Standard regimens for superficial incisional infection following cardiac implantable electronic device insertion

Before starting empirical therapy, obtain blood and wound samples for culture. For advice on obtaining good quality blood samples for culture, see Principles of obtaining blood for culture.

For empirical therapy in adults and children with superficial incisional infection following cardiac implantable electronic device insertion, use:

1dicloxacillin 500 mg (child: 12.5 mg/kg up to 500 mg) orally, 6-hourly for 7 to 10 days. For dosage adjustment in adults with kidney impairment, see dicloxacillin dosage adjustment dicloxacillin dicloxacillin dicloxacillin

OR

1flucloxacillin 500 mg (child: 12.5 mg/kg up to 500 mg) orally, 6-hourly for 7 to 10 days. For dosage adjustment in adults with kidney impairment, see flucloxacillin oral dosage adjustment. flucloxacillin flucloxacillin flucloxacillin

For patients at increased risk of methicillin-resistant S. aureus (MRSA) infection, use:

1trimethoprim+sulfamethoxazole 160+800 mg (child 1 month or older: 4+20 mg/kg up to 160+800 mg) orally, 12-hourly for 7 to 10 days. For dosage adjustment in adults with kidney impairment, see trimethoprim+sulfamethoxazole dosage adjustment trimethoprim + sulfamethoxazole trimethoprim+sulfamethoxazole trimethoprim+sulfamethoxazole

OR

2clindamycin 450 mg (child: 10 mg/kg up to 450 mg) orally, 8-hourly for 7 to 10 days. clindamycin clindamycin clindamycin

Modify therapy based on the results of wound culture and susceptibility testing. If the results of culture are negative, complete 7 to 10 days of therapy using the empirical regimen.