Board-certified emergency physicians' treatment of skin and soft tissue infections in the community-acquired methicillin-resistant Staphylococcus aureus era.
BACKGROUND
Emergency physicians commonly treat skin and soft tissue infections. Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) has become the prominent etiologic agent in these infections. The CA-MRSA is resistant to many antibiotics traditionally used to treat skin and soft tissue infections.


OBJECTIVE
We aim to identify how the increased prevalence of CA-MRSA has changed emergency medicine physician (EMP) prescribing and treatment practices for community-acquired skin and soft tissue infections.


METHODS
The EMPs in the United States were surveyed between June and December of 2006. Two cases of skin and soft tissue infection were presented, and questions were asked about management.


RESULTS
Two hundred seventy-five surveys were returned. The EMPs used a variety of approaches in the antibiotic treatment of skin and soft tissue infections. Two hundred seven (75.3%) of 275 were board-certified EMPs and were included in the analysis. Commonly used agents for outpatient treatment include trimethoprim/sulfamethoxazole, clindamycin, cephalexin, rifampin, and tetracyclines. For patients requiring admission, 60% of providers would include vancomycin in their treatment regimen.


CONCLUSIONS
Many clinicians have changed their practice patterns to include antibiotics that usually display activity against CA-MRSA. However, cephalexin remains a popular agent used for these infections.
LoVecchio
Frank
F
Maricopa Medical Center, Department of Emergency Medicine, Phoenix, AZ 85008, USA; Midwestern University, Arizona College of Osteopathic Medicine, Glendale, AZ 85308, USA. Electronic address: frank.lovecchio@bannerhealth.com.
Perera
Nicholas
N
Maricopa Medical Center, Department of Emergency Medicine, Phoenix, AZ 85008, USA.
Casanova
Lora
L
Midwestern University, Arizona College of Osteopathic Medicine, Glendale, AZ 85308, USA.
Mulrow
Mary
M
Maricopa Medical Center, Department of Emergency Medicine, Phoenix, AZ 85008, USA.
Pohl
Angela
A
Midwestern University, Arizona College of Osteopathic Medicine, Glendale, AZ 85308, USA.
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002568:Certification; D017714:Community-Acquired Infections / Q000175:diagnosis / Q000188:drug therapy; D004635:Emergency Medicine; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D008875:Middle Aged; D010820:Physicians; D011364:Professional Practice; D017192:Skin Diseases, Bacterial / Q000175:diagnosis / Q000188:drug therapy*; D018461:Soft Tissue Infections; D013207:Staphylococcal Skin Infections / Q000175:diagnosis / Q000188:drug therapy*
D000900:Anti-Bacterial Agents