{ "schema_version": 1, "kind": "condition", "id": "mrsa-skin-infection", "name": "Community-Acquired MRSA Skin and Soft Tissue Infection", "category": "infectious", "sources": "Egyptian National Drug Formulary - Antimicrobial 2023 · IDSA Guidelines for the Treatment of Methicillin-Resistant Staphylococcus Aureus Infections 2011 · Egyptian National Drug Formulary (Antimicrobial Chapter 2023) · IDSA Clinical Practice Guidelines for the Treatment of MRSA Infections in Adults and Children, 2011", "review_status": "reviewed", "verified_against": "Egyptian National Drug Formulary - Antimicrobial 2023 · IDSA Guidelines for the Treatment of Methicillin-Resistant Staphylococcus Aureus Infections 2011 · IDSA Clinical Practice Guidelines for the Treatment of MRSA Infections in Adults and Children, 2011", "verified_date": "2026-08", "treatments": [ { "id": 1224, "generic": "Sulphamethoxazole + Trimethoprim", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 800.0, "adult_dose": "800/160 mg (1 double-strength tablet) to 1600/320 mg (2 double-strength tablets) orally twice daily", "adult_duration": "5-10 days", "dose_source": "IDSA Guidelines for the Treatment of Methicillin-Resistant Staphylococcus Aureus Infections 2011", "rationale": "Co-trimoxazole (Sulphamethoxazole + Trimethoprim) remains a highly effective oral first-line option for outpatient CA-MRSA skin infections in Egypt and is widely registered as oral tablets and suspension.", "cautions": [ "Incision and drainage is the definitive primary treatment for purulent skin abscesses; oral antibiotic therapy is adjunctive.", "Contraindicated in severe renal impairment, hyperkalemia, megaloblastic anemia, and third trimester of pregnancy.", "Advise patient to maintain adequate fluid intake to reduce the risk of crystalluria; monitor for severe cutaneous adverse reactions (Stevens-Johnson syndrome)." ], "peds_mgkg_low": 4.0, "peds_mgkg_high": 6.0, "peds_max_mg": 160.0, "peds_basis": "dose", "peds_unit": "mg", "peds_note": "Dosed on trimethoprim component: 4-6 mg/kg per dose orally twice daily (max 160 mg trimethoprim/dose). Contraindicated in infants under 2 months.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": [ { "label": "2 months and over", "age_min_months": 2, "age_max_months": 216, "dose_text": "4 to 6 mg trimethoprim/kg per dose by mouth twice daily, maximum 160 mg trimethoprim per dose. Contraindicated under 2 months." } ], "peds_doses": [ { "weight_kg": 10, "low_mg": 40, "high_mg": 60, "capped": false }, { "weight_kg": 20, "low_mg": 80, "high_mg": 120, "capped": false }, { "weight_kg": 30, "low_mg": 120, "high_mg": 160, "capped": true }, { "weight_kg": 40, "low_mg": 160, "high_mg": 160, "capped": true } ], "brands": [ { "trade_name": "CO-TRIMOXAZOLE 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MUP", "price_egp": 5.0, "pack_count": 20, "unit_price": 0.25, "strength_mg": null, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "COTRIL 400/80MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NASR", "price_egp": 38.0, "pack_count": 20, "unit_price": 1.9, "strength_mg": 80.0, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SEPTAZOLE FORTE 800/160MG 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ALEXANDRIA", "price_egp": 56.0, "pack_count": 20, "unit_price": 2.8, "strength_mg": 160.0, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SEPTRIN D.S 10 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLAXO SMITHKLINE > ASPEN PHARMA TRADING LIMITED", "price_egp": 28.0, "pack_count": 10, "unit_price": 2.8, "strength_mg": null, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SEPTAZOLE 400/80MG 20*10 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ALEXANDRIA", "price_egp": 340.0, "pack_count": 10, "unit_price": 34.0, "strength_mg": 80.0, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SUTRIM 400/80MG 20*10 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS", "price_egp": 340.0, "pack_count": 10, "unit_price": 34.0, "strength_mg": 80.0, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CO-TRIMOXAZOLE 200/40MG SUSP. 120ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MUP", "price_egp": 6.0, "pack_count": null, "unit_price": null, "strength_mg": 40.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "SUTRIM 200/40MG SUSP. 100ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS", "price_egp": 18.5, "pack_count": null, "unit_price": null, "strength_mg": 40.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "mrsa-skin-infection" }, { "id": 1225, "generic": "Doxycycline", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 100.0, "adult_dose": "100 mg orally twice daily", "adult_duration": "5-10 days", "dose_source": "Egyptian National Drug Formulary - Antimicrobial 2023 (doxycycline monograph): adult \"100 to 200 mg/day in 1 to 2 divided doses\" with 100 mg capsules; paediatric \"2.2 mg/kg/dose every 12 hours, maximum dose: 100 mg/dose\", with the formulary's own caution that use below 8 years be reserved for severe infections. The IDSA MRSA guideline is not held in this corpus.", "rationale": "Tetracycline antibiotic active against community-acquired MRSA, an oral first-line option per IDSA guidance for skin and soft tissue infection.", "cautions": [ "Contraindicated in children under 8 years of age due to risk of permanent tooth enamel discoloration and bone growth retardation.", "Contraindicated during pregnancy and breastfeeding.", "Administer with a full glass of water while upright and remain standing or sitting for 30 minutes to prevent esophageal ulceration; advise sun protection." ], "peds_mgkg_low": 2.2, "peds_mgkg_high": 2.2, "peds_max_mg": 100.0, "peds_basis": "dose", "peds_unit": "mg", "peds_note": "Children >= 8 years and weighing < 45 kg: 2.2 mg/kg per dose twice daily (max 100 mg/dose). Contraindicated in children under 8 years of age.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": [ { "label": "8 years and over", "age_min_months": 96, "age_max_months": 216, "dose_text": "Under 45 kg: 2.2 mg/kg per dose twice daily, maximum 100 mg per dose. Contraindicated under 8 years." } ], "peds_doses": [ { "weight_kg": 10, "low_mg": 22, "high_mg": 22, "capped": false }, { "weight_kg": 20, "low_mg": 44, "high_mg": 44, "capped": false }, { "weight_kg": 30, "low_mg": 66, "high_mg": 66, "capped": false }, { "weight_kg": 40, "low_mg": 88, "high_mg": 88, "capped": false } ], "brands": [ { "trade_name": "FARCODOXIN 100MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO", "price_egp": 11.0, "pack_count": 10, "unit_price": 1.1, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DOXY M.R.100 MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ADWIA", "price_egp": 12.0, "pack_count": 10, "unit_price": 1.2, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "GRANUDOXY 100MG 10 F.C. TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLOBAL NAPI PHARMACEUTICALS > PIERRE FRANCE", "price_egp": 12.0, "pack_count": 10, "unit_price": 1.2, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DOXYDOX 100 MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 23.0, "pack_count": 10, "unit_price": 2.3, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DOXYMYCIN 100 MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NILE.", "price_egp": 30.0, "pack_count": 10, "unit_price": 3.0, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "TABOCINE 100MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "TABUK PHARMACEUTICAL MANUFACTURING COMPANY > TABUK PHARMA", "price_egp": 46.0, "pack_count": 10, "unit_price": 4.6, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "VIBRAMYCIN 100MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PFIZER", "price_egp": 65.0, "pack_count": 10, "unit_price": 6.5, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "mrsa-skin-infection" }, { "id": 1226, "generic": "Clindamycin", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": 300.0, "adult_dose": "300-450 mg orally three times daily", "adult_duration": "5-10 days", "dose_source": "IDSA Clinical Practice Guidelines for the Treatment of MRSA Infections in Adults and Children, 2011", "rationale": "Lincosamide antibiotic active against MRSA that also suppresses bacterial toxin production; an alternative first-line oral option, though inducible resistance must be excluded if the isolate is erythromycin-resistant.", "cautions": [ "High risk of Clostridioides difficile-associated diarrhea and pseudomembranous colitis; discontinue immediately if severe diarrhea occurs.", "Check local susceptibility data; perform D-zone test for inducible clindamycin resistance if erythromycin resistant." ], "peds_mgkg_low": 10.0, "peds_mgkg_high": 13.0, "peds_max_mg": 450.0, "peds_basis": "dose", "peds_unit": "mg", "peds_note": "10-13 mg/kg per dose orally every 6-8 hours (max 40 mg/kg/day, and no single dose above 450 mg). This is the CA-MRSA dose and it is higher than clindamycin's dose for ordinary skin infection.", "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": 100, "high_mg": 130, "capped": false }, { "weight_kg": 20, "low_mg": 200, "high_mg": 260, "capped": false }, { "weight_kg": 30, "low_mg": 300, "high_mg": 390, "capped": false }, { "weight_kg": 40, "low_mg": 400, "high_mg": 450, "capped": true } ], "brands": [ { "trade_name": "ADCOCLINDACE 300 MG 16 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ARAB DRUG COMPANY (ADCO)", "price_egp": 24.0, "pack_count": 16, "unit_price": 1.5, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CLINACYN 300MG 16 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA > EGYPTIAN PHARMACISTS COMPANY", "price_egp": 31.5, "pack_count": 16, "unit_price": 1.97, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CLINDAM 300 MG 16 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA > OCTOBER PHARMA", "price_egp": 75.0, "pack_count": 16, "unit_price": 4.69, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MEPACLIND 300MG 8 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEPACO", "price_egp": 38.0, "pack_count": 8, "unit_price": 4.75, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CLINDACINE ART 300 MG 12 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RAMEDA > ART PHARMA", "price_egp": 76.0, "pack_count": 12, "unit_price": 6.33, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ALFACLINDAMYCIN 300 MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ATCO PHARMA > ROTABIOGEN", "price_egp": 69.0, "pack_count": 10, "unit_price": 6.9, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DALACIN C 300MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PFIZER", "price_egp": 114.0, "pack_count": 10, "unit_price": 11.4, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "KLENDABIOTICAM 1 % TOP. SOLUTION", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PANAX PHARMA", "price_egp": 8.5, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "ADCOCLINDACE 10MG/ML TOP. SOL.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ARAB DRUG COMPANY (ADCO)", "price_egp": 12.0, "pack_count": null, "unit_price": null, "strength_mg": 10.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "mrsa-skin-infection" }, { "id": 1227, "generic": "Linezolid", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": 600.0, "adult_dose": "600 mg orally twice daily", "adult_duration": "7-14 days", "dose_source": "IDSA Guidelines for the Treatment of Methicillin-Resistant Staphylococcus Aureus Infections 2011", "rationale": "Oxazolidinone antibiotic with reliable activity against resistant Gram-positive organisms including MRSA; reserved for infections resistant or intolerant to the first-line oral agents to preserve its usefulness.", "cautions": [ "Reserve for documented MRSA resistant or intolerant to first-line oral agents to preserve susceptibility.", "Monitor complete blood count weekly if treatment extends beyond 10-14 days due to risk of reversible myelosuppression and thrombocytopenia.", "Risk of serotonin syndrome when co-administered with serotonergic agents (SSRIs, MAOIs); weak reversible monoamine oxidase inhibitor." ], "peds_mgkg_low": 10.0, "peds_mgkg_high": 10.0, "peds_max_mg": 600.0, "peds_basis": "dose", "peds_unit": "mg", "peds_note": "Children < 12 years: 10 mg/kg per dose orally every 8 hours. Children >= 12 years: 600 mg orally every 12 hours.", "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": 100, "high_mg": 100, "capped": false }, { "weight_kg": 20, "low_mg": 200, "high_mg": 200, "capped": false }, { "weight_kg": 30, "low_mg": 300, "high_mg": 300, "capped": false }, { "weight_kg": 40, "low_mg": 400, "high_mg": 400, "capped": false } ], "brands": [ { "trade_name": "JADOZOLID 600 MG 10 F.C. TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KAHIRA > BETA PHARMA-EGYPT", "price_egp": 79.0, "pack_count": 10, "unit_price": 7.9, "strength_mg": 600.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "THERAZOLIDE 600 MG 20 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EGPI > TABUK PHARMA", "price_egp": 189.0, "pack_count": 20, "unit_price": 9.45, "strength_mg": 600.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "VILZOLID 600 MG 10 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "DELTA GRAND PHARMA > PARKVILLE", "price_egp": 142.0, "pack_count": 10, "unit_price": 14.2, "strength_mg": 600.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LINEZ 600MG 10 F.C.TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SABAA > RAMEDA", "price_egp": 159.0, "pack_count": 10, "unit_price": 15.9, "strength_mg": 600.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LINEZOLID 600MG 14 F.C. TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLOBAL NAPI PHARMACEUTICALS", "price_egp": 232.0, "pack_count": 14, "unit_price": 16.57, "strength_mg": 600.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ELIXOZOLID 600 MG 10 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RAMEDA > ELIXIR PHARMA", "price_egp": 166.0, "pack_count": 10, "unit_price": 16.6, "strength_mg": 600.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "RESPENZO 600 MG 10 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA > HOCHSTER PHARMACEUTICAL INDUSTRIES", "price_egp": 206.0, "pack_count": 10, "unit_price": 20.6, "strength_mg": 600.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AVEROZOLID 600 MG 10 F.C.TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL-OBOUR > AVERROES PHARMA-EGYPT", "price_egp": 231.0, "pack_count": 10, "unit_price": 23.1, "strength_mg": 600.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "JADOZOLID 100MG/5ML SUSP 60 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KAHIRA > BETA PHARMA-EGYPT", "price_egp": 22.8, "pack_count": null, "unit_price": null, "strength_mg": 100.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "SAZIMOLINE 100MG/5ML SUSP. 100 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RAMEDA > GAMMA PHARMA", "price_egp": 23.0, "pack_count": null, "unit_price": null, "strength_mg": 100.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "mrsa-skin-infection" } ] }