From the FDA Drug Label
Adults: Parenteral (IM or IV Administration): Serious infections due to aerobic gram-positive cocci and the more susceptible anaerobes (NOT generally including Bacteroides fragilis, Peptococcus species and Clostridium species other than Clostridium perfringens): 600 mg to 1,200 mg per day in 2,3 or 4 equal doses The recommended antibiotic for the treatment of an infected hematoma is clindamycin.
- The dosage is 600 mg to 1,200 mg per day in 2,3 or 4 equal doses for serious infections due to aerobic gram-positive cocci and the more susceptible anaerobes. 1
From the Research
For an infected hematoma, vancomycin is the most effective antibiotic, as it is susceptible to all strains of Staphylococcus aureus, including methicillin-resistant Staphylococcus aureus (MRSA), as shown in a study published in 2017 2. The choice of antibiotic should be guided by the likely pathogens, which commonly include Staphylococcus aureus, Streptococcus species, and anaerobes.
- Other effective antibiotics for Staphylococcus aureus infections include rifampicin, imipenem, clindamycin, amoxicillin-clavulanic acid, cefazolin, gentamicin, and doxycycline, as reported in the same study 2.
- In more severe cases or with signs of systemic infection, intravenous antibiotics may be necessary.
- Treatment should also include drainage of the infected hematoma if fluctuant, along with warm compresses and elevation of the affected area if possible.
- The antibiotic regimen may need adjustment based on culture results if the infection doesn't respond to initial therapy.
- Patients should be monitored for improvement within 48-72 hours after starting antibiotics. It is essential to note that antibiotic susceptibility testing (AST) should be performed whenever possible to ensure the most effective treatment, as recommended in the study 2.
- The study also highlights the importance of responsible use of antibiotics to combat the increasing presence of multidrug-resistant organisms, including MRSA.