Treatment of Noncultured Skin Infections in the Age of CA-MRSA

Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) is the most common organism identified from skin infections in emergency department patients in the U.S. (JW Emerg Med Sep 8 2006). In response, emergency physicians have increased their use of trimethoprim-sulfamethoxazole (TMP-SMX) and other CA-MRSA–active agents for treating skin infections (JW Emerg Med Mar 28 2008). However, no evidence exists that antibiotics are required for abscesses or that CA-MRSA causes nonpurulent skin infections. In a retrospective chart review, these authors evaluated rates of treatment failure in 2096 children who received oral monotherapy for skin infections that were not drained or cultured at five pediatric practices in Philadelphia b…