From the Guidelines
Post-biopsy skin infections with intravenous (IV) antibiotics should be treated with agents such as vancomycin, daptomycin, linezolid, or ceftaroline.
Treatment Options
- The choice of IV antibiotic depends on the severity of the infection and the suspected causative organism, with vancomycin 15 mg/kg IV q12h 1 and daptomycin 4–6 mg/kg q24h 1 being commonly recommended options.
- Other IV antibiotics that may be used include linezolid 600 mg q12h 1, ceftaroline 600 mg q12h 1, and tigecycline 100 mg IV as a single dose, then 50 mg IV q12h 1.
- The duration of therapy is typically 7 to 14 days, but should be individualized based on the patient's clinical response 2.
Clinical Considerations
- The decision to use IV antibiotics should be based on the severity of the infection, with severe infections requiring IV therapy and mild infections being treated with oral antibiotics 1.
- Patients with systemic signs of infection, compromised immune status, or severe comorbidities may require broader-spectrum antibiotic coverage 3.
- Cultures should be obtained from patients with severe local infection or signs of systemic illness, and antibiotic therapy should be tailored based on culture results 4.
From the Research
Treatment for Post-Biopsy Skin Infection with IV Antibiotics
- The treatment for post-biopsy skin infection with intravenous (IV) antibiotics typically involves the use of antibiotics that are effective against the causative pathogens, such as Staphylococcus aureus 5, 6.
- A single-dose, long-acting IV antibiotic, such as dalbavancin, has been shown to be effective in reducing hospitalization rates and shortening inpatient length of stay for patients with acute bacterial skin and skin structure infections (ABSSSI) 5, 7.
- The use of IV antibiotics in dermatology is not common, but it is important for dermatologists to be familiar with the presenting symptoms, various stages of disease, and treatment for serious infections, such as cellulitis and methicillin-resistant Staphylococcus aureus 8.
- Early switch from IV to oral antibiotics in skin and soft tissue infections has been shown to be effective in reducing treatment duration and hospitalization days, with a proposed decision algorithm for early switch being successful in 95% of cases 9.
Key Considerations
- The choice of IV antibiotic should be based on the suspected or confirmed causative pathogen and the severity of the infection 5, 6.
- Patients with unstable comorbidities or infection complications requiring complex management may require hospitalization and multidose IV antibiotics 7.
- Early assessment of patient's clinical conditions and response to treatment is useful in facilitating patients' discharge and reducing hospitalization rates 6, 9.
Antibiotic Options
- Dalbavancin is a single-dose, long-acting IV antibiotic that has been shown to be effective in reducing hospitalization rates and shortening inpatient length of stay for patients with ABSSSI 5, 7.
- Other IV antibiotics, such as those effective against Gram-positive bacteria, including Staphylococcus aureus, may also be used to treat post-biopsy skin infections 6, 8.