care after abscess incision and drainage

Do not routinely use topical antibiotics on a surgical wound. Get the latest updates on news, specials and skin care information. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Note characteristics of drainage from wound (if inserted), presence of erythema. Treatment of necrotizing fasciitis involves early recognition and surgical debridement of necrotic tissue, combined with high-dose broad-spectrum intravenous antibiotics. Antibiotic therapy should be continued until features of sepsis have resolved and surgery is completed. Most community-acquired infections are caused by methicillin-resistant Staphylococcus aureus and beta-hemolytic streptococcus. Rhle A, Oehme F, Brnert K, Fourie L, Babst R, Link BC, Metzger J, Beeres FJ. Large incisions are not necessary to drain breast abscesses. Unlike other infections, antibiotics alone will not usually cure an abscess. Skin abscesses can be a significant source of morbidity and are frequently encountered by physicians across the country. An abscess is a localized collection of purulent material surrounded by inflammation and granulation in response to an infectious source. You have questions or concerns about your condition or care. Make sure to properly clean your hands with soap or even disinfectants if necessary. & Accessibility Requirements. The Best 8 Home Remedies for Cysts: Do They Work? FOIA A cruciate incision is made through the skin allowing the free drainage of pus. This, and sometimes a course of antibiotics, is really all thats involved. Severe burns and wounds that cover large areas of the body or involve the face, joints, bone, tendons, or nerves should generally be referred to wound care specialists. A warm, wet towel applied for 20 minutes several times a day is enough. You should see a doctor if the following symptoms develop: A doctor can usually diagnose a skin abscess by examining it. Discussion: A doctor will numb the area around the abscess, make a small incision, and allow the pus. Posted in Cyst Popping Tagged abscess drainage procedure., abscess drainage videos, abscess healing stages, care after abscess incision and drainage, hard lump after abscess drained, how to drain abscess at home, how to tell if abscess is healing, what to expect after abscess drainage Leave a Comment on Inflamed Abscess Drainage Post . Incision and drainage (I and D) is a procedure to drain the pus from an abscess, which aids healing. An abscess doesnt always require medical treatment. If you were prescribed antibiotics, take them as directed until they are all gone. x[[oF~0RaoEQqn8[mdKJR6~8FEisf\s8.l9z6_]6m:+o7w_]B*q|J Once the packing is removed, you should wash the area in the shower, or clean the area as directed by your healthcare provider. We avoid using tertiary references. Antibiotics may not be required to treat a simple abscess, unless the infection spreads into the skin around the wound. Author disclosure: No relevant financial affiliations. Epub 2015 Feb 20. Avoid antibiotics and wound cultures in emergency department patients with uncomplicated skin and soft tissue abscesses after successful incision and drainage and with adequate medical follow-up. The Laboratory Risk Indicator for Necrotizing Fasciitis score uses laboratory parameters to stratify patients into high- and low-risk categories for necrotizing fasciitis (Table 4); a score of 6 or higher is indicative, whereas a score of 8 or higher is strongly predictive (positive predictive value = 93.4%).19, Blood cultures are unlikely to change the management of simple localized SSTIs in otherwise healthy, immunocompetent patients, and are typically unnecessary.20 However, because of the potential for deep tissue involvement, cultures are useful in patients with severe infections or signs of systemic involvement, in older or immunocompromised patients, and in patients requiring surgery.5,21,22 Wound cultures are not indicated in most healthy patients, including those with suspected MRSA infection, but are useful in immunocompromised patients and those with significant cellulitis; lymphangitis; sepsis; recurrent, persistent, or large abscesses; or infections from human or animal bites.22,23 Tissue biopsies, which are the preferred diagnostic test for necrotizing SSTIs, are ideally taken from the advancing margin of the wound, from the depth of bite wounds, and after debridement of necrotizing infections and traumatic wounds. Search dates: May 7, 2014, through May 27, 2015. A doctor will numb the area around the abscess, make a small incision, and allow the pus inside to drain. Skin and soft tissue infections result from microbial invasion of the skin and its supporting structures. 2020 Nov;13(11):37-43. The lower extremities are most commonly involved.9 Induration is characteristic of more superficial infections such as erysipelas and cellulitis. LESS THAN. Depending on the size of the abscess, it may also be treated with an antibiotic and 'packed' to help it heal. An abscess is usually a collection of pus made up of living and dead white blood cells, fluid, bacteria, and dead tissue. Simple Wound Irrigation in the Postoperative Treatment for Surgically Drained Spontaneous Soft Tissue Abscesses: Study Protocol for a Prospective, Single-Blinded, Randomized Controlled Trial. Mupirocin (Bactroban) is preferred for wounds with suspected methicillin-resistant. In studies of clean surgical incisions, there was no high-quality evidence that one antiseptic was superior to another for preventing wound infections. Intravenous antibiotics should be continued until the clinical picture improves, the patient can tolerate oral intake, and drainage or debridement is completed. You may use acetaminophen or ibuprofen to control pain, unless another pain medicine was prescribed. Avoid antibiotics and wound cultures in emergency department patients with uncomplicated skin and soft tissue abscesses after successful incision and drainage and with adequate medical follow-up. If you have a severe bacterial infection, you may need to be admitted to a hospital for additional treatment and observation. Language assistance services are availablefree of charge. 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. Bethesda, MD 20894, Web Policies How long does it take for an abscess to heal? endobj Patient information: See related handout on wound care, written by the authors of this article. Empiric antibiotic treatment should be based on the potentially causative organism. If a gauze packing was placed inside the abscess pocket, you may be told to remove it yourself. Your provider will need to remove or replace it on your next visit. Would you like email updates of new search results? Do this once a day until packing is gone. Cats will commonly lick at their wound. 2010 May;55(5):401-7. doi: 10.1016/j.annemergmed.2009.03.014. Discover the causes and treatment of boils, and how to tell the differences from. There is no evidence that antiseptic irrigation is superior to sterile. The incision and drainage can be performed with local anesthesia. For severe infections with potential methicillin-resistant S. aureus involvement, treatment should start with linezolid (Zyvox), daptomycin (Cubicin), or vancomycin.30, Puncture Wounds. Continued drainage from the abscess will spoil the dressing and it is therefore necessary to change this at least on a daily basis or more frequently if the dressing becomes particularly soiled. If you follow your doctors advice about at-home treatment, the abscess should heal with little scarring and a lower chance of recurrence. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. This may also help reduce swelling and start the healing. Rationale: Reduces risk of spread of bacteria. Diagnostic testing should be performed early to identify the causative organism and evaluate the extent of involvement, and antibiotic therapy should be commenced to cover possible pathogens, including atypical organisms that can cause serious infections (e.g., resistant gram-negative bacteria, anaerobes, fungi).5, Specific types of SSTIs may result from identifiable exposures. 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). It can be caused by conditions that range from mild, Learn all about dark circles under your eyes. 2022 Fairview Health Services. Within a week, your doctor will remove the dressing and any inside packing to examine the wound during a follow-up appointment. V+/T >`xG; |L\rC/.)cOs[&`(&I{WVj6}\,2a Care Instructions| Hearns CW. What role do antibiotics have in the treatment of uncomplicated skin abscesses after incision and drainage? Blood cultures seldom change treatment and are not required in healthy immunocompetent patients with SSTIs. % The procedure is typically done on an outpatient basis. J Clin Aesthet Dermatol. Pus is drained out of the abscess pocket. CJEM. 02:00. The gauze dressing on the skin over the wound incision may need to be in place for a couple of days or a week for an abscess that was especially large or deep. They may make a small incision in your skin over the abscess, then insert a thin plastic tube called a drainage catheter into it. Apply Vaseline to wound. Antibiotics may be given to help prevent or fight infection. Perianal Abscess. Patients with complicated infections, including suspected necrotizing fasciitis and gangrene, require empiric polymicrobial antibiotic coverage, inpatient treatment, and surgical consultation for. Incision and Drainage of Abscess-Dr. Anvar demonstrates an incision and drainage of an abscess technique in this video. Abscess drainage. Care should be taken to avoid injecting anesthetic into the abscess cavity, as this will increase pressure (and thus pain for the patient) and is unlikely to successfully anesthetize. Always follow your healthcare professional's instructions. 98 0 obj <>stream Common simple SSTIs include cellulitis, erysipelas, impetigo, ecthyma, folliculitis, furuncles, carbuncles, abscesses, and trauma-related infections6 (Figures 1 through 3). Once the abscess has been located, the surgeon drains the pus using the needle. Available for Android and iOS devices. The recommendations apply to all adults and children with uncomplicated skin abscesses who present to the emergency department or family physician offices, including those with abscesses of all . But you may not need them to treat a simple abscess. Short description: Encntr for surgical aftcr fol surgery on the skin, subcu The 2023 edition of ICD-10-CM Z48.817 became effective on October 1, 2022. These infections require broad-spectrum antibiotics that are active against gram-positive and gram-negative organisms, including S. aureus, Streptococcus pyogenes, Pseudomonas, Acinetobacter, and Klebsiella. Leave pressure dressing on and dry for 24 hours. An abscess can be formed in the skin making it visible or in any part . endobj Suturing, if required, can be completed up to 24 hours after the trauma occurs, depending on the wound site. After I&D, instruct the patient to watch for signs of cellulitis or recollection of pus. 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. The signs are listed below. The observational studies demonstrated mixed results regarding rates of treatment cure with appropriate antibiotic selection, specifically in patients with positive wound cultures for MRSA. Do this as long as you have pain in your anal area. If everything looks good, you may be shown how to care for the wound and change the dressing and inside packing going forward. 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). Do not keep packing in place more than 3 Do not let your wound dry out. Gently pull packing strip out -1 inch and cut with scissors. Based on 2013 data from the CDC, cutaneous abscesses . This activity will focus specifically on its use in the management of cutaneous abscesses. Copyright Merative 2022 Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. For very large abscess cavities, you can use additional small incisions. Nonsuperficial mild to moderate wound infections can be treated with oral antibiotics. Hospitalization is also indicated for patients who initially present with severe or complicated infections, unstable comorbid illnesses, or signs of systemic sepsis, or who need surgical intervention under anesthesia.3,5 Broad-spectrum antibiotics with proven effectiveness against gram-positive and gram-negative organisms and anaerobes should be used until pathogen-specific sensitivities are available; coverage can then be narrowed. You may need antibiotics. $U? 0. The skin is left open and the cavity heals from inside out . 2013 Sep;48(9):1962-5. doi: 10.1016/j.jpedsurg.2013.01.027. Although patients are often instructed to keep their wounds covered and dry after suture placement, sutures can get wet within the first 24 to 48 hours without increasing the risk of infection. Wound care instructions from your doctor may include wound repacking, soaking, washing, or bandaging for about 7 to 10 days. Wound culture and antibiotics do not improve healing, but packing wounds larger than 5 cm may reduce recurrence and . Regardless of the . Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Erysipelas: usually over face, ears, or lower legs; distinctly raised inflamed skin, Signs or symptoms of infection,* lymphangitis or lymphadenitis, leukocytosis, Most SSTIs occur de novo, or follow a breach in the protective skin barrier from trauma, surgery, or increased tissue tension secondary to fluid stasis. %PDF-1.6 % 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. The operation is performed under general anaesthesia. This content is owned by the AAFP. It will stick to the packing and possibly pull it out at the next dressing change. Treatment may include debridement and wound dressings that promote granulation, tissue preservation, and moisture. Some recent evidence has suggested that routinely performed treatment modalities may not be beneficial. Tissue adhesives can be used as an alternative for closure of simple, noninfected lacerations in which the wound edges are easily approximated in areas of low tension and moisture. If this dressing becomes soaked with drainage, it will need to be changed. In general an abscess must open and drain in order for it to improve. The most common mistake made when incising an abscess is not to make the incision big enough. The RCTs failed to show decreases in treatment failure rates with antibiotics, but two studies demonstrated a short-term decrease in new lesion formation. A mini surgical incision is made through the skin. The .gov means its official. National Library of Medicine 75 0 obj <>/Filter/FlateDecode/ID[<872B7A6F2C7DA74D949F559336DF4F28>]/Index[49 50]/Info 48 0 R/Length 121/Prev 122993/Root 50 0 R/Size 99/Type/XRef/W[1 3 1]>>stream <> 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. The primary way to treat an abscess is via incision and drainage. Older age, cardiopulmonary or hepatorenal disease, diabetes mellitus, debility, immunosenescence or immunocompromise, obesity, peripheral arteriovenous or lymphatic insufficiency, and trauma are among the risk factors for SSTIs (Table 2).911 Outbreaks are more common among military personnel during overseas deployment and athletes participating in close-contact sports.12,13 Community-acquired MRSA causes infection in a wide variety of hosts, from healthy children and young adults to persons with comorbidities, health care professionals, and persons living in close quarters. Abscess incision and drainage. <>/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>> The abscess cavity is thoroughly irrigated. If drainage persists then repack the wound and have the patient return in 24 to 48 hours for a wound check. Uncomplicated purulent SSTIs in easily accessible areas without overlying cellulitis can be treated with incision and drainage only; antibiotic therapy does not improve outcomes. Laboratory testing may be required to confirm an uncertain diagnosis, evaluate for deep infections or sepsis, determine the need for inpatient care, and evaluate and treat comorbidities. This may cause the hair around the abscess to part and make the abscess more visible to you. Care for Your Open Wound, or Draining Abscess Careful attention will help your wound heal smoothly. %PDF-1.5 Older studies in animals and humans suggest that moist wounds had faster rates of re-epithelialization compared with dry wounds.911, Guidelines recommend primary closure of wounds that are clean and have no signs of infection within six to 12 hours of the injury; one study suggests that suturing can be delayed for up to 18 hours.12,13 Wounds to areas with an extensive vascular supply (e.g., head, face) may be closed up to 24 hours from the time of injury.13 Because of the high risk of infection, bite wounds are typically left open unless they are on the face and are potentially disfiguring. 2004 Feb;23(2):123-7. doi: 10.1097/01.inf.0000109288.06912.21. Antibiotics may have been prescribed if the infection is spreading around the wound. Percutaneous abscess drainage is generally used to remove infected fluid from the body, most commonly in the abdomen and pelvis. None of the studies demonstrated a difference in treatment failure rates, recurrence rates, or need for secondary interventions in non-packed wounds; however, packing groups had more pain. The recommended duration of antibiotic therapy for hospitalized patients is seven to 14 days. YL{54| Please enable it to take advantage of the complete set of features! Do I need antibiotics after abscess drainage? The abscess may be a result of recent surgery or secondary to an infection such as appendicitis. Randomized Controlled Trial of a Novel Silicone Device for the Packing of Cutaneous Abscesses in the Emergency Department: A Pilot Study. DIET: Diet as desired unless otherwise instructed. At the very least, a dressing change will be necessary anywhere from a few days to a week after the procedure. Patients may require repeated surgery until debridement and drainage are complete and healing has commenced. This causes an infection and inflammation along with pain and redness. Immunocompromised patients are more prone to SSTIs and may not demonstrate classic clinical features and laboratory findings because of their attenuated inflammatory response. Healing could take a week or two, depending on the size of the abscess. Perianal abscess requires formal incision of the abscess to allow drainage of the pus. Consensus guidelines recommend trimethoprim/sulfamethoxazole or tetracycline if methicillin-resistant S. aureus infection is suspected,30 although a Cochrane review found insufficient evidence that one antibiotic was superior for treating methicillin-resistant S. aureuscolonized nonsurgical wounds.36, Moderate wound infections in immunocompromised patients and severe wound infections usually require parenteral antibiotics, with possible transition to oral agents.30,31 The choice of agent should be based on the potentially causative organism, history, and local antibiotic resistance patterns. 1 Abscesses can form anywhere on the body. Epub 2020 Nov 1. 8600 Rockville Pike This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. 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. The abscess is left open but covered with a wound dressing to absorb any more pus that is produced initially after the procedure. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); This field is for validation purposes and should be left unchanged. For example, a perianal abscess almost exclusively general anaesthetic (GA) or spinal. Only recent manuscripts published in the English language and in the past 10 years (2004 through 2014) were included due to the emergence of methicillin-resistant Staphylococcus aureus (MRSA) as one of the leading causative organism of soft tissue infections in the past decade. Incision and drainage of the skin abscess either under local or general anaesthesia remain the gold standard of treatment [2]. Soaking a cloth compress in hot water and Epsom salt and applying it gently to an abscess a few times a day may also help dry it out. Routine cultures and antibiotics are usually unnecessary if an abscess is properly drained. You may do this in the shower. 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. Nursing Interventions. In the case of lactational breast abscesses, milk drainage is performed to resolve the infection and relieve pain. Data sources include IBM Watson Micromedex (updated 5 Feb 2023), Cerner Multum (updated 22 Feb 2023), ASHP (updated 12 Feb 2023) and others. You should also be able to answer questions about your symptoms, such as: To identify the type of infection you have, your doctor may send pus drained from the area to a lab for analysis. 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. endobj 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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