Antimicrobial activity against CA-MRSA and treatment of uncomplicated nonpurulent cellulitis.
Evaluation of: Pallin DJ, Binder WD, Allen MB et al.


BACKGROUND
comparative effectiveness of cephalexin plus trimethoprim-sulfamethoxazole versus cephalexin alone for treatment of uncomplicated cellulitis: a randomized controlled trial. Clin. Infect. Dis. 56(12), 1754-1762 (2013). The rise of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has complicated the empirical antimicrobial treatment of cellulitis. CA-MRSA is frequently the cause of purulent infections, to include purulent cellulitis. The role of CA-MRSA in nonpurulent cellulitis is less clear. Published clinical practice guidelines suggest that CA-MRSA plays only a minor role in nonpurulent cellulitis and that initial treatment should be primarily directed at β-hemolytic streptococci. Until now, there have been no data from prospective randomized control trials to support this recommendation. In this review, we examine the findings from a recent prospective, double-blind, randomized controlled trial that refutes the need for empirical coverage of CA-MRSA when treating nonpurulent cellulitis.
Department of Medicine, F Edward Hebert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA. matthew.griffith@usuhs.edu
Matthew E
ME
Griffith
Michael W
MW
Ellis
D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002481:Cellulitis / Q000188:drug therapy*; D002506:Cephalexin / Q000008:administration & dosage*; D006801:Humans; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000008:administration & dosage*
D000900:Anti-Bacterial Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D002506:Cephalexin