Patients at increased risk of MRSA infection
For empirical therapy of post-traumatic wound infection associated with systemic features or involving deeper tissues in patients at increased risk of MRSA infection, use:
vancomycin intravenously; see Intermittent vancomycin dosing in noncritically ill adults or Intermittent vancomycin dosing for young infants and children for initial dosing. wound infection, post-traumatic vancomycin
For heavily contaminated severe injuries or significant tissue maceration, use:
vancomycin intravenously; see Intermittent vancomycin dosing in noncritically ill adults or Intermittent vancomycin dosing for young infants and children for initial dosing wound infection, post-traumatic vancomycin
PLUS
metronidazole 500 mg (child: 12.5 mg/kg up to 500 mg) intravenously, 12-hourly. wound infection, post-traumatic: low risk of mrsa metronidazole
For patients who have sustained a penetrating injury through footwear, use:
vancomycin intravenously; see Intermittent vancomycin dosing in noncritically ill adults or Intermittent vancomycin dosing for young infants and children for initial dosing wound infection, post-traumatic vancomycin
PLUS
metronidazole 500 mg (child: 12.5 mg/kg up to 500 mg) intravenously, 12-hourly wound infection, post-traumatic: increased risk of mrsa metronidazole
PLUS
ciprofloxacin 400 mg (child: 10 mg/kg up to 400 mg) intravenously, 8-hourly1. For dosage adjustment in adults with kidney impairment, see ciprofloxacin intravenous dosage adjustment. wound infection, post-traumatic: increased risk of mrsa ciprofloxacin
See General principles for duration of therapy, including switch to oral therapy.