Pyomyositis

• Purulent infection of skeletal muscle that arises by haematogenous spread - investigate for source.
• Pyomyositis may be managed conservatively but consult a surgical team.

Pathogens

• Common: Staphylococcus aureus
• Other: Streptococci

Drug Treatment

• Duration: 4 weeks or more

Empiric

flucloxacillin HMLSchedNZFPMLnoids Flucloxacillin F: 0.9 Half life: 1 hour Elimination: renal fe: 0.7

IV 2 g every six hours

• fe = 0.7, consider adjusting dose if CrCl reduced.
• Risk of hepatotoxicity is increased in females, patients > 55 years old, high doses, and courses longer than 14 days duration.

Mild penicillin allergy

cefazolin HMLSchedNZFPMLnoids Cefazolin F: n/a Half life: 2 hours Elimination: renal fe: 0.9

IV 2 g every eight hours

• fe = 0.9, consider adjusting dose if CrCl is reduced.

Severe penicillin allergy

Consult Infectious Diseases/Clinical Microbiology.

Topic Code: 99268

must be prescribed or recommended by a consultant.