Not post-partum, not postsurgical

- Strong association with smoking, and to a lesser extent, with diabetes.

 
Usual Pathogens

Anaerobes
Actinomyces spp
S. aureus

 

Mild

 

Empiric Therapy Dose Duration
Amoxicillin-clavulanate 875mg PO bid 7-10 days

Penicillin/amoxicillin allergy

Empiric Therapy Dose Duration
Cefuroxime axetil 500mg PO bid 7-10 days
+    
Metronidazole 500mg PO bid  

Cefuroxime allergy

Empiric Therapy Dose Duration
Clindamycin 300mg PO qid 7-10 days

 

Moderate-severe

Empiric Therapy Dose Duration
[Cloxacillin 2g IV q6h 7-10 days
or    
Cefazolin]  2g IV q8h 7-10 days
+    
Metronidazole IV/PO 500mg IV/PO q12h  

Penicillin and cefazolin allergy

Empiric Therapy Dose Duration
Ceftriaxone 2g IV daily 7-10 days
+    
Metronidazole IV/PO 500mg IV/PO q12h  

Ceftriaxone allergy

Empiric Therapy Dose Duration
Clindamycin IV/PO 600mg IV q8h/300mg PO qid 7-10 days