title: Impact of methicillin-resistant Staphylococcus aureus on treatment of hand infections.
abstract: OBJECTIVE
  With the increasing incidence of methicillin-resistant Staphylococcus aureus (MRSA) in hand infections in urban centers, multiple studies have recommended using MRSA-effective antibiotics as first-line treatment of hand infections. This study assesses the effect of adopting this recommendation for the treatment of hand infections at the authors' hospital.
  
  
  METHODS
  Patients with hand infections drained in the authors' hospital were prospectively enrolled in an observational study over a 12-month period. Culture results and response to treatment were recorded.
  
  
  RESULTS
  Twenty-two patients met inclusion criteria. Eleven of 14 patients with S aureus infections had MRSA. All of these patients responded to the initial antibiotic selected. Two patients had infections that did not respond to trimethoprim-sulfamethoxazole. One grew group A Streptococcus infection, and the other had lymphangitic streaking that suggested Streptococcus infection.
  
  
  CONCLUSIONS
  Because of the high prevalence of MRSA among hand infections at the authors' institution, we continue to prescribe MRSA-effective antibiotics as first-line treatment of hand abscesses. Close follow-up is still necessary to confirm that each patient has responded appropriately to treatment or to allow modification of the treatment plan if the patient has not responded to treatment.
authors.affiliation: Department of Surgery, Division of Plastic Surgery, Johns Hopkins University, Baltimore, MD, UAS. slifche1@jhmi.edu
authors.forename: Scott D
authors.initials: SD
authors.lastname: Lifchez
authors.forename: David A
authors.initials: DA
authors.lastname: Harriman