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Originally Posted by ender18d
Type, dose, route, and reasoning please.
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This depends on what is on hand.
I doubt we have vancomycin available, and his hydration status keeps me from wanting to further stress his kidneys.
I would choose clindamycin (good coverage for oral bacteria, covers some strains of MRSA and also effective against malaria) - given the clinical scenaria I would give IV if possible/available. I would dose at 600mg IV q8hrs.
Prior to starting Abx can we draw a blood sample for culture (to be analyzed at the facility to which we are heading)? It's best to ID the bug so treatment can be tailored based upon sensitivities (if available).
The reason some of us want to rule out bacterial endocarditis is because transient bacteremia during/following dental work can lead to cardiac bacterial vegetations that shower off bacteria, may cause septic emboli and persistent bacteremia which would put him at risk of further end-organ infections.
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Last edited by PedOncoDoc; 12-05-2013 at 09:26.
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