureus (including penicillinase-producing strains) Streptococcus pyogenes, group D streptococcus including . faecalis, Acinetobacter sp. including iA. calcoaceticus] Citrobactersp.] E. coli] Enterobacter cloacae, K. pneumoniae]... 

Compiicated skin and skin structure infections Caused by Staphyiococcus aureus (methicillin-susceptible strains only). Streptococcus pyogenes, E. coii, or Peptostreptococcus sp. 

Skin and skin structure infections Skin and skin structure infections, including those associated with postoperative wounds, ulcers, and burns caused by . coli, P. mirabilis, S. marcescens, Enterobacter sp., P. aeruginosa, K. pneumoniae, and Citrobacter sp. 

Children Safety and efficacy of IV aztreonam have been established children 9 months to 16 years of age. Sufficient data are not available for pediatric patients younger than 9 months of age or for treatment of the following indications/pathogens Septicemia and skin and skin-structure infections (where the skin infection is caused by H. influenzae type b). In pediatric patients with cystic fibrosis, higher doses of aztreonam may be warranted. 

Dosage The recommended dosage regimen for tigecycline is an initial dose of 100 mg, followed by 50 mg every 12 hours. Intravenous (IV) infusions of tigecycline should be administered over approximately 30 to 60 minutes every 12 hours. Treatment duration The recommended duration of treatment with tigecycline for complicated skin and skin structure infections or for complicated intraabdominal infections is 5 to 14 days. 

Community-acquired pneumonia of mild severity, pharyngitis/tonsillitis (as second-line therapy), and uncomplicated skin and skin structure infections 500 mg as a single dose on the first day followed by 250 mg once daily on days 2 through 5. For community-acquired pneumonia, a single 2 g dose of Zmax may be given. 

Complicated skin and skin structure infections Administer daptomycin 4 mg/kg over a 30-minute period by IV infusion in 0.9% sodium chloride injection once every 24... 

Elderly In the two phase 3 clinical studies in patients with complicated skin and skin structure infections (cSSSI), lower clinical success rates were seen in patients 65 years of age and older compared with those younger than 65 years of age. In addition, treatment-emergent adverse events were more common in patients 65 years of age and older than in patients younger than 65 years of age in both cSSSI studies. 

Severe staphylococcal Infections - Severe staphylococcal infections (including methicillin-resistant staphylococci) in patients who cannot receive or who have failed to respond to penicillins and cephalosporins, or who have infections with resistant staphylococci. Infections may include endocarditis, bone infections, lower respiratory tract infections, septicemia, and skin and skin structure infections. 

Complicated skin and skin structure infections (SSSIs) For the treatment of complicated SSSIs caused by S. aureus (methicillin-susceptible and -resistant strains). Streptococcus pyogenes, or Streptococcus agalactiae. It has not been studied in the treatment of diabetic foot and decubitus ulcers. 

Skin and skin structure infections - Caused by Bacteroides sp. including the B. fragilis group, Clostridium sp., Peptococcus sp., Peptostreptococcus niger, and Fusobacterium sp. 

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