Table 4 Suggested potential antibiotics therapeutic regimens depending on pathogens organisms, clinical conditions, predisposing factors, and antimicrobial choices

Gram-positive organisms

Group A streptococcus (S. pyogenes)

Erysipelas

Minor skin trauma or skin break

penicillins or cephalosporins, or alternative therapy: clindamycin, macrolides, glycopeptidescephalosporins, semi-synthetic resistant penicillin or

Cellulitis

Minor skin trauma or break

alternative therapy: clindamycin, macrolides, glycopeptides

Necrotizing fasciitis with/without myonecrosis

Minor skin trauma or skin break, superinfection of varicella lesion, DM, non-steroid anti-inflammatory drugs

high dose penicillin G, clindamycin or alternative therapy: clindamycin

Group β streptococcus (S. agalactiae)

Necrotizing fasciitis

DM, premature neonates

high dose penicillin G, clindamycin or alternative therapy: clindamycin

Community-acquired meticillin resistant; Staphilococcus aureus (CO-MRSA)

No specific risk factors

glycopeptides or clindamycin, or alternative therapy: linezolidin, sulfomethoxazole, clindamycin

Nasocomial MRSA in health care facilities is the major risk factor

high dose penicillin G, clindamycin or alternative therapy: clindamycin, metronidazole

Clostridium spp

Gross tidy and contaminated wounds

(C. perfrigens)

Colonic contamination (C. septicum)

IV drug use (C sordellil, C nayvi)

Gram-negative organisms

Pasteurella spp

Dog bites (P canis)

Cat bites (P multocida)

amoxicillin, clavulanate piperacillin, tazobactam, III-generation cephalosporin metronidasole or alternative therapy: clindamycin, flouroquinolone, trimoxasole

Aeromonas spp (A. hydrophilia)

Freshwater exposure, medical leeches

fluoroquinolones or alternative therapy: trimoxasole, cephalsporins, aminolgycosides

Vibrio spp (V. vulnificus)

Chronic liver disease, DM

minocycline, cephalosporine or alternative therapy: ciprofloxacin

Klebsiella pneumonia

Chronic liver disease, DM

cephalosporines, amoxicillin, carbapenems, flouroquinolones, or alternative therapy: amynoglycosides

Escherichia coli

Cirrhosis

cephalosporines, amoxicillin, carbapenems, flouroquinolones, or alternative therapy: amynoglycosides

Serratia marcescens

Chronic renal failure, DM

cephalosporines, amoxicillin, piperacillin, tazobactam, carbapenems, flouroquinolones, or alternative therapy: amynoglycosides

Pseudomonas aeruginosa

Neutropenia, haematological malignancy, burns, HIV infection, injection drug use

amoxicilin, aminoglycosides, or alternative therapy: flouroquinolones