1 tablet (160 mg TMP/800 mg SMX) PO bid
Base dose on TMP:
8-12 mg TMP
(& 40-60 mg SMX)
in 2 doses; not to exceed adult dose
|minocycline or doxycycline**
||100 mg PO bid
for pediatric use –
suggest consultation with infectious
disease specialist before use
||300-450 mg PO qid
||10-20 mg/kg/day in
3-4 doses; not to exceed adult dose
**Tetracycline - minocycline and
doxycycline have greater antistaphylococcal activity than other oral
tetracyclines and have been effective clinically. Minocycline may cause
vestibular disturbances with vertigo, nausea and vomiting.
NOTE: If Group A streptococcal infection is suspected, oral therapy
should include an agent active against this organism (ß-lactam, macrolide, clindamycin). Tetracyclines and trimethoprim-sulfamethoxazole, although
active against many MRSA, are not recommended treatments for suspected
NOTE: Outpatient use of quinolones or macrolides. Fluoroquinolones (e.g.,ciprofloxicin, levofloxacin, moxifloxacin, gatifloxacin ) and macrolides
(e.g., erythromycin, clarithromycin, azithromycin) are NOT recommended for treatment of MRSA because of high resistance rates. If fluoroquinolones are being considered, consult with infectious disease specialist before use.
NOTE: Outpatient use of Linezolid in SSTI. Linezolid is costly and has
great potential for inappropriate use, inducing antimicrobial resistance, and toxicity. Although it is 100% bioavailable and effective in SSTI, it is not recommended for empiric treatment or routine use because of these
concerns. It is strongly recommended that linezolid only be used after consultation with an infectious disease specialist to determine if alternative antimicrobials would be more appropriate.
*Isolates resistant to erythromycin and sensitive to clindamycin
should be evaluated for inducible clindamycin resistance (MLSB phenotype) using the “D test.” Consult with your reference laboratory
to determine if “D testing” is routine or must be specifically requested.
If inducible resistance is present, an alternative agent to clindamycin
should be considered.
MRSA Susceptibilities at HMC
Click on image to enlarge