Purulent Skin and Soft Tissue Infection: Antibiotic Selection in the Community

• Published in: Journal of primary care & community health 2010-10, Vol.1 (3), p.187-191
• Main Authors: Kahn, Steven Alexander, Venniro, Erika, Beers, Ryan J., Lentz, Christopher W.
• Format: Article
• Language: English
• ISSN: 2150-1319; 2150-1327
• DOI: 10.1177/2150131910375295

Introduction: Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) requently causes skin and soft tissue infections (SSTIs). Referring primary care physicians often prescribe inactive antibiotics when referring SSTIs caused by MRSA for incision and debridement. Methods: Demographics and culture results (organism and sensitivity) were collected for patients treated for SSTI between 2007-2009. Antibiotic regimens started by referring PCPs were noted. Prevalence of MRSA and antibiotic resistance profiles were tabulated. Isolates resistant to the drug initially prescribed were also noted. Results: Of 187 patients, 40.1% grew MRSA. All MRSA was sensitive to doxycycline and trimethoprim-sulfamethoxazole, whereas 88% were sensitive to clindamycin and 79% to levofloxacin. 48% of patients received an antibiotic inadequate for their isolate before referral. Conclusions: CA-MRSA is extremely common. Patients are often prescribed antibiotics inadequate for MRSA. Doxycycline or trimethoprim-sulfamethoxazole with incision/drainage should be used as initial therapy for SSTI when MRSA is suspected.