TABLE 5.
Microorganism(s) | Preferred treatment | Alternate treatment | Combination therapyb |
---|---|---|---|
Methicillin-susceptible staphylococci | Cefazolin or nafcillin | Vancomycin, daptomycin, or linezolid | Rifampin for DAIR and one-stage exchange |
Methicillin-resistant staphylococci | Vancomycin | Daptomycin or linezolid | Rifampin for DAIR and one-stage exchange |
Penicillin-susceptible enterococci | Penicillin or ampicillin | Vancomycin, daptomycin, or linezolid | Consider aminoglycoside |
Penicillin-resistant enterococci | Vancomycin | Daptomycin or linezolid | Consider aminoglycoside |
Pseudomonas aeruginosa | Cefepime or meropenem | Ciprofloxacin or ceftazidime | Consider aminoglycoside or fluoroquinolone |
Enterobacter species | Cefepime or ertapenem | Ciprofloxacin | No |
Enterobacteriaceae | Beta-lactam or ciprofloxacin | No | |
Beta-hemolytic streptococci | Penicillin or ceftriaxone | No | |
Propionibacterium acnes | Penicillin or ceftriaxone | No |
All antimicrobials are to be given intravenously, except ciprofloxacin or linezolid. (Adapted from reference 60 by permission of Oxford University Press/Infectious Diseases Society of America.)
DAIR, debridement, antibiotics, and implant retention.