title: The evaluation and treatment of complicated skin and skin structure infections.
abstract: BACKGROUND
  Skin and skin structure infections are frequently encountered in clinical practice. Fortunately, these infections usually produce only mild to moderate symptoms and signs. Some, however, are severe and may even be life-threatening.
  
  
  OBJECTIVE
  To review the approach to the evaluation and treatment of patients with complicated skin and skin structure infections and to discuss when to consider using either established antibiotics or recently licensed agents for treating these infections.
  
  
  METHODS
  In addition to a non-systematic literature review of complicated skin and skin structure infections and necrotizing fasciitis, we identified recent articles examining the microbiology and describing recently licensed antibiotics for treating these infections.
  
  
  CONCLUSIONS
  Clinicians must learn to recognize the early symptoms and signs of severe skin and skin structure infections to ensure they select appropriate empiric antibiotic therapy and, when needed, obtain prompt surgical consultation. While the recent approvals of new agents for treating these infections are welcome, particularly in light of the continued emergence of antibiotic-resistant bacteria, traditional antibiotic regimens remain appropriate for most cases.
authors.affiliation: University of Washington School of Medicine, Primary and Specialty Medicine Service, Veterans Affairs Puget Sound Health Care System and Department of Medicine, Seattle, WA 98108-1597, USA. paul.cornia@med.va.gov
authors.forename: Paul B
authors.initials: PB
authors.lastname: Cornia
authors.forename: Heather L
authors.initials: HL
authors.lastname: Davidson
authors.forename: Benjamin A
authors.initials: BA
authors.lastname: Lipsky
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001419:Bacteria / Q000187:drug effects; D024881:Drug Resistance, Bacterial; D019115:Fasciitis, Necrotizing / Q000175:diagnosis / Q000382:microbiology / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D012720:Severity of Illness Index; D017192:Skin Diseases, Bacterial / Q000175:diagnosis / Q000382:microbiology / Q000503:physiopathology / Q000628:therapy*; D018461:Soft Tissue Infections / Q000175:diagnosis / Q000382:microbiology / Q000503:physiopathology / Q000628:therapy*
chemical_list: D000900:Anti-Bacterial Agents