Published on Infectious Diseases Management Program at UCSF (http://idmp.ucsf.

edu)
Home > Pediatric Guidelines: Skin & Soft Tissue Infections - Abscess/Purulent Cellulitis

Pediatric Guidelines: Skin & Soft Tissue Infections - Abscess/Purulent Cellulitis

Alternative
Condition Major Pathogens First Choice Therapy Comments
Therapy

Consider drainage alone if isolated

abscess or minor surrounding
cellulitis; antibiotic therapy
recommended if significant
surrounding cellulitis, unable to drain,
severe infection, or Clindamycin
Abscess with or immunocompromised patient 10mg/kg/dose Duration: 5-7 days
without surrounding IV/PO q8h (max for non-severe
Staphylococcus
cellulitis Outpatient/non-severe infection, > 600mg/dose PO, infection
aureus
1 month old: 900mg/dose IV)
Surrounding cellulitis = See Antibiogram for
Other pathogens
marked erythema Trimethoprim-sulfamethoxazole OR inpatient [1]and
depending on
larger than the extent (Bactrim/Septra) 4-6 mg/kg/dose outpatient [2]S.
specific
of overlying induration trimethoprim PO BID (max 160mg Doxycycline aureus
exposures/risk
OR extending > 5cm trimethoprim/dose) 2mg/kg/dose PO susceptibilities
factors
from abscess for adult- BID (max
sized patient 100mg/dose) if >=
8 years old
Severe infection:

Vancomycin 15mg/kg/dose IV q6-8h

(initial max 1g/dose)
References:

Stevens DL, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the
Infectious Diseases Society of America [3]. Clin Infect Dis 2014;59:e10-e52.

Liu C, et al. Clinical practice guidelines by the Infectious Diseases Society of America for the treatment of methicillin-resistant
Staphylococcus aureus infections in adults and children [4]. Clin Infect Dis 2011;52:e18-e55.

These are guidelines only and not intended to replace clinical judgment. Modification of therapy may be indicated based on patient comorbidities, previous antibiotic therapy or infection history. Doses
provided are usual doses but may require modification based on patient age or comorbid conditions. Refer toPediatric Antimicrobial Dosing Guideline[5] for further guidance on dosing in children, and
Neonatal Dosing Guideline[6] for infants < 1 month of age. Consult a pediatric pharmacist for individualized renal or hepatic dose adjustment. For additional guidance, please contact Pediatric Infectious
Diseases (ID) or the Pediatric Antimicrobial Stewardship Program (ASP).

Contact Us
UCSF Main Site

2013 The Regents of the University of California

Source URL: http://idmp.ucsf.edu/pediatric-guidelines-skin-soft-tissue-infections-abscesspurulent-cellulitis?mag_q=printpdf/1036

Links:
[1] http://idmp.ucsf.edu/ucsf-benioff-childrens-hospital-antimicrobial-susceptibility-gram-positives-inpatients
[2] http://idmp.ucsf.edu/ucsf-benioff-childrens-hospital-antimicrobial-susceptibility-staphylococcus-aureus-susceptibility
[3] http://cid.oxfordjournals.org/content/early/2014/06/14/cid.ciu296.full.pdf
[4] http://www.idsociety.org/uploadedFiles/IDSA/Guidelines-Patient_Care/PDF_Library/MRSA.pdf
[5] http://idmp.ucsf.edu/pediatric-antimicrobial-dosing-benioff-childrens-hospital
[6] http://idmp.ucsf.edu/neonatal-antimicrobial-dosing-benioff-childrens-hospital-san-francisco