title: Acute bacterial skin infections: developments since the 2005 Infectious Diseases Society of America (IDSA) guidelines.
abstract: BACKGROUND
  Patients with acute bacterial skin and skin structure infections (ABSSSI) commonly present to Emergency Departments (EDs) where physicians encounter a wide spectrum of disease severity. The prevalence of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) has increased in the past decade, and CA-MRSA is now a predominant cause of purulent ABSSSI in the United States (US).
  
  
  OBJECTIVE
  This article reviews significant developments since the most recent Infectious Diseases Society of America (IDSA) guidelines for the management of ABSSSI in the CA-MRSA era, focusing on recent studies and recommendations for managing CA-MRSA, newer antimicrobials with improved MRSA activity, new diagnostic technologies, and options for outpatient parenteral antimicrobial therapy (OPAT).
  
  
  CONCLUSIONS
  The increasing prevalence of CA-MRSA has led the IDSA and other organizations to recommend empiric coverage of CA-MRSA for purulent ABSSSI. The availability of rapid MRSA detection assays from skin and soft tissue swabs could potentially facilitate earlier selection of targeted antimicrobial therapy. Several newer intravenous antibiotics with expanded MRSA coverage, including ceftaroline fosamil, daptomycin, linezolid, and telavancin, may be utilized for treatment of ABSSSI. OPAT may be an option for intravenous administration of antibiotics in selected patients and may prevent or shorten hospitalizations, decrease readmission rates, and reduce nosocomial infections and complications.
  
  
  CONCLUSIONS
  The growing prevalence of CA-MRSA associated with ABSSSI in the US has a significant impact on clinical management decisions in the ED. Recent availability of new diagnostic testing and therapeutic options may help meet the demand for effective antistaphylococcal agents.
authors: Department of Emergency Medicine, Olive View-UCLA Medical Center, Sylmar, CA 91342, USA.
authors: Gregory J
authors: GJ
authors: Moran
authors: Fredrick M
authors: FM
authors: Abrahamian
authors: Frank
authors: F
authors: Lovecchio
authors: David A
authors: DA
authors: Talan
mesh_terms: D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004635:Emergency Medicine; D004636:Emergency Service, Hospital; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus; D017410:Practice Guidelines as Topic; D017192:Skin Diseases, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D012955:Societies, Medical; D018461:Soft Tissue Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*
chemical_list: D000900:Anti-Bacterial Agents