Soft Tissue Injury, established Infection
For skin and soft tissue wounds that have developed secondary infection
- Thorough cleaning and/or surgical debridement may be indicated
- Tetanus risk assessment should be performed. See also Tetanus-prone wounds
- Take a swab if discharge from wound and send to microbiology. Re-assess wound after 24-48 hours if no improvement.
- Treat for 5-7 days depending on response to therapy.
Preferred
co-amoxiclav 30mg/kg (Max 1.2g) iv TDS (BD if 1-2 months old)
Oral switch: co-amoxiclav po (see dosing table)
| Age | co-amoxiclav oral dose |
| 1 month to 11 months |
0.5mL/kg of 125mg/31mg/5mL suspension TDS |
| 1 year to 5 years |
10mLs of 125mg/31mg/5mL suspension TDS |
| 6 years to 11 years |
10mLs of 250mg/62mg/5mL suspension TDS |
| 12 years to 17 years | One 625mg tablet TDS OR 10mLs of 250mg/62mg/5mL suspension TDS if patient cannot take tablets |
Alternative
For penicillin allergy (non-severe and severe) or MRSA sensitive to clindamycin
For patients one month and over:
clindamycin 10mg/kg (max 600mg) iv QDS
Oral switch: clindamycin 6mg/kg (max 450mg) po QDS
For other MRSA positive patients: vancomycin iv
Oral switch: co-trimoxazole po (see dosing table)
| Age | co-trimoxazole oral dose |
| 6 Weeks to 5 Months | 120mg BD |
| 6 Months to 5 Years | 240mg BD |
| 6 Years to 11 years | 480mg BD |
| 12 years to 17 years | 960mg BD |
For infected wounds with exposure to fresh- or sea- water:
For patients one month and over: ADD ciprofloxacin* 20mg/kg (max 750mg) po BD
*Ciprofloxacin may induce convulsions in patients with or without a history of convulsions – use with caution