title: Outcomes of community-acquired, methicillin-resistant Staphylococcus aureus, soft tissue infections treated with antibiotics other than vancomycin.
abstract: Community-acquired, methicillin-resistant Staphylococcus aureus (cMRSA), soft tissue infections are becoming increasingly prevalent in the outpatient setting. Few studies have been specifically designed to examine the efficacy of oral antibiotic therapy for these infections. We performed an observational study to determine the effect of alternative, orally administered antibiotics on cMRSA soft tissue infections. Consecutive patients between January 2001 and March 2004 who had skin or soft tissue infections from which cMRSA was isolated and who had never received vancomycin were studied through retrospective and concurrent review. Primary outcome measures were improvement or resolution of infection 5 and 14 days after initiation of treatment with orally administered antibiotics and rates of recurrence within 30 days after completion of treatment. Thirty subjects met the inclusion criteria. Twenty-one subjects received either clindamycin, trimethoprim/sulfamethoxazole, doxycycline/minocycline, or a fluoroquinolone. Five subjects received a beta-lactam antibiotic with abscess drainage, and four subjects underwent abscess drainage alone. Improvement was noted for all subjects at 5 days, complete resolution of infection occurred for all subjects by 14 to 17 days, and in no case did relapse occur within 30 days. cMRSA skin and soft tissue infections can be successfully treated with orally administered antibiotics to which the organism has demonstrable in vitro susceptibility.
authors.affiliation: Department of Medicine, Brooke Army Medical Center, Fort Sam Houston, TX 78234, USA.
authors.forename: Edward V
authors.initials: EV
authors.lastname: Barnes
authors.forename: David P
authors.initials: DP
authors.lastname: Dooley
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Hepburn
authors.forename: Sue E
authors.initials: SE
authors.lastname: Baum
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D002981:Clindamycin / Q000627:therapeutic use*; D017714:Community-Acquired Infections / Q000188:drug therapy*; D004318:Doxycycline / Q000627:therapeutic use*; D005260:Female; D024841:Fluoroquinolones / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D016106:Methicillin Resistance; D008875:Middle Aged; D012189:Retrospective Studies; D018461:Soft Tissue Infections / Q000188:drug therapy* / Q000382:microbiology; D013203:Staphylococcal Infections / Q000188:drug therapy*; D013207:Staphylococcal Skin Infections / Q000188:drug therapy* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000187:drug effects*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones; D002981:Clindamycin; D004318:Doxycycline