SSTI

Question 1

Mild purulent SSTI

Answer 1

Incision and drainage
No abx

Question 2

Moderate purulent SSTI

Answer 2

Target MSSA, S. pyogenes

Incision and drainage
PO Cephalexin or
PO Cloxacillin or
PO Clindamycin

Consider CA-MRSA risk
Consider abscesses affecting perioral, perianal, vulvovaginal –> PO Augmentin

Question 3

Severe purulent SSTI

Answer 3

Target MSSA, S. pyogenes

Incision and drainage
IV Cefazolin or
IV Cloxacillin or
IV Clindamycin or
IV Vancomycin

Consider CA-MRSA risk
Consider abscesses affecting perioral, perianal, vulvovaginal –> PO Augmentin

Question 4

Mild nonpurulent SSTI

Answer 4

Target S. pyogenes

PO Pen GK or
PO Amoxicillin or
PO Cloxacillin or
PO Cephalexin

Question 5

Moderate nonpurulent SSTI

Answer 5

Target MSSA, S. pyogenes

IV Cloxacillin or
IV Cefazolin or
IV Clindamycin

Question 6

Severe nonpurulent SSTI

Answer 6

Target broad spectrum (Gram +ve, -ve, Pseudomonas)

IV Pip/tazo or
IV Cefepime or
IV Meropenem

Consider MRSA risk

Question 7

Mild DFI

Answer 7

Target MSSA, S. pyogenes

PO Cloxacillin or
PO Cephalexin or
PO Clindamycin

Consider MRSA –> change to:
PO Bactrim or
PO Clindamycin or
PO Doxycycline

Question 8

Moderate DFI

Answer 8

Target MSSA, S. pyogenes, Gram -ve +/- Psuedomonas, anaeroabes

IV Augmentin or
IV Cefepime + IV Metronidazole

Consider MRSA –> add:
IV Vancomycin or
IV Daptomycin or
IV Linezolid

Question 9

Severe DFI

Answer 9

Target MSSA, S. pyogenes, Gram -ve including Psuedomonas, anaeroabes

IV Pip/tazo or
IV Meropenem or
IV Cefepime + IV Metronidazole or
IV Ceftazidime + IV Clindamycin or
IV Ciprofloxacin + IV Clindamycin

Consider MRSA –> add:
IV Vancomycin or
IV Daptomycin or
IV Linezolid

Question 10

Adjunctive therapy for SSTI

Answer 10

Ibuprofen or prednisolone