All Purulence Is Local

Epidemiology and Management of Skin and Soft Tissue Infections in Three Urban Emergency Departments

Chris Merritt; John P Haran; Jacob Mintzer; Joseph Stricker; Roland C Merchant


BMC Emerg Med. 2013;13(26) 

In This Article


Staphylococcus aureus is the predominant pathogen in community-acquired purulent SSTIs in the ED, and most patients evaluated for these infections received antibiotics even after I&D. Although antibiotic use, including multi-drug "double coverage", remained common in the sample studied, empiric antibiotics used varied widely, and were poorly targeted toward the causative organisms, all of which represents an opportunity to reduce antibiotic overuse. Local epidemiologic data is critical to the decision-making of ED clinicians, and laboratories should consider reporting disease-specific antibiograms. Future efforts to identify SSTIs in which antibiotic use, particularly anti-MRSA therapy, is indicated could further reduce antibiotic overuse and improve antibiotic stewardship.