Empirical MRSA Coverage for Nonpurulent Cellulitis: Swinging the Pendulum Away From Routine Use

Cellulitis is an infection of the deep dermis and subcutaneous tissue, manifesting as expanding erythema, edema, and warmth of the skin. In most instances of cellulitis, the causative microorganism cannot be definitively determined. However, based on studies using blood cultures, other laboratory ma...

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Bibliographic Details
Published in:JAMA : the journal of the American Medical Association 2017-05, Vol.317 (20), p.2070-2071
Main Authors: Shuman, Emily K, Malani, Preeti N
Format: Article
Language:English
Subjects:
Amides
Antiinfectives and antibacterials
Antimicrobial agents
Bacterial infections
Blood
Cellulitis
Cephalexin
Dermis
Drug resistance
Drug therapy
Edema
Erythema
Humans
Infections
Markers
Methicillin
Methicillin-Resistant Staphylococcus aureus
Skin
Staphylococcal Infections
Staphylococcal Skin Infections
Staphylococcus infections
Sulfamethoxazole
Therapy
Trimethoprim
Trimethoprim-sulfamethoxazole
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Description
Summary:Cellulitis is an infection of the deep dermis and subcutaneous tissue, manifesting as expanding erythema, edema, and warmth of the skin. In most instances of cellulitis, the causative microorganism cannot be definitively determined. However, based on studies using blood cultures, other laboratory markers, and clinical response to β-lactam antimicrobials, the vast majority of cellulitis is thought to be caused by β-hemolytic streptococci. Staphylococci, including methicillin-resistant Staphylococcus aureus, are a less common cause of cellulitis and are more likely to be encountered in cases of purulent cellulitis or abscess formation. Here, Shuman et al examine whether combination antimicrobial therapy with trimethoprim-sulfamethoxazole and a β-lactam is superior to treatment with cephalexin alone for nonpurulent cellulitis without abscess.
ISSN:0098-7484
1538-3598
DOI:10.1001/jama.2017.5654