Management of Skin and Soft Tissue Infections in
Management of Skin and Soft Tissue Infections in
Management of Skin and Soft Tissue Infections in
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When to culture a purulent SSTI?<br />
• Patients Rx with antibiotics<br />
• Patients with severe local <strong>in</strong>fections<br />
• Patients with signs <strong>of</strong> systemic illness<br />
• Patient has not responded to <strong>in</strong>itial Rx<br />
• Concern for outbreak or cluster<br />
28 y/o woman presents<br />
with erythema <strong>of</strong> her left<br />
foot over past 48 hrs<br />
No purulent dra<strong>in</strong>age,<br />
exudate , or fluctuance.<br />
T 37.0 BP 132/70 P 78<br />
Case 2<br />
Liu C. Cl<strong>in</strong> Infect Dis. 2011<br />
Eels SJ et al Epidemiology <strong>and</strong> Infection 2010<br />
Empiric oral antibiotic Rx<br />
for uncomplicated purulent SSTI<br />
Drug Adult Dose<br />
TMP/SMX DS 1-2 BID<br />
Doxycycl<strong>in</strong>e, M<strong>in</strong>ocycl<strong>in</strong>e 100 BID<br />
Cl<strong>in</strong>damyc<strong>in</strong> 300-450 TID<br />
L<strong>in</strong>ezolid 600 BID<br />
*Rifamp<strong>in</strong> is NOT recommended for rout<strong>in</strong>e treatment <strong>of</strong> SSTIs<br />
How would you manage this<br />
patient?<br />
A. Cl<strong>in</strong>damyc<strong>in</strong> 300 mg TID<br />
B. Cephalex<strong>in</strong> 500 mg QID,<br />
monitor cl<strong>in</strong>ically with addition<br />
<strong>of</strong> TMP/SMX if no response<br />
C. Cephalex<strong>in</strong> 500 mg QID + TMP/<br />
SMX 2 DS BID<br />
21%<br />
54%<br />
25%<br />
A. B. C.<br />
4/12/2011<br />
3
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