Limb Wound Infection (Post-operative)

• Mild erythema – may not require antimicrobial therapy

Slowly spreading cellulitis

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.

Modify according to Gram stain or swab results.

Rapidly spreading cellulitis with systemic toxicity

May indicate severe infection including fasciitis. Consult urgently with Infectious Diseases/Clinical Microbiology.

• fe = 0.7, consider adjusting dose if CrCl reduced.

AND

gentamicin HMLSchedNZFPMLnoids Gentamicin F: n/a Half life: 3 hours Elimination: renal fe: 0.9 Additional points: TDM.

See dosing guidelines

• fe = 0.9, adjust dose if CrCl reduced.

PLUS or MINUS

clindamycin HMLSchedNZFPMLnoids Clindamycin F: 0.9 Half life: 3 hours Elimination: CYP3A fe: 0.1

IV 900 mg every eight hours

• Metabolised by CYP3A. (fe < 0.1).

Surgical debridement should be considered.

Topic Code: 99291

must be prescribed or recommended by a consultant.