Antibiotic choice for water-immersed wound infections

If prophylaxis or presumptive therapy is indicated (see Principles of management of water-immersed wounds) and oral therapy is appropriate, use the antibiotics recommended for localised water-immersed wound infections. If intravenous therapy is appropriate, use the antibiotics recommended for infections associated with systemic features or deeper tissues. See Prophylaxis for traumatic wounds or Presumptive therapy for bites and clenched-fist injuries for duration of therapy.

Antibiotic choice for infected wounds depends on infection severity (see Localised infection or Infection associated with systemic symptoms or deeper tissues), the water source in which the wound was immersed, and whether the patient has risk factors for developing severe disease (eg cirrhosis, iron overload, immune compromise). Treat patients with risk factors for developing severe disease with the regimens for infection associated with systemic symptoms or involving deeper tissues even if the infection is localised, because of the risk of fulminant infection.