Toxic shock syndrome

ceftriaxone 100mg/kg (max 4g) iv OD

AND

clindamycin 10mg/kg (max 900mg) iv QDS

Review at 24 hours-36 hours when blood culture result is available AND ceftriaxone to be reviewed and stepped down to the following depending on causative organism identified in cultures and aetiology:

flucloxacillin 50mg/kg (max 2g) iv QDS AND clindamycin 10mg/kg (max 900mg) iv QDS

OR

benzylpenicillin 50mg/kg (max 2.4g) iv QDS (can be increased to every 4 hours for severe infection) AND clindamycin 10mg/kg (max 900mg) iv QDS

For pencillin allergy (non-severe and severe) or MRSA positive patients

vancomycin iv

AND

clindamycin 10mg/kg (max 900mg) iv QDS

AND

ciprofloxacin* 10mg/kg (max 400mg) iv TDS  

*ciprofloxacin may induce convulsions in patients with or without a history of convulsions – use with caution

Review at 24 hours-36 hours when blood culture result is available AND tailor therapy to the sensitivities of the causative organism identified in cultures and etiology.