Staphylococcal scalded skin syndrome: Difference between revisions
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==Treatment== | ==Treatment== | ||
*Often requires | *Often requires inpatient therapy, [[Fluid Resuscitation]], parenteral [[antibiotics]] | ||
*Antibiotics | *[[Antibiotics]] | ||
**Nafcillin 100 mg/kg/d IV in 4 divided doses OR 50 mg/kg/d in 4 divided doses PO x7-10d | **Nafcillin 100 mg/kg/d IV in 4 divided doses OR 50 mg/kg/d in 4 divided doses PO x7-10d | ||
**Penicillin G procaine (300K U/d IM for <30 kg, 600K to 1 million U/d IM for >30 kg) | **Penicillin G procaine (300K U/d IM for <30 kg, 600K to 1 million U/d IM for >30 kg) | ||
| Line 18: | Line 18: | ||
***Clindamycin 40mg/kg/d IV or PO in 4 divided doses x7-10d | ***Clindamycin 40mg/kg/d IV or PO in 4 divided doses x7-10d | ||
***[[Bactrim]] 10 mg/kg/d in 2 divided doses x7-10d | ***[[Bactrim]] 10 mg/kg/d in 2 divided doses x7-10d | ||
***Vancomycin 10-15mg/kg/d in 2 divided doses up to 1 gm q12hr | ***[[Vancomycin]] 10-15mg/kg/d in 2 divided doses up to 1 gm q12hr | ||
==Disposition== | ==Disposition== | ||
Revision as of 07:19, 3 March 2014
Background
- Most pts <2yr old, nearly all <6 yr old
Diagnosis
- Rash progresses from erythroderma to extensive areas of exfoliation
- Systemic symptoms (malaise, fever, irritability, skin tenderness) are common
- Nikolsky sign (separation of epidermis when pressure is applied) is present
Treatment
- Often requires inpatient therapy, Fluid Resuscitation, parenteral antibiotics
- Antibiotics
- Nafcillin 100 mg/kg/d IV in 4 divided doses OR 50 mg/kg/d in 4 divided doses PO x7-10d
- Penicillin G procaine (300K U/d IM for <30 kg, 600K to 1 million U/d IM for >30 kg)
- Amoxicillin-clavulanate 45 mg/kg/d PO in 2 divided doses x 7-10d
- Cefazolin 100 mg/kg/d IV in 4 divided doses
- Cephalexin 40 mg/kg/d in 4 divided doses x 7-10d
- If possible MRSA:
- Clindamycin 40mg/kg/d IV or PO in 4 divided doses x7-10d
- Bactrim 10 mg/kg/d in 2 divided doses x7-10d
- Vancomycin 10-15mg/kg/d in 2 divided doses up to 1 gm q12hr
Disposition
- Transfer to burn center if diffuse
- Localized infection may d/c home w/ f/u
Source
Tintinalli