Purulent Skin and Soft Tissue Infections (Furuncles, Carbuncles, Abscesses)

General Principles

Methicillin-resistant S. aureus (MRSA) and methicillin-sensitive S. aureus (MSSA) account for 25%–50% of cases.

Treatment

  • Incision and drainage (I&D) alone is usually adequate, especially for abscesses measuring <5 cm.
  • Antibiotic therapy is needed for extensive disease; systemic illness; rapid progression with associated cellulitis; comorbid diseases (diabetes mellitus); immunosuppression, location on face, hand, or genitalia; or lack of response to I&D.
  • Empiric antibiotic therapy should cover community-acquired MRSA. Oral antibiotics include clindamycin 300–450 mg q8h, trimethoprim-sulfamethoxazole (TMP-SMX) 1–2 double-strength tablets q12h, doxycycline 100 mg q12h, and linezolid 600 mg q12h.
  • Duration of antibiotic therapy is usually 5–7 days.1

References

  1. Stevens DL, Bisno AL, Chambers HF, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis. 2014;59(2):147-159.  [PMID:24947530]

Outline


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Purulent Skin and Soft Tissue Infections (Furuncles, Carbuncles, Abscesses) is a sample topic from the Washington Manual of Medical Therapeutics.

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