{
  "schema_version": 1,
  "kind": "condition",
  "id": "infected-wound",
  "name": "Infected wound or laceration",
  "category": "infectious",
  "sources": "Cellulitis and erysipelas - disease-level clinical article (cellulitis-clinical.txt) · Post-Exposure Tetanus Prophylaxis - disease-level clinical article (tetanus-prophylaxis-clinical.txt) · IDSA Practice Guidelines for Skin and Soft Tissue Infections 2014 · Egyptian National Drug Formulary - Antimicrobial 2023 (cefadroxil monograph) · Egyptian National Drug Formulary - Antimicrobial 2023 (amoxicillin and clavulanate monograph)",
  "review_status": "reviewed",
  "verified_against": "Cellulitis and erysipelas - disease-level clinical article (cellulitis-clinical.txt) · Egyptian National Drug Formulary - Antimicrobial 2023 · Egyptian National Drug Formulary - Antimicrobial 2023 (amoxicillin and clavulanate monograph) · Egyptian National Drug Formulary - Antimicrobial 2023 (cefadroxil monograph) · IDSA Practice Guidelines for Skin and Soft Tissue Infections 2014 · Post-Exposure Tetanus Prophylaxis - disease-level clinical article (tetanus-prophylaxis-clinical.txt)",
  "verified_date": "2026-08",
  "treatments": [
    {
      "id": 974,
      "generic": "Wound toilet, tetanus assessment & safety-netting (no drug therapy)",
      "line": 1,
      "is_adjunct": false,
      "form": null,
      "strength_mg": null,
      "adult_dose": null,
      "adult_duration": null,
      "dose_source": "Post-Exposure Tetanus Prophylaxis - disease-level clinical article (tetanus-prophylaxis-clinical.txt)",
      "rationale": "The non-drug backbone. Cleaning and debridement carry the tetanus source's own instruction that prophylaxis is given in conjunction with them, not instead of them.",
      "cautions": [
        "Classify the wound before deciding tetanus cover. The source's split is low risk (clean and minor) versus high risk (contaminated, puncture, avulsions, or resulting from missiles, crushing, burns, animal or human bites, or frostbite).",
        "Fewer than 3 prior doses or unknown: give the vaccine for a low-risk wound; for a high-risk wound give both the vaccine and human tetanus immune globulin.",
        "Three or more prior doses: vaccine only if the last dose was over 10 years ago for a low-risk wound, or over 5 years ago for a high-risk wound.",
        "Give prophylaxis as soon as possible, and still give it on delayed presentation - the incubation period is long and variable.",
        "Look for a retained foreign body and for compromised blood supply. A missed foreign body is listed as a predisposing factor for tetanus.",
        "Tetanus-prone wounds may be left open, to avoid the anaerobic conditions the organism needs."
      ],
      "peds_mgkg_low": null,
      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": "Same for children; the tetanus decision uses the same wound classification.",
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
      "peds_age_max_months": null,
      "peds_age_bands": null,
      "peds_doses": null,
      "brands": [],
      "condition_id": "infected-wound"
    },
    {
      "id": 975,
      "generic": "Cefalexin",
      "line": 1,
      "is_adjunct": false,
      "form": "oral.solid",
      "strength_mg": null,
      "adult_dose": "500 mg every 6 hours, or 1 g twice daily",
      "adult_duration": "5-7 days",
      "dose_source": "IDSA Practice Guidelines for Skin and Soft Tissue Infections 2014",
      "rationale": "First choice when the infection is non-purulent spreading redness around the wound. The dose is the one already carried by the cellulitis card, whose source states cephalexin 500 mg every 6 hours for non-purulent cellulitis with a course of at least 5 days.",
      "cautions": [
        "Covers streptococci and MSSA. It does not cover MRSA - see co-trimoxazole if the wound is purulent or there are MRSA risk factors."
      ],
      "peds_mgkg_low": 25.0,
      "peds_mgkg_high": 50.0,
      "peds_max_mg": 2000.0,
      "peds_basis": "day",
      "peds_unit": "mg",
      "peds_note": null,
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
      "peds_age_max_months": null,
      "peds_age_bands": null,
      "peds_doses": [
        {
          "weight_kg": 10,
          "low_mg": 250,
          "high_mg": 500,
          "capped": false
        },
        {
          "weight_kg": 20,
          "low_mg": 500,
          "high_mg": 1000,
          "capped": false
        },
        {
          "weight_kg": 30,
          "low_mg": 750,
          "high_mg": 1500,
          "capped": false
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        {
          "weight_kg": 40,
          "low_mg": 1000,
          "high_mg": 2000,
          "capped": false
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      ],
      "brands": [
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          "trade_name": "AMTHROST 250 MG 10 F.C. TAB.",
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          "exact_strength": true,
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        {
          "trade_name": "CEPHALEXIN 250MG 12CAPS. B.P.2000",
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          "manufacturer": "ARAB DRUG COMPANY (ADCO)",
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          "trade_name": "CEPHALEXCID 250MG 12CAPS.",
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          "manufacturer": "CID",
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          "trade_name": "OSPEXIN 1000 MG 12 TABS.",
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          "strength_mg": 1000.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "CEPOREX 1 GM 8 TABLETS",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "GLAXO SMITHKLINE",
          "price_egp": 78.0,
          "pack_count": 8,
          "unit_price": 9.75,
          "strength_mg": 1000.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "CEPOREX 250 MG/5ML SYRUP 60 ML",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "GLAXO SMITHKLINE",
          "price_egp": 23.5,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 250.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
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        },
        {
          "trade_name": "AMTHROST 125MG/5ML SUSP. 60ML",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "SIGMA > SABAA",
          "price_egp": 4.0,
          "pack_count": null,
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          "exact_strength": false,
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        },
        {
          "trade_name": "AMTHROST 250MG/5ML SUSP. 60ML",
          "scientific_name": null,
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          "manufacturer": "SIGMA > SABAA",
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          "exact_strength": false,
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          "discontinued": false,
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        }
      ],
      "condition_id": "infected-wound"
    },
    {
      "id": 976,
      "generic": "Cefadroxil",
      "line": 1,
      "is_adjunct": false,
      "form": "oral.solid",
      "strength_mg": null,
      "adult_dose": "500 mg to 1 g twice daily (every 12 hours)",
      "adult_duration": "5-7 days",
      "dose_source": "Egyptian National Drug Formulary - Antimicrobial 2023 (cefadroxil monograph)",
      "rationale": "The same first-line cephalosporin step in the form most reliably stocked in Egypt - 41 products in the national register against 43 for cefalexin. Twice-daily dosing also aids adherence.",
      "cautions": [
        "Same cephalosporin class and the same gap as cefalexin: no MRSA cover. Switch or add co-trimoxazole if the wound is purulent.",
        "Cross-reactivity means it is not the answer for a patient with a severe penicillin or cephalosporin allergy - use clindamycin."
      ],
      "peds_mgkg_low": 30.0,
      "peds_mgkg_high": 50.0,
      "peds_max_mg": 2000.0,
      "peds_basis": "day",
      "peds_unit": "mg",
      "peds_note": null,
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
      "peds_age_max_months": null,
      "peds_age_bands": null,
      "peds_doses": [
        {
          "weight_kg": 10,
          "low_mg": 300,
          "high_mg": 500,
          "capped": false
        },
        {
          "weight_kg": 20,
          "low_mg": 600,
          "high_mg": 1000,
          "capped": false
        },
        {
          "weight_kg": 30,
          "low_mg": 900,
          "high_mg": 1500,
          "capped": false
        },
        {
          "weight_kg": 40,
          "low_mg": 1200,
          "high_mg": 2000,
          "capped": false
        }
      ],
      "brands": [
        {
          "trade_name": "MEGADROXIL 500 MG 8 CAPS.",
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          "manufacturer": "SHIFA MEDICAL PRODUCTS > MASH PREMIERE",
          "price_egp": 4.5,
          "pack_count": 8,
          "unit_price": 0.56,
          "strength_mg": 500.0,
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        {
          "trade_name": "CEFADROXIL 500MG 8 CAPS.",
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        {
          "trade_name": "DURICEF 250MG 8 CAPS.",
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          "manufacturer": "SMITHKLINE BEECHAM",
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          "exact_strength": true,
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        {
          "trade_name": "BIODROXIL 500MG 8 CAPS.",
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          "trade_name": "CEFEX 1 GM 8 F.C.TABS.",
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          "trade_name": "CEFADROXIL 1 GM 6 DISPERSIBLE TAB.",
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        },
        {
          "trade_name": "DURICEF 1 GM 6 DISPERSABLE TAB.",
          "scientific_name": null,
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          "manufacturer": "SMITHKLINE BEECHAM",
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          "unit_price": null,
          "strength_mg": 1000.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
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        },
        {
          "trade_name": "LONGICEF 125MG/5ML SUSP. 60 ML",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "KAHIRA",
          "price_egp": 4.25,
          "pack_count": null,
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          "strength_mg": 125.0,
          "exact_strength": false,
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        },
        {
          "trade_name": "CEFADROXIL 250MG/5ML PD. FOR ORAL SUSP. 60ML",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "SIGMA",
          "price_egp": 7.5,
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          "exact_strength": false,
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        }
      ],
      "condition_id": "infected-wound"
    },
    {
      "id": 979,
      "generic": "Amoxicillin + Clavulanic acid",
      "line": 1,
      "is_adjunct": false,
      "form": "oral.solid",
      "strength_mg": null,
      "adult_dose": "875/125 mg twice daily",
      "adult_duration": "5-7 days",
      "dose_source": "Egyptian National Drug Formulary - Antimicrobial 2023 (amoxicillin and clavulanate monograph)",
      "rationale": "For a wound caused by an animal or human bite. The cellulitis source names Pasteurella multocida after a dog or cat bite, which the cephalosporins above do not reliably cover. The dose is the Egyptian formulary's standard adult dose for this drug; applying it to bite wounds is an extrapolation from the monograph, not a bite-specific guideline recommendation.",
      "cautions": [
        "A bite also raises rabies - see Post-Exposure Rabies Prophylaxis (Animal Bite).",
        "Bite wounds are high-risk for tetanus under the classification above."
      ],
      "peds_mgkg_low": 25.0,
      "peds_mgkg_high": 45.0,
      "peds_max_mg": 1750.0,
      "peds_basis": "day",
      "peds_unit": "mg",
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      "peds_doses": [
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          "weight_kg": 10,
          "low_mg": 250,
          "high_mg": 450,
          "capped": false
        },
        {
          "weight_kg": 20,
          "low_mg": 500,
          "high_mg": 900,
          "capped": false
        },
        {
          "weight_kg": 30,
          "low_mg": 750,
          "high_mg": 1350,
          "capped": false
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        {
          "weight_kg": 40,
          "low_mg": 1000,
          "high_mg": 1750,
          "capped": true
        }
      ],
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          "trade_name": "E-MOXCLAV 1G 10 F.C. TAB.",
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          "manufacturer": "EIPICO",
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          "trade_name": "AUJED 625 MG 12 F.C. TAB.",
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          "trade_name": "CLAVOCILLIN 1 GM 10 DISPERSIBLE TABS.",
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        {
          "trade_name": "AUGMENTIN ADULTS 1GM/125MG 12 PWD. ORAL SUSP. SACHETS",
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          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
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        },
        {
          "trade_name": "LARYNCLAVE 125/31 PD. FOR ORAL SUSP. 70ML",
          "scientific_name": null,
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          "manufacturer": "MISR > AL ROWAD PHARMACEUTICAL INDUSTRIAL CO.",
          "price_egp": 8.0,
          "pack_count": null,
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        },
        {
          "trade_name": "MEGACLAVOX 156MG/5ML PD. FOR SUSP. 60 ML",
          "scientific_name": null,
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          "manufacturer": "CID",
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          "pack_count": null,
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          "exact_strength": false,
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        }
      ],
      "condition_id": "infected-wound"
    },
    {
      "id": 977,
      "generic": "Co-trimoxazole",
      "line": 2,
      "is_adjunct": false,
      "form": "oral.solid",
      "strength_mg": null,
      "adult_dose": "800 mg/160 mg twice daily",
      "adult_duration": "5 days",
      "dose_source": "Cellulitis and erysipelas - disease-level clinical article (cellulitis-clinical.txt) for the indication; the paediatric weight band is from Egyptian National Drug Formulary - Antimicrobial 2023 (sulfamethoxazole and trimethoprim monograph): \"6 to 12 mg TMP/kg/day in divided doses every 12 hours; maximum single dose: 160 mg TMP/dose\", which the clinical article does not carry.",
      "rationale": "Add when the wound is purulent, when an abscess is present, or where there are MRSA risk factors - the source pairs it with the cephalosporin rather than replacing it.",
      "cautions": [
        "Avoid in the third trimester of pregnancy and in infants under 6 weeks.",
        "Drainage, not antibiotics, is the treatment for an abscess. Antibiotics are the addition."
      ],
      "peds_mgkg_low": 6.0,
      "peds_mgkg_high": 12.0,
      "peds_max_mg": 320.0,
      "peds_basis": "day",
      "peds_unit": "mg",
      "peds_note": "6 to 12 mg trimethoprim/kg/day in divided doses every 12 hours; maximum single dose 160 mg trimethoprim (Egyptian National Drug Formulary - Antimicrobial 2023).",
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
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        {
          "weight_kg": 10,
          "low_mg": 60,
          "high_mg": 120,
          "capped": false
        },
        {
          "weight_kg": 20,
          "low_mg": 120,
          "high_mg": 240,
          "capped": false
        },
        {
          "weight_kg": 30,
          "low_mg": 180,
          "high_mg": 320,
          "capped": true
        },
        {
          "weight_kg": 40,
          "low_mg": 240,
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        }
      ],
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        {
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        },
        {
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        },
        {
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        },
        {
          "trade_name": "SEPTRIN D.S 10 TABS.",
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        },
        {
          "trade_name": "SEPTAZOLE 400/80MG 20*10 TABS.",
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          "exact_strength": true,
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        },
        {
          "trade_name": "SUTRIM 400/80MG 20*10 TAB.",
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          "exact_strength": true,
          "exact_form": true,
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        },
        {
          "trade_name": "CO-TRIMOXAZOLE 200/40MG SUSP. 120ML",
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        },
        {
          "trade_name": "SUTRIM 200/40MG SUSP. 100ML",
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        }
      ],
      "condition_id": "infected-wound"
    },
    {
      "id": 978,
      "generic": "Clindamycin",
      "line": 2,
      "is_adjunct": false,
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      "adult_duration": "5-7 days",
      "dose_source": "Egyptian National Drug Formulary - Antimicrobial 2023",
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      "cautions": [
        "Carries the highest Clostridioides difficile risk of the options here; warn about diarrhoea."
      ],
      "peds_mgkg_low": 8.0,
      "peds_mgkg_high": 20.0,
      "peds_max_mg": null,
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      "peds_unit": "mg",
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      "peds_min_weight_kg": null,
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      "peds_age_min_months": null,
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      "peds_age_bands": null,
      "peds_doses": [
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          "high_mg": 200,
          "capped": false
        },
        {
          "weight_kg": 20,
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        },
        {
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        },
        {
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        }
      ],
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        {
          "trade_name": "ADCOCLINDACE 150 MG 16 CAPS.",
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        },
        {
          "trade_name": "ALFACLINDAMYCIN 150 MG 10 CAPS.",
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        },
        {
          "trade_name": "ADCOCLINDACE 300 MG 16 CAPS.",
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        },
        {
          "trade_name": "CLINACYN 300MG 16 CAPS.",
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        },
        {
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        },
        {
          "trade_name": "MEPACLIND 300MG 8 CAPS.",
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          "pack_count": 8,
          "unit_price": 4.75,
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        },
        {
          "trade_name": "ALFACLINDAMYCIN 300 MG 10 CAPS.",
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          "exact_strength": true,
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        },
        {
          "trade_name": "DALACIN C 300MG 10 CAPS.",
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        },
        {
          "trade_name": "KLENDABIOTICAM 1 % TOP. SOLUTION",
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        },
        {
          "trade_name": "ADCOCLINDACE 10MG/ML TOP. SOL.",
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          "exact_strength": false,
          "exact_form": false,
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        }
      ],
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    }
  ]
}