The infection most likely is due to MRSA, so drugs like cephalexin and dicloxacillin
probably will not be effective.
In areas with a high prevalence of CA-MRSA, empiric treatment for SSTIs with [beta]-lactam agents such as cephalexin or dicloxacillin
may no longer be appropriate.
The comparators included ceftriaxone and cefpodoxime proxetil (cephalosporins); dicloxacillin
and oxacillin (beta-lactams); clarithromycin (a macrolide); and vancomycin (a glycopeptide).
Patients were judged to have a penicillin allergy if they responded positively to the questions, "Are you allergic to penicillin or its derivatives (for example, amoxicillin, Augmentin, ampicillin, dicloxacillin
, piperacillin, ticarcillin)?
Isolates with an interpretative AST result of "R" (resistant) to oxacillin or one of its equivalents (cloxacillin, dicloxacillin
, and flucloxacillin) were defined as MRSA.
Intravenous antibiotics were continued for two months, followed by oral dicloxacillin
for two months.
For moderate cases of purulent infection with some systemic involvement, incision and drainage should be followed by culture and sensitivity testing, the guidelines say, listing two antibiotics, trimethoprim-sulfamethoxazole and doxycycline, as appropriate for empiric treatment, while trimethoprim-sulfamethoxazole is recommended if the pathogen is found to be methicillin-resistant Staphylococcus aureus (MRSA) and dicloxacillin
or cephalexin if it is methicillin-susceptible S.
The earlier case-patient was successfully treated with flucloxacillin and doxycycline, followed by dicloxacillin
and doxycycline (5).
The first case was in a premature (1,180 g at birth) quadruplet born to an Algerian mother who developed mastitis the day after delivery and was treated with dicloxacillin
Nafcillin is changed to dicloxacillin
500 mg orally every hours when the patient is tolerating liquids by mouth.
We have tried several antibiotics like dicloxacillin
, angmentin, ciproffaxacin, cyclosporin, etc.
Broncho-alveolar lavage (BAL) fluid demonstrated gram-positive cocci in tetrads, and intravenous vancomycin and dicloxacillin
were added to therapy.