Post-operative - spinal rods
- All require surgical debridement for therapy and C&S of bone.
- Hardware should be removed if possible. If not possible, consider adding rifampin if S. aureus/MRSA.
- Hold antibiotics until cultures are obtained unless the child is unwell or no debridement is planned.
Usual Pathogens
S. aureus
Coagulase negative Staph
Group A Streptococci
Enterobacterales
P. aeruginosa
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Cefazolin (pending cultures) | 100mg/kg/d IV div q8h | 6 weeks |
| + | ||
| Gentamicin | 7mg/kg IV q24h |
Severely ill
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Piperacillin-tazobactam | 240-300mg piperacillin/kg/d IV div q6-8h | 6 weeks |
| +/- | ||
| Tobramycin | 7mg/kg IV q24h |
MRSA colonized
Add Vancomycin to above regimens
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Vancomycin | 60mg/kg/d IV div q6h |