Template:Osteomyelitis Antibiotics

Risk Factor	Likely Organism	Initial Empiric Antibiotic Therapy'
Elderly, hematogenous spread	MRSA, MSSA, gram neg	Vancomycin 1gm + (Piperacillin/Tazobactam 3.375 grams OR Imipenem 500mg)
Sickle Cell Disease	Salmonella, gram-negative bacteria	Ceftriaxone 50mg/kg IV once daily OR Cefotaxime 50mg/kg IV three times daily, PLUS Vancomycin 15mg/kg IV four times daily OR Clindamycin 10mg/kg IV PO four times daily OR Nafcillin 50 mg/kg IV four times daily to cover K. Kingae (common in daycare population)
DM or vascular insufficiency	Polymicrobial: Staph, strep, coliforms, anaerobes	Vancomycin 1gm + (Piperacillin/Tazobactam 3.375 grams OR Imipenem 500mg)
IV drug user	MRSA, MSSA, pseudomonas	Vancomycin 1gm
Newborn	MRSA, MSSA, GBS, Gram Negative	Vancomycin 15mg/kg load, then reduce dose, AND Ceftazidime 30mg/kg IV q12 h
Children	MRSA, MSSA	Vancomycin 10mg/kg q6 h AND Ceftazidime 50mg/kg q8hr
Postoperative (ortho)	MRSA, MSSA	Vancomycin 1gm
Human bite	Strep, anaerobes, HACEK organism	Piperacillin/Tazobactam 3.375gm OR Imipenem 500mg
Animal bites	Pasteurella, Eikenella, HACEK organism	Piperacillin/Tazobactam 3.375gm OR Imipenem 500mg
Foot puncture wound	Pseudomonas	Anti-pseudomonal, staph coverage

• Dicloxacillin <40kg: 50-100mg/kg/day PO divided q6h; >40kg: 250-500mg PO q6h