Lacerations
No signs/prophylaxis - Outpatient

No signs/prophylaxis - Outpatient

Notes

Prophylactic antibiotics are not routinely indicated in immunocompetent patients

Prescribe prophylaxis only if patient has risk factors for developing infection

Risk Factors

Patient risk factors: advanced age, diabetes, chronic renal/liver failure, immunocompromised

Wound risk factors: visibly contaminated, jagged wound, wound length >5 cm, width >1 mm, deep (beneath subcutaneous layer), lower extremity location, presence of foreign body, intra-oral wounds

Duration of Therapy

3 - 5 days

1st Line Regimen

  • Cephalexin shares structural side chains with penicillins.
  • If PCN allergy, use cefuroxime or clindamycin below.

2nd Line OR Mild-Mod Penicillin Allergy or Intolerance

  • Does not share any structural side chains with penicillin or cephalexin
  • Note: non-formulary for inpatient/ED use. Prescribe for outpatient use only.

3rd Line OR Life-Threatening Penicillin and/or Ceph Allergy

  • Consider 450mg QID if wt > 120 kg
  • Not routinely recommended due to poor Strep coverage in our region. Do not use unless cefuroxime contraindicated.