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    Natasha Press, MD, FRCPC (biography and disclosures) What I did before A 32 year old woman, otherwise healthy, presented with a “spider-bite”. It was associated with some surrounding cellulitis but no fever or other systemic features. I recommended incision and drainage, but she wasn’t keen on it, so I gave her a 7-day prescription for cephalexin (keflex) 500 mg po qid. What changed my practice The woman returned to the office 1 week later. The abscess had increased in size and another one had appeared on her labia. She was in significant discomfort and reported no improvement with the cephalexin. Incision and drainage of her abscesses were done, and the culture result from the swab showed community-associated methicillin resistant Staphylococcus aureus (ca-MRSA). This patient did not improve because her abscesses were caused by ca-MRSA which is resistant to cephalexin and other beta-lactam antibiotics. buy phenergan suppositories online (MRSA) infections have been increasing since the 1990s, when four fatal cases were reported in Native American children. Although community-acquired MRSA occurs worldwide, the problem is of special concern in the United States where it accounts for up to 60 to 75 percent of all reported infections. Most of these infections are relatively minor soft-tissue and skin infections, with or without purulence. However, they can also cause more serious infections, including pneumonia, pelvic osteomyelitis, septic thrombophlebitis, and necrotizing fasciitis. Because community-acquired MRSA is resistant to traditional treatments such as antistaphylococcal penicillins (e.g., dicloxacillin) and cephalosporins (e.g., cephalexin [Keflex], cefadroxil [formerly Duricef]), U. physicians have prescribed a variety of other antibiotics to treat these infections The National Institutes of Health has initiated several clinical trials examining the effectiveness of alternative antibiotics, but there are currently no randomized prospective trials of agents used to treat skin and soft-tissue infections from community-acquired MRSA. Until such data are complete, only anecdotal and retrospective data are available to guide treatment recommendations. Community-acquired MRSA skin and soft-tissue infections, such as pustules, furuncles, and small abscesses, usually respond to incision and drainage.

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    • MRSA skin and soft tissue infections This Changed My Practice
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