IV Abx

Appendix A. Glossary

Term	Description
Abcess	Cutaneous abcesses are collections of pus that are characterized by swelling and redness around a pustule. Most are caused by multiple organisms.
Carbuncle	Large staphylococcal infection containing subcutaneous pus pockets usually found on the buttocks or back of the neck
Cellulitis	Acute skin and subcutaneous infection with redness and inflammation, heat, swelling, and pain; most common in the lower extremities; differentiated from erysipelas by the deeper infection affecting the deeper dermis and subcutaneous fat and not generally as clearly demarcated as erysipelas.
Complicated skin and soft tissue infections (CSSTI)	Complicated skin and soft tissue infections that have spread to deeper soft tissues and may require intravenous antibiotic or surgical treatments or the patient has a concomitant disease such as diabetes or immune deficiency that slows or complicates the healing process.
Ecthyma	Skin eruptions caused by streptococcal infection in an area of minor trauma
Erysipelas	Streptococcal infectious skin disease characterized by redness, swelling, bullae, fever, and pain affecting the upper dermis. Lesions are usually raised with clear demarcation of involved tissues, usually on the face or lower extremities. Staphylococcus aureus is sometimes involved as well.
Folliculitis	Superficial or deep inflammation that can be related to an infection (usually staphylococcus, streptococcus, or fungus) or to occlusion.
Furuncle	A hair follicle infection, also called a boil, characterized by swelling, pain, and redness caused by bacterial infection and may include tissue necrosis in the deep center.
Gangrene	Necrotic tissue from an interruption in blood supply that is sometimes related to bacterial infection; dry gangrene is related to diabetes mellitus atherosclerosis and is characterized by drying, shriveling, and turning black; wet gangrene is often related to blood supply loss due to injury or other restriction in flow and is characterized by rapid spread and strong odor
Impetigo	Streptococcal, Staphylococcal, or combined infection of the skin characterized by redness, inflammation, and possible progression to skin eruptions and erosions. Bullous impetigo is less common, usually related to Staphylococcus aureus and is characterized by blisters.
Myositis	Includes anaerobic streptococcal myositis, pyomyositis, cynergistic necrotizing cellulitis, Fournier gangrene, and clostridial myonecrosis. Treatment is according to pathogen and susceptibility and may include penicillin or ampicillin in high doses for anaerobic streptococcal myositis, penicillin plus clindamycin in clostridial myonecrosis.
Necrotizing fasciitis	Rare subcutaneous infections characterized by swelling, redness, and especially hardness and inflexibility of cutaneous tissues, but 20% may have no visible appearance on the skin. Mostly seen in patients with an underlying risk factor (atherosclerosis, diabetes, venous insufficiency) and often associated with abdominal surgical procedures, decubitus ulcers, and abscesses.
Neutropenia	Low neutrophil counts that result in immune dysfunction; normal level is >1200/mL in blacks and >1500/mL in whites; mild neutropenia is 1000-1500/mL; moderate neutropenia is 500-1000/mL; severe neutropenia is <500/mL.
Osteomyelitis	Local or general infection of bone and/or bone marrow, usually involving staphylococcal transfer from a nearby infection; this can be particularly persistent with exacerbations and remissions of infection over a period of years
Outpatient parenteral antimicrobial therapy (OPAT)	Refers to antimicrobial therapies (including antiviral, antifungal, and antibacterial medications) provided intravenously in non-hospital settings, such as home care.
Paronychia	Infection of the skin at the finger or toenail margin
Skin and soft tissue infections (SSTI)	Infections of non-skeletal tissues that range from superficial skin infections to complicated and deeper soft tissue infections. Superficial skin infections are usually treated with topical or oral antibiotics.

Appendix B. Resources

Association for the Advancement of Wound Care (AAWC). Summary algorithm for venous ulcer care with annotations of available evidence. Available at: http://www.aawcone.org/pdf/Summary%20Algorithm%20for%20Venous%20Ulcer%20Care%20with%20Annotations%20of%20Available%20Evidence.pdf.

Benson CA, Kaplan JE, Masur H, Pau A, Holmes KK. Treating opportunistic infections among HIV-exposed and infected adults and adolescents : recommendations from CDC, the National Institutes of Health, and the Infectious Diseases Society of America. MMWR Recomm Rep 2004;53(RR-15):1-118. Available at: http://www.cdc.gov/mmwr/PDF/rr/rr5315.pdf. Note: since this guideline was released there have been several regulatory notices for labeling and recommended use changes in some of the drugs listed. In addition, new drugs have been introduced. For more information on these notices, see: http://www.guideline.gov/summary/summary.aspx?ss=15&doc_id=6223&nbr=&string=.

Lipsky BA, Berendt AR, Gunner Deery H, Embil JM, Joseph WS, Karchmer AW, LeFrock JL, Lew DP, Mader JT, Norden C, Tan JS. Diagnosis and treatment of diabetic foot infections. Clin Infect Dis. 2004;39:885-910. Available at: http://www.journals.uchicago.edu/CID/journal/issues/v39n7/34365/34365.web.pdf?erFrom=-638807370791816397Guest.

O’Grady NP, Alexander M, Dellinger EP, Gerberding JL, Heard SO, Maki DG, Masur H, McCormick RD, Mermel LA, Pearson ML, Raad II, Randolph A, Weinstein RA. Guidelines for the prevention of intravascular catheter-related infections. MMWR Recomm Rep 2002;51(RR-10):1-29. Available at: http://www.cdc.gov/mmwr/PDF/rr/rr5110.pdf. [erratum to correct the summary table in MMWR Weekly 2002;51(32):711. Available at: http://www.cdc.gov/mmwr/PDF/wk/mm5132.pdf - see page 711]

Silberzweig JE, Sacks D, Khorsandi AS, Bakal CW, Society of Interventional Radiology Technology Assessment Committee. Reporting Standards for Central Venous Access Devices. J Vasc Interv Radiol. 2003;14:S443-S452. Available at: http://www.sirweb.org/clinical/cpg/S443.pdf.

Stevens DL, Bisno AL, Chambers HF, Everet ED, Dellinger P, Goldstein EJC, Gorbach SL, Hirschmann JV, Kaplan EL, Montoya JG, Wade JC. Practice guidelines for the diagnosis and management of skin and soft-tissue infections. Clin Infect Dis. 2005;41:1373-1406. Available at: http://www.journals.uchicago.edu/CID/journal/issues/v41n10/37519/37519.web.pdf.