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Impetigo Mupirocin; (bacitracin and neomycin, are less effective.) numerous lesions or not responding to topical agents: oral antimicrobials effective against both S. aureus and S. pyogenes.
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Impetigo
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Folliculitis Local measures such as saline compresses and topical antibacterials (e.g., mupirocin) are usually sufficient to control the infection.
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Furuncles and Carbuncles Most furuncles: moist heat. carbuncle, a furuncle with surrounding cellulitis or fever, or a furuncle located about the midface: an antistaphylococcal antibiotic (e.g., dicloxacillin). In a penicillin-allergic adult: clindamycin, or co-trimoxazole. Patients with moderate to severe disease are best treated with initial parenteral therapy (e.g., vancomycin, linezolid, or daptomycin)
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Erysipelas Mild early cases of erysipelas in an adult may be treated with oral penicillin V (500 mg every 6 hours) or initial IM procaine penicillin (600,000 units once or twice daily). Erythromycin (250 to 500 mg orally every 6 hours) or other macrolides are suitable alternatives. More extensive erysipelas, hospitalization and parenteral aqueous penicillin G (2,000,000 units every 6 hours). If differentiation from cellulitis is difficult: a PRP (nafcillin or oxacillin), a cephalo 1, or therapy against MRSA.
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cellulitis Outpatient: PRP (nafcillin or oxacillin), cephalo 1 MRSA is suspected: clindamycin, TMP-SMX, doxycycline or minocycline + B-lactam (eg, amoxicillin), linezolid. Inpatient: PRP, cephalo 1 MRSA is suspected: vancomycin, linezolid, daptomycin, clindamycin
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Diabetic Ulcers Mild: PO cephalexin, dicloxacillin, clindamycin Moderate to severe: IV clindamycin plus a cephalo 3, clindamycin plus a fluoroquinolone, piperacillin-tazobactam, carbapenem, ampicillin-sulbactam, ticarcillin-clavulanate.
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Diabetic Ulcers
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Gastroenteritis ciprofloxacin, ofloxacin, levofloxacin, norfloxacin Azithromycin
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Typhoid Fever
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Gastroenteritis (nosocomial)
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CNS Infections (Meningitis)
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CNS Infections (Brain Abscess)
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CNS Infections (Shunt Infection) vancomycin plus either cefepime, ceftazidime, or meropenem
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CNS Infections (Subdural Empyema, Epidural Abscess) vancomycin plus cefepime or ceftazidime + metronidazole or meropenem In spinal cases, anaerobic coverage is not required.
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CNS Infections (Suppurative Intracranial Thrombophlebitis) vancomycin plus cephalo 3 or 4 + metronidazole or meropenem
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