Guidelines
Prophylaxis or Mild-Moderate - Inpatient

Prophylaxis or Mild-Moderate - Inpatient

Notes

Prophylactic antibiotics are not routinely indicated in immunocompetent patients. Prescribe prophylaxis only if patient has risk factors for developing deep infection.

Risk Factors

Patient Risk Factors: advanced age, diabetes, immunocompromised 

Wound Risk Factors: penetrates muscle, injury through shoe, grossly contaminated, retained foreign body

Duration of Therapy

Prophylaxis: 3 - 5 days

Mild-moderate infection: 5 - 7 days Consider 7-10 days if follow-up not available and multiple risk factors for developing deeper infection

First Line Regimens (Tolerates PO)

  • Cephalexin shares structural side chains with penicillins.
  • If severe PCN allergy, use cefdinir

OR

OR

First Line Regimens (IV)

Does not share any side chains with penicillins, okay to use in PCN allergy

OR

Puncture Through Sole of Shoe