Purulent SSTIs Flashcards
Cutaneous abscess
Collection of pus within the dermis and deeper skin tissues
Painful, fluctuant red nodules, often topped with pustule, rum of erythematous swelling
Types of cutaneous abscesses
Furuncles (infection of a single hair follicle) and carbuncles (collection of infected follicles)
Cutaneous abscesses are limited to what layers of the skin?
Dermis and epidermis
The majority of purulent SSTIs are caused by what bacteria?
Staph aureus
Mild purulent SSTI
Purulent infection with no systemic signs of infection
Moderate purulent SSTI
Purulent infection with systemic signs of infection
Severe purulent SSTI
Patients who have failed incision and drainage plus PO ABX, septic, immunocompromised patients, substantial pain
Purulent SSTI treatment
Drainage +/- ABX
When do you add ABX in purulent SSTI treatment?
Patient has systemic signs of infection, is immunocompromised, or doesn’t respond to incision and drainage
SIRS criteria
Temperature >38ºC or <36ºC
Tachypnea >24 breaths/minute
Tachycardia >90 beats per minute
WBC >12,000 or <4,000 cells/microliter
First-line treatment for severe cases of purulent SSTI
IV vancomycin 15mg/kg q12h
Goal trough of vanco monitoring
10-15 mcg/ml
Vanco side effects
Red Man Syndrome, renal dysfunction
Alternate IV options for MRSA when Vanco fails
Daptomycin, ceftaroline, dalbavancin/oritavancin, linezolid
PO options for MRSA
Bactrim**, doxycycline, linezolid
