Results: Apply ice several times a day for 10 to 20 minutes at a time. If the abscess was packed (with a cotton wick), leave it in until instructed by your clinician to remove the packing or return for re-evaluation. Most severe infections, and moderate infections in high-risk patients, require initial parenteral antibiotics.30,31 Cultures should be obtained for wounds that do not respond to empiric therapy, and in immunocompromised patients.30. If everything looks good, you may be shown how to care for the wound and change the dressing and inside packing going forward. The search included systematic reviews, meta-analyses, reviews of clinical trials and other primary sources, and evidence-based guidelines. Cats will commonly lick at their wound. Available for Android and iOS devices. Patient information: See related handout on wound care, written by the authors of this article. Cover the wound with a clean dry dressing. Home . Human bite wounds may include streptococci, S. aureus, and Eikenella corrodens, in addition to many anaerobes.30 For mild to moderate infections, a five- to 10-day course of oral amoxicillin/clavulanate (Augmentin) is preferred. Dressings protect the wound by acting as a barrier to infection and absorbing wound fluid. Make the incision. Within a week, your doctor will remove the dressing and any inside packing to examine the wound during a follow-up appointment. It happens when bacteria get trapped under the skin and start to grow. 2021 Jul 27;13:335-341. doi: 10.2147/OAEM.S317713. Lack of purulent drainage or inflammation, Cellulitis extending less than 2 cm from the wound and at least two of the following: erythema, induration, pain, purulence, tenderness, or warmth; limited to skin or superficial tissues; no evidence of systemic illness, Abscess without surrounding cellulitis: incision and drainage, destruction of loculations, dry dressing, Superficial infections (e.g., impetigo, abrasions, lacerations): topical mupirocin (Bactroban); bacitracin and neomycin less effective, Deeper infections: oral penicillin, first-generation cephalosporin, macrolide, or clindamycin, Topical mupirocin, oral trimethoprim/sulfamethoxazole, or oral tetracycline for MRSA, At least one of the following: cellulitis extending 2 cm or more from wound; deep tissue abscess; gangrene; involvement of fascia; lymphangitis; evidence of muscle, tendon, joint, or bone involvement, Cellulitis: five-day course of penicillinase-resistant penicillin or first-generation cephalosporin; clindamycin or erythromycin for patients allergic to penicillin, Bite wounds: five- to 10-day course of amoxicillin/clavulanate (Augmentin); doxycycline or trimethoprim/sulfamethoxazole, or fluoroquinolone plus clindamycin for patients allergic to penicillin, Trimethoprim/sulfamethoxazole for MRSA; patients who are immunocompromised or at risk of noncompliance may require parenteral antibiotics, Acidosis, fever, hyperglycemia, hypotension, leukocytosis, mental status changes, tachycardia, vomiting, In most cases, hospitalization and initial treatment with parenteral antibiotics, Cellulitis: penicillinase-resistant penicillin, first-generation cephalosporin, clindamycin, or vancomycin, Bite wounds: ampicillin/sulbactam (Unasyn), ertapenem (Invanz), or doxycycline, Linezolid (Zyvox), daptomycin (Cubicin), or vancomycin for cellulitis with MRSA; ampicillin/sulbactam or cefoxitin for clenched-fist bite wounds, Progressive infection despite empiric therapy, Spreading of infection, new symptoms (e.g., fever, metabolic instability), Treatment should be guided by results of Gram staining and cultures, along with drug sensitivities, Vancomycin, linezolid, or daptomycin for MRSA; consider switching to oral trimethoprim/sulfamethoxazole if wound improves, Treatment for an infected wound should begin with cleansing the area with sterile saline. Healthy tissue will grow from the bottom and sides of the opening until it seals over. Many boils contain staph bacteria which can, A purpuric rash is made up of small, discolored spots under your skin from leaking blood vessels. After I&D, instruct the patient to watch for signs of cellulitis or recollection of pus. Percutaneous abscess drainage is generally used to remove infected fluid from the body, most commonly in the abdomen and pelvis. Perianal Abscess. Once the packing is removed, you should wash the area in the shower, or clean the area as directed by your healthcare provider. Skin abscesses can be a significant source of morbidity and are frequently encountered by physicians across the country. Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. Carefully throw away the packing to prevent spreading any infection. If you were prescribed antibiotics, take them as directed until they are all gone. You may also be advised to gently clean the area with soap and warm water before putting on new dressing. You may be able to help a small abscess start to drain by applying a hot, moist compress to the affected area. Along with the causes of dark, Split nails are often caused by an injury such as a stubbed toe or receiving a severe blow to a finger or thumb. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Stopping your antibiotics too early may increase your risk of having the infection return. Six studies investigated the post-procedural use of antibiotics. 33O(d9r"nf8bh =-*k6M&4B 3J=yD)S'|}Zy#O 5\TCwE#!,k4Uy>vkcb/NB/] %H837 q'_/e2rM4^zU7z5V^(5*|mfR7`fz6B Do not let your wound dry out. Wounds on the head and face may be closed up to 24 hours from the time of injury. Tap water produces similar outcomes to sterile saline irrigation of minor wounds. This search included meta-analyses, randomized controlled trials, clinical trials, and reviews limited to English-language articles about human participants. Copyright 2023 American Academy of Family Physicians. Tips and Tricks When doing a field block, after the first injection always reinsert the needle through anesthetized skin to minimize the number of painful pricks. However, you should check with your doctor or a nurse about home care. Debridement can be performed using surgical techniques or topical agents that lead to enzymatic breakdown or autolysis of necrotic tissue. Superficial mild infections can be treated with topical agents, whereas mild and moderate infections involving deeper tissues should be treated with oral antibiotics. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. If the abscess pocket was large, your provider may have put in gauze packing. Learn the Signs, Overview of Purpuric Rash, a Symptom of Some Conditions, Debra Sullivan, Ph.D., MSN, R.N., CNE, COI, How to Get Rid of Dark Circles Permanently. Search dates: February 1, 2014 to September 19, 2014. Inpatient treatment is recommended for patients with uncontrolled SSTIs despite adequate oral antibiotic therapy; those who cannot tolerate oral antibiotics; those who require surgery; those with initial severe or complicated SSTIs; and those with underlying unstable comorbid illnesses or signs of systemic sepsis. The care after abscess I & D, as well as recovery time, will depend on the infection's severity and where it occurred. Your doctor may send a sample of the pus to a lab for a culture to determine the cause of the bacterial infection. An abscess can be formed in the skin making it visible or in any part . For example, a perianal abscess almost exclusively general anaesthetic (GA) or spinal. For example: an abscess of the eyelid should be billed with procedure code 67700 (Blepharotomy, drainage of abscess, eyelid); a perirectal abscess should be billed with procedure code 46040 (Incision and drainage of ischiorectal and/or perirectal abscess . Sterile aspiration of infected tissue is another recommended sampling method, preferably before commencing antibiotic therapy.22, Imaging studies are not indicated for simple SSTIs, and surgery should not be delayed for imaging. Replace Polysporin antibiotic and dressing over wound daily for 1-2 weeks, or until wound is well healed. Incision and drainage (I&D) is a widely used procedure in various care settings, including emergency departments and outpatient clinics. Common simple SSTIs include cellulitis, erysipelas, impetigo, ecthyma, folliculitis, furuncles, carbuncles, abscesses, and trauma-related infections6 (Figures 1 through 3). hb````0e```b Your healthcare provider has drained the pus from your abscess. endobj The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). %PDF-1.6 % The American Burn Association has created criteria to help determine when referral is recommended (available at https://www.aafp.org/afp/2012/0101/p25.html#afp20120101p25-t4).29. Care An abscess incision and drainage (I and D) is a procedure to drain pus from an abscess and clean it out so it can heal. Abscess incision and drainage. Your doctor makes an incision through the numbed skin over the abscess. Because wounds can quickly become infected, the most important aspect of treating a minor wound is irrigation and cleaning. Nursing Interventions. Incision and drainage are required for definitive treatment; antibiotics alone are not sufficient. Due to limited studies and conflicting data, we are unable to make a recommendation in support or opposition of adjunctive post-procedural packing and antibiotics in an immunocompromised patient. LESS THAN. (2018). Occlusion of the wound is key to preventing contamination. I prefer to use a #15 blade scalpel rather than the traditional #11 bladebut either will work. If there is still drainage, you may put gauze over non-stick pad. It happens when one of your anal glands gets clogged and infected. This usually depends on the size and severity of the abscess. The wound may drain for the first 2 days. You can pull the dirty gauze out, and gently tuck a fresh strip of ribbon gauze (use one-quarter inch width ribbon gauze for most abscesses, which you can buy at a drugstore) inside the wound. Straight or jagged skin tear; caused by blunt trauma (e.g., fall, collision), Little to profuse bleeding; ragged edges may not readily align, Sutures, stapling, tissue adhesive, bandage, or skin closure tape, Scraped skin caused by friction against a rough surface, Minimal bleeding; first- (epidermis only), second- (to dermis), or third-degree (to subcutaneous skin) injury, Skin irrigation and removal of foreign bodies, topical antibiotic, occlusive dressing; third-degree injuries may require topical and oral antibiotics and consultation with plastic surgeon for skin grafting, Broken skin caused by penetration of sharp object, Typically more bleeding internally than externally, causing skin discoloration, High-pressure irrigation and removal of foreign bodies, tetanus prophylaxis with possible antibiotics; human bites to the hand require prophylactic antibiotics; plantar puncture wounds are susceptible to pseudomonal infection, Dynamic injury, may progress two to three days after initial injury, Depends on degree and size; in general, first-degree burns do not require therapy (topical nonsteroidal anti-inflammatory drugs and aloe vera can be helpful); deep second- and third-degree burns require topical antimicrobials and referral to burn subspecialist, Poorly controlled diabetes mellitus or peripheral vascular disease; immunocompromised, Severe or circumferential burns, or burns to the face or appendages, Wounds affecting joints, bones, tendons, or nerves. 7V`}QPX`CGo1,Xf&P[+_l H If drainage persists then repack the wound and have the patient return in 24 to 48 hours for a wound check. It offers faster recovery than open surgical drainage. Blockage of nipple ducts because of scarring can also cause breast abscesses. The skin is left open and the cavity heals from inside out . Lee MC, Rios AM, Aten MF, Mejias A, Cavuoti D, McCracken GH Jr, Hardy RD. Curr Opin Pediatr. With local anesthesia, you'll stay awake but the area will be numb. Fournier gangrene (necrotizing fasciitis) is a surgical emergency and requires prompt hemodynamic resuscitation, broad spectrum antibiotics, and . Antibiotics: Take your antibiotics as prescribed until they are gone , even if your swelling has gone down. Patients may prefer irrigation with warm fluids. An incision and drainage procedure as the name implies involves making an incision into the body and draining fluid from the body. The area around your abscess has red streaks or is warm and painful. Preauricular abscess drainage without Incision: No Incision-Dr D K Gupta. Search dates: May 7, 2014, through May 27, 2015. The pus is then drained via a small incision. Your healthcare provider can drain a perineal abscess. You may need to return in 1 to 3 days to have the gauze in your wound removed and your wound examined. Boils themselves are not contagious, however the infected contents of a boil can be extremely contagious. Dog and cat bites in an immunocompromised host and those that involve the face or hand, periosteum, or joint capsule are typically treated with a beta-lactam antibiotic or beta-lactamase inhibitor (e.g., amoxicillin/clavulanate [Augmentin]).5 In patients allergic to penicillin, a combination of trimethoprim/sulfamethoxazole or a quinolone with clindamycin or metronidazole (Flagyl) can be used. What role do antibiotics have in the treatment of uncomplicated skin abscesses after incision and drainage? Although patients are often instructed to keep their wounds covered and dry after suturing, they can get wet within the first 24 to 48 hours without increasing the risk of infection. MRSA infection. The operation is performed under general anaesthesia. Incision and drainage are the standard of care for breast abscesses. Empiric antibiotic treatment should be based on the potentially causative organism. Care for Your Open Wound, or Draining Abscess Careful attention will help your wound heal smoothly. Epub 2020 Aug 1. Milder abscesses may drain on their own or with a variety of home remedies. Gently pull packing strip out -1 inch and cut with scissors. Superficial mild wound infections can be treated with topical agents, whereas deeper mild and moderate infections should be treated with oral antibiotics. You may also see pus draining from the site. The above information is an educational aid only. This field is for validation purposes and should be left unchanged. Noninfected wounds caused by clean objects may undergo primary closure up to 18 hours from the time of injury. Infections can be classified as simple (uncomplicated) or complicated (necrotizing or nonnecrotizing), or as suppurative or nonsuppurative. There is no evidence that antiseptic irrigation is superior to sterile saline or tap water. The primary way to treat an abscess is via incision and drainage. and transmitted securely. Epub 2009 May 5. Readily drained abscesses do not benefit from antibiotics after incision, and the surrounding cellulitis of the abscess will be cured with incision and drainage alone. A consultation with one of our skin care experts is the best way to determine which of these treatments will help brighten your skin and get rid of acne for a long time. Skin and soft tissue infections result from microbial invasion of the skin and its supporting structures. You have increased redness, swelling, or pain in your wound. Change the dressing if it becomes soaked with blood or pus. <>>> This article reviews common questions associated with wound healing and outpatient management of minor wounds (Table 1). At first glance, coding incision and drainage procedures looks pretty straightforward (there are just a . Gentle heat will increase blood flow, and speed healing. Home| Management and outcome of children with skin and soft tissue abscesses caused by community-acquired methicillin-resistant Staphylococcus aureus. Copyright 2015 by the American Academy of Family Physicians. Your provider will need to remove or replace it on your next visit. What Post-Operative Care is needed at Home after the Bartholin's Gland Abscess Drainage surgical procedure? Continue to do this until the skin opening has closed. They result when oil-producing or sweat glands are obstructed, and bacteria are trapped. sharing sensitive information, make sure youre on a federal We avoid using tertiary references. Immunocompromised patients are more prone to SSTIs and may not demonstrate classic clinical features and laboratory findings because of their attenuated inflammatory response. YL{54| <>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 28 0 R 31 0 R] /MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> A deeper or larger abscess may require a gauze wick to be placed inside to help keep the abscess open. endobj 2015 Jul;17(4):420-32. doi: 10.1017/cem.2014.52. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. Predisposing factors for SSTIs include reduced tissue vascularity and oxygenation, increased peripheral fluid stasis and risk of skin trauma, and decreased ability to combat infections. The wound will take about 1 to 2 weeks to heal depending on the size of the cyst. Incision and drainage of cutaneous abscess with or without cavity packing: a systematic review, meta-analysis, and trial sequential analysis of randomised controlled trials. An abscess is a painful infection that can drive many people to the emergency room. Federal government websites often end in .gov or .mil. 13120 Biscayne Blvd., North Miami 305-585-9210 Schedule an Appointment. Less commonly, percutaneous abscess drainage may be used . The drainage should decrease as the wound heals over time. J Clin Aesthet Dermatol. Care after abscess drainage The physician will advise you on how to take care of the wound after abscess drainage. "RLn/WL/qn["C)X3?"gp4&RO May 7, 2013 #1 . Treatment may include debridement and wound dressings that promote granulation, tissue preservation, and moisture. Always follow your healthcare professional's instructions. Treatment of necrotizing fasciitis involves early recognition and surgical consultation for debridement of necrotic tissue combined with empiric high-dose intravenous broad-spectrum antibiotics.5 The antibiotic spectrum can be narrowed once the infecting microbes are identified and susceptibility testing results are available. For the first few days after the procedure, you may want to apply a warm, dry compress (or heating pad set to low) over the wound three or four times per day. A skin abscess, sometimes referred to as a boil, can form just about anywhere on the body. 18910 South Dixie Hwy., Cutler Bay 305-585-9230 Schedule an Appointment. Incision and drainage after care? Patients with necrotizing fasciitis may have pain disproportionate to the physical findings, rapid progression of infection, cutaneous anesthesia, hemorrhage or bullous changes, and crepitus indicating gas in the soft tissues.5 Tense overlying edema and bullae, when present, help distinguish necrotizing fasciitis from non-necrotizing infections.18, The diagnosis of SSTIs is predominantly clinical. Doral Urgent Care. A small abscess with little pain, swelling, or other symptoms can be watched for a few days and treated with a warm compress to see if it recedes. DISCHARGE INSTRUCTIONS: Contact your healthcare provider if: The area around your abscess has red streaks or is warm and painful. This may cause the hair around the abscess to part and make the abscess more visible to you. Make an incision directly over the center of the cutaneous abscess; the incision should be oriented along the long axis of the fluid collection. Initial antimicrobial choice is empiric, and in simple infections should cover Staphylococcus and Streptococcus species. 2010 May;55(5):401-7. doi: 10.1016/j.annemergmed.2009.03.014. This may also help reduce swelling and start the healing. Because wounds can quickly become infected, the most important aspect of treating a minor wound is irrigation and cleaning. However, there are several reasons for hospitalization or referral (Table 3).2830,36,38,39, Patients with severe wound infections may require treatment with intravenous antibiotics, with possible referral for exploration, incision, drainage, imaging, or plastic surgery.38,39, Necrotizing fasciitis is a rare but life-threatening infection that may result from traumatic or surgical wounds. The https:// ensures that you are connecting to the Please see our Nondiscrimination 2022 Fairview Health Services. Complicated infections extending into and involving the underlying deep tissues include deep abscesses, decubitus ulcers, necrotizing fasciitis, Fournier gangrene, and infections from human or animal bites7 (Figure 4). Sometimes draining occurs on its own, but generally it must be opened with the help of a warm compress or by a doctor in a procedure called incision and drainage (I&D). Continue wound care after packing is out until wound is healed. Care Instructions| The most obvious symptom of an abscess is a painful, compressible area of skin that may look like a large pimple or even an open sore. Post-Operative Instructions after Incision And Drainage of a Dental Infection (Abscess) - 2 - What medications do I need to take? Prior to making an incision, your doctor will clean and sterilize the affected area. Incision and drainage (I&D) remains the standard of care; however, significant variability exists in the treatment of abscesses after I&D. Some recent evidence has suggested that routinely performed treatment modalities may not be beneficial. Smaller abscesses may not need to be drained to disappear. Many boils can be treated at home. Before a skin abscess drainage procedure, you may be started on a course of antibiotic therapy to help treat the infection and prevent associated infection from occurring elsewhere in the body. Service. An abscess appears like a large and deep bump or mass within or underneath the tissue of the body. A Cochrane review did not establish the superiority of any one pathogen-sensitive antibiotic over another in the treatment of MRSA SSTI.35 Intravenous antibiotics may be continued at home under close supervision after initiation in the hospital or emergency department.36 Antibiotic choices for severe infections (including MRSA SSTI) are outlined in Table 6.5,27, For polymicrobial necrotizing infections; safety of imipenem/cilastatin in children younger than 12 years is not known, Common adverse effects: anemia, constipation, diarrhea, headache, injection site pain and inflammation, nausea, vomiting, Rare adverse effects: acute coronary syndrome, angioedema, bleeding, Clostridium difficile colitis, congestive heart failure, hepatorenal failure, respiratory failure, seizures, vaginitis, Children 3 months to 12 years: 15 mg per kg IV every 12 hours, up to 1 g per day, Children: 25 mg per kg IV every 6 to 12 hours, up to 4 g per day, Children: 10 mg per kg (up to 500 mg) IV every 8 hours; increase to 20 mg per kg (up to 1 g) IV every 8 hours for Pseudomonas infections, Used with metronidazole (Flagyl) or clindamycin for initial treatment of polymicrobial necrotizing infections, Common adverse effects: diarrhea, pain and thrombophlebitis at injection site, vomiting, Rare adverse effects: agranulocytosis, arrhythmias, erythema multiforme, Adults: 600 mg IV every 12 hours for 5 to 14 days, Dose adjustment required in patients with renal impairment, Rare adverse effects: abdominal pain, arrhythmias, C. difficile colitis, diarrhea, dizziness, fever, hepatitis, rash, renal insufficiency, seizures, thrombophlebitis, urticaria, vomiting, Children: 50 to 75 mg per kg IV or IM once per day or divided every 12 hours, up to 2 g per day, Useful in waterborne infections; used with doxycycline for Aeromonas hydrophila and Vibrio vulnificus infections, Common adverse effects: diarrhea, elevated platelet levels, eosinophilia, induration at injection site, Rare adverse effects: C. difficile colitis, erythema multiforme, hemolytic anemia, hyperbilirubinemia in newborns, pulmonary injury, renal failure, Adults: 1,000 mg IV initial dose, followed by 500 mg IV 1 week later, Common adverse effects: constipation, diarrhea, headache, nausea, Rare adverse effects: C. difficile colitis, gastrointestinal hemorrhage, hepatotoxicity, infusion reaction, Adults and children 12 years and older: 7.5 mg per kg IV every 12 hours, For complicated MSSA and MRSA infections, especially in neutropenic patients and vancomycin-resistant infections, Common adverse effects: arthralgia, diarrhea, edema, hyperbilirubinemia, inflammation at injection site, myalgia, nausea, pain, rash, vomiting, Rare adverse effects: arrhythmias, cerebrovascular events, encephalopathy, hemolytic anemia, hepatitis, myocardial infarction, pancytopenia, syncope, Adults: 4 mg per kg IV per day for 7 to 14 days, Common adverse effects: diarrhea, throat pain, vomiting, Rare adverse effects: gram-negative infections, pulmonary eosinophilia, renal failure, rhabdomyolysis, Children 8 years and older and less than 45 kg (100 lb): 4 mg per kg IV per day in 2 divided doses, Children 8 years and older and 45 kg or more: 100 mg IV every 12 hours, Useful in waterborne infections; used with ciprofloxacin (Cipro), ceftriaxone, or cefotaxime in A. hydrophila and V. vulnificus infections, Common adverse effects: diarrhea, photosensitivity, Rare adverse effects: C. difficile colitis, erythema multiforme, liver toxicity, pseudotumor cerebri, Adults: 600 mg IV or orally every 12 hours for 7 to 14 days, Children 12 years and older: 600 mg IV or orally every 12 hours for 10 to 14 days, Children younger than 12 years: 10 mg per kg IV or orally every 8 hours for 10 to 14 days, Common adverse effects: diarrhea, headache, nausea, vomiting, Rare adverse effects: C. difficile colitis, hepatic injury, lactic acidosis, myelosuppression, optic neuritis, peripheral neuropathy, seizures, Children: 10 to 13 mg per kg IV every 8 hours, Used with cefotaxime for initial treatment of polymicrobial necrotizing infections, Common adverse effects: abdominal pain, altered taste, diarrhea, dizziness, headache, nausea, vaginitis, Rare adverse effects: aseptic meningitis, encephalopathy, hemolyticuremic syndrome, leukopenia, optic neuropathy, ototoxicity, peripheral neuropathy, Stevens-Johnson syndrome, For MSSA, MRSA, and Enterococcus faecalis infections, Common adverse effects: headache, nausea, vomiting, Rare adverse effects: C. difficile colitis, clotting abnormalities, hypersensitivity, infusion complications (thrombophlebitis), osteomyelitis, Children: 25 mg per kg IM 2 times per day, For necrotizing fasciitis caused by sensitive staphylococci, Rare adverse effects: anaphylaxis, bone marrow suppression, hypokalemia, interstitial nephritis, pseudomembranous enterocolitis, Adults: 2 to 4 million units penicillin IV every 6 hours plus 600 to 900 mg clindamycin IV every 8 hours, Children: 60,000 to 100,000 units penicillin per kg IV every 6 hours plus 10 to 13 mg clindamycin per kg IV per day in 3 divided doses, For MRSA infections in children: 40 mg per kg IV per day in 3 or 4 divided doses, Combined therapy for necrotizing fasciitis caused by streptococci; either drug is effective in clostridial infections, Adverse effects from penicillin are rare in nonallergic patients, Common adverse effects of clindamycin: abdominal pain, diarrhea, nausea, rash, Rare adverse effects of clindamycin: agranulocytosis, elevated liver enzyme levels, erythema multiforme, jaundice, pseudomembranous enterocolitis, Children: 60 to 75 mg per kg (piperacillin component) IV every 6 hours, First-line antimicrobial for treating polymicrobial necrotizing infections, Common adverse effects: constipation, diarrhea, fever, headache, insomnia, nausea, pruritus, vomiting, Rare adverse effects: agranulocytosis, C. difficile colitis, encephalopathy, hepatorenal failure, Stevens-Johnson syndrome, Adults: 10 mg per kg IV per day for 7 to 14 days, For MSSA and MRSA infections; women of childbearing age should use 2 forms of birth control during treatment, Common adverse effects: altered taste, nausea, vomiting, Rare adverse effects: hypersensitivity, prolonged QT interval, renal insufficiency, Adults: 100 mg IV followed by 50 mg IV every 12 hours for 5 to 14 days, For MRSA infections; increases mortality risk; considered medication of last resort, Common adverse effects: abdominal pain, diarrhea, nausea, vomiting, Rare adverse effects: anaphylaxis, C. difficile colitis, liver dysfunction, pancreatitis, pseudotumor cerebri, septic shock, Parenteral drug of choice for MRSA infections in patients allergic to penicillin; 7- to 14-day course for skin and soft tissue infections; 6-week course for bacteremia; maintain trough levels at 10 to 20 mg per L, Rare adverse effects: agranulocytosis, anaphylaxis, C. difficile colitis, hypotension, nephrotoxicity, ototoxicity.
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