Update on Management of Skin and Soft Tissue Infections in the Emergency Department

  • Michael S. Pulia
  • Mary R. Calderone
  • John R. Meister
  • Jamie Santistevan
  • Larissa May
Skin, Soft Tissue, Bone and Joint Infectious Diseases (N Safdar, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Skin, Soft Tissue, Bone and Joint Infections


Skin and soft tissue infections (SSTIs) are frequently treated in the emergency department (ED) setting. Recent studies provide critical new information that can guide new approaches to the diagnosis and treatment of SSTIs in the ED. Rapid polymerase chain reaction assays capable of detecting MRSA in approximately 1 h hold significant potential to improving antibiotic stewardship in SSTI care. Emergency ultrasound continues to demonstrate value in guiding appropriate management of SSTIs, including the early diagnosis of necrotizing infections. Since emerging in the 1990s, community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) continues to increase in prevalence, and it represents a significant challenge to optimizing ED antibiotic use for SSTI management. Growing literature reinforces the current recommendation of incision and drainage without antibiotics for uncomplicated abscesses. Selecting antibiotics with CA-MRSA coverage is recommended when treating purulent SSTIs; however, it is generally not necessary in cases of nonpurulent cellulitis. Future advances in ED SSTI care may involve expansion of outpatient parenteral antimicrobial therapy protocols and the recent development of a novel, once weekly antibiotic with activity against MRSA.


Abscess Cellulitis Skin and soft tissue infection CA-MRSA Antimicrobial Infection Antibiotic stewardship PCR Necrotizing fasciitis Blood cultures Emergency ultrasound Incision and drainage ABSSSI Home infusion therapy 


Compliance with Ethics Guidelines

Conflict of Interest

Mary Calderone, Jamie Santistevan and John Meister declare no conflicts of interest. Larissa May has served as a consultant for Durata Therapeutics and has received payment for educational presentation from Cepheid and research support from Cepheid. Michael Pulia received payment for educational presentations and research support from Cepheid.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    Pallin D, Egan D, Pelletier A, Espinola J, Hooper D, Camargojr C. Increased US emergency department visits for skin and soft tissue infections, and changes in antibiotic choices, during the emergence of community-associated methicillin-resistant Staphylococcus aureus. Ann Emerg Med. 2008;51(3):291–8.PubMedCrossRefGoogle Scholar
  2. 2.
    Shukla SK. Community-associated methicillin-resistant staphylococcus aureus and its emerging virulence. Clin Med Res. 2005;3(2):57–60.PubMedCentralPubMedCrossRefGoogle Scholar
  3. 3.
    Qualls ML, Mooney MM, Camargo Jr CA, Zucconi T, Hooper DC, Pallin DJ. Emergency department visit rates for abscess versus other skin infections during the emergence of community-associated methicillin-resistant Staphylococcus aureus, 1997–2007. Clin Infect Dis. 2012;55(1):103–5.PubMedCrossRefGoogle Scholar
  4. 4.
    Taira BR, Singer AJ, Thode Jr HC, Lee CC. National epidemiology of cutaneous abscesses: 1996 to 2005. Am J Emerg Med. 2009;27(3):289–92.PubMedCrossRefGoogle Scholar
  5. 5.
    Borgundvaag B, Ng W, Rowe B, Katz K. Prevalence of methicillin-resistant Staphylococcus aureus in skin and soft tissue infections in patients presenting to Canadian emergency departments. CJEM. 2013;15(3):141–60.PubMedGoogle Scholar
  6. 6.
    Karamatsu ML, Thorp AW, Brown L. Changes in community-associated methicillin-resistant Staphylococcus aureus skin and soft tissue infections presenting to the pediatric emergency department: comparing 2003 to 2008. Pediatr Emerg Care. 2012;28(2):131–5.PubMedGoogle Scholar
  7. 7.
    Marra F, Patrick DM, Chong M, McKay R, Hoang L, Bowie WR. Population-based study of the increased incidence of skin and soft tissue infections and associated antimicrobial use. Antimicrob Agents Chemother. 2012;56(12):6243–9.PubMedCentralPubMedCrossRefGoogle Scholar
  8. 8.
    Merritt C, Haran JP, Mintzer J, Stricker J, Merchant RC. All purulence is local - epidemiology and management of skin and soft tissue infections in three urban emergency departments. BMC Emerg Med. 2013;13:26.PubMedCentralPubMedCrossRefGoogle Scholar
  9. 9.
    Moran GJ, Krishnadasan A, Gorwitz RJ, Fosheim GE, McDougal LK, Carey RB, et al. Methicillin-resistant S. aureus infections among patients in the emergency department. N Engl J Med. 2006;355(7):666.PubMedCrossRefGoogle Scholar
  10. 10.
    Wackett A, Nazdryn A, Spitzer E, Singer AJ. MRSA rates and antibiotic susceptibilities from skin and soft tissue cultures in a suburban ED. J Emerg Med. 2012;43(4):754–7.PubMedCrossRefGoogle Scholar
  11. 11.
    Bassetti M, Baguneid M, Bouza E, Dryden M, Nathwani D, Wilcox M. European perspective and update on the management of complicated skin and soft tissue infections due to methicillin-resistant Staphylococcus aureus after more than 10 years of experience with linezolid. Clin Microbiol Infect. 2014;20 Suppl 4:3–18.PubMedCrossRefGoogle Scholar
  12. 12.
    Casey JA, Cosgrove SE, Stewart WF, Pollak J, Schwartz BS. A population-based study of the epidemiology and clinical features of methicillin-resistant Staphylococcus aureus infection in Pennsylvania, 2001–2010. Epidemiol Infect. 2013;141(6):1166–79.PubMedCrossRefGoogle Scholar
  13. 13.
    Cohen PR. Community-acquired methicillin-resistant Staphylococcus aureus skin infections: a review of epidemiology, clinical features, management, and prevention. Int J Dermatol. 2007;46(1):1–11.PubMedCrossRefGoogle Scholar
  14. 14.
    Jacobus CH, Lindsell CJ, Leach SD, Fermann GJ, Kressel A, Rue LE. Prevalence and demographics of methicillin resistant Staphylococcus aureus in culturable skin and soft tissue infections in an urban emergency department. BMC Emerg Med. 2007;7(1):19.PubMedCentralPubMedCrossRefGoogle Scholar
  15. 15.
    Vayalumkal JV, Suh KN, Toye B, Ramotar K, Saginur R, Roth VR. Skin and soft tissue infections caused by methicillin-resistant Staphylococcus aureus (MRSA): an affliction of the underclass. CJEM. 2012;14(6):335–43.PubMedGoogle Scholar
  16. 16.
    Liu C, Bayer A, Cosgrove SE, Daum RS, Fridkin SK, Gorwitz RJ, et al. Infectious Diseases Society of America. Clinical practice guidelines by the infectious diseases society of america for the treatment of methicillin-resistant staphylococcus aureus infections in adults and children. Clin Infect Dis. 2011;52:e18–55.PubMedCrossRefGoogle Scholar
  17. 17.
    Spellberg B, Blaser M, Guidos RJ, Boucher HW, Bradley JS, Eisenstein BI, et al. Combating antimicrobial resistance: policy recommendations to save lives. Clin Infect Dis. 2011;52 Suppl 5:S397–428.PubMedGoogle Scholar
  18. 18.
    May L, Cosgrove S, L’archeveque M, Talan DA, Payne P, Jordan J, et al. A call to action for antimicrobial stewardship in the emergency department: approaches and strategies. Ann Emerg Med. 2013;62(1):69–77.e2.PubMedCrossRefGoogle Scholar
  19. 19.
    Rossney AS, Herra CM, Brennan GI, Morgan PM, O’Connell B. Evaluation of the Xpert Methicillin-Resistant Staphylococcus Aureus (MRSA) assay using the GeneXpert real-time PCR platform for rapid detection of MRSA from screening specimens. J Clin Microbiol. 2008;46(10):3285–90.PubMedCentralPubMedCrossRefGoogle Scholar
  20. 20.
    Wassenberg MWM, Kluytmans JAJW, Box ATA, Bosboom RW, Buiting AGM, van Elzakker EPM, et al. Rapid screening of methicillin-resistant Staphylococcus aureus using PCR and chromogenic agar: a prospective study to evaluate costs and effects. Clin Microbiol Infect. 2010;16(12):1754–61.PubMedCrossRefGoogle Scholar
  21. 21.•
    Pulia M, Calderone M, Hansen B, Stake C, Cichon L, et al. Feasibility of rapid polymerase chain reaction for detection of methicillin-resistant Staphylococcus aureus colonization among emergency department patients with abscesses. Open Access Emerg Med. 2013;5:17–22. This study established the feasibility of deploying a rapid PCR assay for MRSA for patients with abscess during emergency department triage. Utilization of rapid MRSA diagnostics has the potential to improve antibiotic stewardship in the ED care of abscesses.CrossRefGoogle Scholar
  22. 22.
    May L, Dissen E, Smith M, Rabinowitz N, Malott B, McCann C, et al. Clinical decisionmaking and antibiotic use in patients with abscesses after rapid point-of-care MRSA/MSSA testing in the emergency department. Ann Emerg Med. 2011;58(4):S292–3.CrossRefGoogle Scholar
  23. 23.
    Wong C-H, Chang H-C, Pasupathy S, Khin L-W, Tan J-L, Low C-O. Necrotizing fasciitis: clinical presentation, microbiology, and determinants of mortality. J Bone Joint Surg Am. 2003;85-A(8):1454–60.PubMedGoogle Scholar
  24. 24.
    Lee TC, Carrick MM, Scott BG, Hodges JC, Pham HQ. Incidence and clinical characteristics of methicillin-resistant Staphylococcus aureus necrotizing fasciitis in a large urban hospital. Am J Surg. 2007;194(6):809–12. discussion 812–813.PubMedCrossRefGoogle Scholar
  25. 25.
    Abrahamian FM, Talan DA, Moran GJ. Management of skin and soft-tissue infections in the emergency department. Infect Dis Clin N Am. 2008;22(1):89–116. vi.CrossRefGoogle Scholar
  26. 26.
    Wong C-H, Khin L-W, Heng K-S, Tan K-C, Low C-O. The LRINEC (Laboratory Risk Indicator for Necrotizing Fasciitis) score: a tool for distinguishing necrotizing fasciitis from other soft tissue infections. Crit Care Med. 2004;32(7):1535–41.PubMedCrossRefGoogle Scholar
  27. 27.
    Burner E, Sanko S, Burke G, Henderson SO. The laboratory risk indicator for necrotizing fasciitis lacks sensitivity for patients with necrotizing fasciitis who present to the emergency department: an external validation study. Ann Emerg Med. 2012;60(4):S120.CrossRefGoogle Scholar
  28. 28.
    Wilson MP, Schneir AB. A case of necrotizing fasciitis with a LRINEC score of zero: clinical suspicion should trump scoring systems. J Emerg Med. 2013;44(5):928–31.PubMedCrossRefGoogle Scholar
  29. 29.
    Perl B, Gottehrer NP, Raveh D, Schlesinger Y, Rudensky B, Yinnon AM. Cost-effectiveness of blood cultures for adult patients with cellulitis. Clin Infect Dis. 1999;29(6):1483–8.PubMedCrossRefGoogle Scholar
  30. 30.
    Paolo WF, Poreda AR, Grant W, Scordino D, Wojcik S. Blood culture results do not affect treatment in complicated cellulitis. J Emerg Med. 2013;45(2):163–7.PubMedCrossRefGoogle Scholar
  31. 31.
    Marin JR, Bilker W, Lautenbach E, Alpern ER. Reliability of clinical examinations for pediatric skin and soft-tissue infections. Pediatrics. 2010;126(5):925–30.PubMedCentralPubMedCrossRefGoogle Scholar
  32. 32.
    Tayal VS, Hasan N, Norton HJ, Tomaszewski CA. The effect of soft-tissue ultrasound on the management of cellulitis in the emergency department. Acad Emerg Med. 2006;13(4):384–8.PubMedCrossRefGoogle Scholar
  33. 33.
    Singer AJ, Richman PB, Kowalska A, Thode Jr HC. Comparison of patient and practitioner assessments of pain from commonly performed emergency department procedures. Ann Emerg Med. 1999;33(6):652–8.PubMedGoogle Scholar
  34. 34.
    Marin JR, Dean AJ, Bilker WB, Panebianco NL, Brown NJ, Alpern ER. Emergency ultrasound-assisted examination of skin and soft tissue infections in the pediatric emergency department. Acad Emerg Med. 2013;20(6):545–53.PubMedCentralPubMedCrossRefGoogle Scholar
  35. 35.•
    Iverson K, Haritos D, Thomas R, Kannikeswaran N. The effect of bedside ultrasound on diagnosis and management of soft tissue infections in a pediatric ED. Am J Emerg Med. 2012;30(8):1347–51. This study is a useful addition to the growing body of evidence indicating that emergency ultrasound improves diagnostic accuracy and appropriate treatment for patients with skin and soft tissue infections.Google Scholar
  36. 36.
    Berger T, Garrido F, Green J, Lema PC, Gupta J. Bedside ultrasound performed by novices for the detection of abscess in ED patients with soft tissue infections. Am J Emerg Med. 2012;30(8):1569–73.PubMedCrossRefGoogle Scholar
  37. 37.
    Castleberg E, Jenson N, Dinh VA. Diagnosis of necrotizing faciitis with bedside ultrasound: the STAFF exam. West J Emerg Med. 2014;15(1):111–3.PubMedCentralPubMedCrossRefGoogle Scholar
  38. 38.
    Coyne C, Perera P, Mailhot T. Diagnosis of Fournier’s Gangres on Bedside Ultrasound. West J Emerg Med. 2014;15(2). http://escholarship.org/uc/item/7zm202hx. Published Feb 28, 2014. Accessed 1 Apr 2014.
  39. 39.
    Oelze L, Wu S, Carnell J. Emergency ultrasonography for the early diagnosis of necrotizing fasciitis: a case series from the ED. Am J Emerg Med. 2013;31(3):632. e5–7.PubMedCrossRefGoogle Scholar
  40. 40.
    Yen Z-S, Wang H-P, Ma H-M, Chen S-C, Chen W-J. Ultrasonographic screening of clinically-suspected necrotizing fasciitis. Acad Emerg Med. 2002;9(12):1448–51.PubMedCrossRefGoogle Scholar
  41. 41.
    Tsoraides SS, Pearl RH, Stanfill AB, Wallace LJ, Vegunta RK. Incision and loop drainage: a minimally invasive technique for subcutaneous abscess management in children. J Pediatr Surg. 2010;45(3):606–9.PubMedCrossRefGoogle Scholar
  42. 42.
    Wright TN, Gilligan L, Zhurbich O, Davenport DL, Draus Jr JM. Minimally invasive drainage of subcutaneous abscesses reduces hospital cost and length of stay. South Med J. 2013;106(12):689–92.PubMedCrossRefGoogle Scholar
  43. 43.
    Alimov V, Lovecchio F, Sinha M, Foster KN, Drachman D. Use of a silver-containing hydrofiber dressing for filling abscess cavity following incision and drainage in the emergency department: a randomized controlled trial. Adv Skin Wound Care. 2013;26(1):20–5.PubMedCrossRefGoogle Scholar
  44. 44.
    Kessler DO, Krantz A, Mojica M. Randomized trial comparing wound packing to no wound packing following incision and drainage of superficial skin abscesses in the pediatric emergency department. Pediatr Emerg Care. 2012;28(6):514–7.PubMedCrossRefGoogle Scholar
  45. 45.
    O’Malley GF, Dominici P, Giraldo P, Aguilera E, Verma M, Lares C, et al. Routine packing of simple cutaneous abscesses is painful and probably unnecessary. Acad Emerg Med. 2009;16(5):470–3.PubMedCrossRefGoogle Scholar
  46. 46.
    Singer AJ, Thode Jr HC, Chale S, Taira BR, Lee C. Primary closure of cutaneous abscesses: a systematic review. Am J Emerg Med. 2011;29(4):361–6.PubMedCrossRefGoogle Scholar
  47. 47.
    Singer AJ, Taira BR, Chale S, Bhat R, Kennedy D, Schmitz G. Primary versus secondary closure of cutaneous abscesses in the emergency department: a randomized controlled trial. Acad Emerg Med. 2013;20(1):27–32.PubMedCrossRefGoogle Scholar
  48. 48.
    Duong M, Markwell S, Peter J, Barenkamp S. Randomized, controlled trial of antibiotics in the management of community-acquired skin abscesses in the pediatric patient. Ann Emerg Med. 2010;55(5):401–7.PubMedCrossRefGoogle Scholar
  49. 49.
    Schmitz GR, Bruner D, Pitotti R, Olderog C, Livengood T, Williams J, et al. Randomized controlled trial of trimethoprim-sulfamethoxazole for uncomplicated skin abscesses in patients at risk for community-associated methicillin-resistant staphylococcus aureus infection. Ann Emerg Med. 2010;56(3):283–7.PubMedCrossRefGoogle Scholar
  50. 50.••
    Singer AJ, Thode HC Jr. Systemic antibiotics after incision and drainage of simple abscesses: a meta-analysis [published online ahead of print May 18 2013]. Emerg Med J. 2013. This systemic review provides further support for guidelines that emphasize the lack of benefit for antibiotics after incision and drainage of uncomplicated abscesses. Google Scholar
  51. 51.••
    Pallin DJ, Binder WD, Allen MB, Lederman M, Parmar S, Filbin MR, et al. Clinical trial: comparative effectiveness of cephalexin plus trimethoprim-sulfamethoxazole versus cephalexin alone for treatment of uncomplicated cellulitis: a randomized controlled trial. Clin Infect Dis. 2013;56(12):1754–62. This randomized controlled trial represents the best evidence to date that the addition of a CA- MRSA active antibiotic does not improve outcomes in uncomplicated cellulitis.PubMedCrossRefGoogle Scholar
  52. 52.
    Pichereau S, Rose WE. Invasive community-associated MRSA infections: epidemiology and antimicrobial management. Expert Opin Pharmacother. 2010;11(18):3009–25.PubMedCrossRefGoogle Scholar
  53. 53.
    Burke GV, Burner E, Sanko S. The microbiology of necrotizing fasciitis and associated mortality in an urban environment. Ann Emerg Med. 2013;62(4):S65.CrossRefGoogle Scholar
  54. 54.
    Shehab N, Patel PR, Srinivasan A, Budnitz DS. Emergency department visits for antibiotic-associated adverse events. Clin Infect Dis. 2008;47(6):735.PubMedCrossRefGoogle Scholar
  55. 55.
    Chua K, Laurent F, Coombs G, Grayson ML, Howden BP. Not community-associated methicillin-resistant staphylococcus aureus (CA-MRSA)! A clinician’s guide to community MRSA - its evolving antimicrobial resistance and implications for therapy. Clin Infect Dis. 2011;52(1):99–114.PubMedCrossRefGoogle Scholar
  56. 56.
    McDougal LK, Fosheim GE, Nicholson A, Bulens SN, Limbago BM, Shearer JES, et al. Emergence of resistance among USA300 methicillin-resistant staphylococcus aureus isolates causing invasive disease in the United States. Antimicrob Agents Chemother. 2010;54(9):3804–11.PubMedCentralPubMedCrossRefGoogle Scholar
  57. 57.
    Pate AJ, Terribilini RG, Ghobadi F, Azhir A, Barber A, Pearson JM, et al. Antibiotics for methicillin-resistant Staphylococcus aureus skin and soft tissue infections: the challenge of outpatient therapy. Am J Emerg Med. 2014;32(2):135–8.PubMedCrossRefGoogle Scholar
  58. 58.
    Fuller BM, Mohr N, Skrupky L, Mueller K, McCammon C. Emergency department vancomycin use: dosing practices and associated outcomes. J Emerg Med. 2013;44(5):910–8.PubMedCentralPubMedCrossRefGoogle Scholar
  59. 59.
    Leonard B, Johnson M, Bhan A, Pawlak J, Manzor O, Saravolatz LD. Changing epidemiology of community‐onset methicillin‐resistant staphylococcus aureus bacteremia. Infect Control Hosp Epidemiol. 2003;24(6):431–5.CrossRefGoogle Scholar
  60. 60.
    Roghmann M. Predicting methicillin resistance and the effect of inadequate empiric therapy on survival in patients with staphylococcus aureus bacteremia. Arch Intern Med. 2000;160(7):1001–4.PubMedCrossRefGoogle Scholar
  61. 61.
    Johnson SV, Hoey LL, Vance-Bryan K. Inappropriate vancomycin prescribing based on criteria from the Centers for Disease Control and Prevention. Pharmacotherapy. 1995;15(5):579–85.PubMedGoogle Scholar
  62. 62.
    Levy ER, Swami S, Dubois SG, Wendt R, Banerjee R. Rates and appropriateness of antimicrobial prescribing at an academic children’s hospital, 2007–2010. Infect Control Hosp Epidemiol Off J Soc Hosp Epidemiol Am. 2012;33(4):346–53.Google Scholar
  63. 63.
    Rybak MJ, Lomaestro BM, Rotschafer JC, Moellering RC, Craig WA, Billeter M, et al. Vancomycin therapeutic guidelines: a summary of consensus recommendations from the infectious diseases Society of America, the American Society of Health-System Pharmacists, and the Society of Infectious Diseases Pharmacists. Clin Infect Dis Off Publ Infect Dis Soc Am. 2009;49(3):325–7.CrossRefGoogle Scholar
  64. 64.
    Wright SW, Wrenn KD. Appropriateness of vancomycin use in the emergency department. Ann Emerg Med. 1998;32(5):531–6.PubMedCrossRefGoogle Scholar
  65. 65.
    Rosini JM, Grovola MR, Levine BJ, Jasani NB. Prescribing habits of vancomycin in the Emergency Department: are we dosing appropriately? J Emerg Med. 2013;44(5):979–84.PubMedCrossRefGoogle Scholar
  66. 66.
    May L, Harter K, Yadav K, Strauss R, Abualenain J, Keim A, et al. Practice patterns and management strategies for purulent skin and soft-tissue infections in an urban academic ED. Am J Emerg Med. 2012;30(2):302–10.PubMedCrossRefGoogle Scholar
  67. 67.
    Schmitz G, Goodwin T, Singer A, Kessler CS, Bruner D, Larrabee H, et al. The treatment of cutaneous abscesses: comparison of emergency medicine providers’ practice patterns. West J Emerg Med. 2013;14(1):23–8.PubMedCentralPubMedCrossRefGoogle Scholar
  68. 68.
    Walraven CJ, Lingenfelter E, Rollo J, Madsen T, Alexander DP. Diagnostic and therapeutic evaluation of community-acquired methicillin-resistant Staphylococcus Aureus (MRSA) skin and soft tissue infections in the emergency department. J Emerg Med. 2012;42(4):392–9.PubMedCrossRefGoogle Scholar
  69. 69.
    Pallin DJ, Camargo CA, Schuur JD. Skin Infections as Targets for Antibiotic Stewardship: Analysis of Emergency Department Prescribing Practices, 2007–2010. West J Emerg Med. 2014;0(0). http://escholarship.org/uc/item/5f16c3zs. Published Jan 6, 2014. Accessed 31 Mar 2014.
  70. 70.
    Itani KMF, Shorr AF. FDA guidance for ABSSSI trials: implications for conducting and interpreting clinical trials. Clin Infect Dis. 2014;58 Suppl 1:S4–9.PubMedCrossRefGoogle Scholar
  71. 71.
    Anstead GM, Cadena J, Javeri H. Treatment of infections due to resistant Staphylococcus aureus. Methods Mol Biol. 2014;1085:259–309.PubMedCrossRefGoogle Scholar
  72. 72.
    Moran GJ, Abrahamian FM, Lovecchio F, Talan DA. Acute bacterial skin infections: developments since the 2005 Infectious Diseases Society of America (IDSA) guidelines. J Emerg Med. 2013;44(6):e397–412.PubMedCrossRefGoogle Scholar
  73. 73.
    Prasad P, Sun J, Danner RL, Natanson C. Excess deaths associated with tigecycline after approval based on noninferiority trials. Clin Infect Dis. 2012;54(12):1699–709.PubMedCentralPubMedCrossRefGoogle Scholar
  74. 74.
    Itani KMF, Biswas P, Reisman A, Bhattacharyya H, Baruch AM. Clinical efficacy of oral linezolid compared with intravenous vancomycin for the treatment of methicillin-resistant Staphylococcus aureus-complicated skin and soft tissue infections: a retrospective, propensity score-matched, case–control analysis. Clin Ther. 2012;34(8):1667–73. e1.PubMedCrossRefGoogle Scholar
  75. 75.
    Yue J, Dong BR, Yang M, Chen X, Wu T, Liu GJ. Linezolid versus vancomycin for skin and soft tissue infections. Cochrane Database Syst Rev. 2013;7, CD008056.PubMedGoogle Scholar
  76. 76.
    Puzniak LA, Capitano B, Biswas P, Lodise TP. Impact of patient characteristics and infection type on clinical outcomes of patients who received linezolid or vancomycin for complicated skin and skin structure infections caused by methicillin-resistant Staphylococcus aureus: a pooled data analysis. Diagn Microbiol Infect Dis. 2014;78(3):295–301.PubMedCrossRefGoogle Scholar
  77. 77.
    Barriere SL. ATLAS trials: efficacy and safety of telavancin compared with vancomycin for the treatment of skin infections. Future Microbiol. 2010;5(12):1765–73.PubMedCrossRefGoogle Scholar
  78. 78.
    Stryjewski ME, Barriere SL, O’Riordan W, Dunbar LM, Hopkins A, Genter FC, et al. Efficacy of telavancin in patients with specific types of complicated skin and skin structure infections. J Antimicrob Chemother. 2012;67(6):1496–502.PubMedCrossRefGoogle Scholar
  79. 79.
    Marcos LA, Camins BC, Ritchie DJ, Casabar E, Warren DK. Acute renal insufficiency during telavancin therapy in clinical practice. J Antimicrob Chemother. 2012;67(3):723–6.PubMedCrossRefGoogle Scholar
  80. 80.
    Prokocimer P, De Anda C, Fang E, Mehra P, Das A. Tedizolid phosphate vs linezolid for treatment of acute bacterial skin and skin structure infections: the ESTABLISH-1 randomized trial. JAMA. 2013;309(6):559–69.PubMedCrossRefGoogle Scholar
  81. 81.
    Andrews S, Rivera S, Baner N, Goltser Y, Wu M, Chen A, et al. Intravenous home infusion therapy instituted from a 24-hour clinical decision unit decreases hospitalization for patients with cellulitis. Ann Emerg Med. 2013;62(4):S50.CrossRefGoogle Scholar
  82. 82.
    Brown GR. Cephalosporin-probenecid drug interactions. Clin Pharmacokinet. 1993;24:289–300.PubMedCrossRefGoogle Scholar
  83. 83.
    Garrett T, Harbort Y, Trebble M, Docherty T. Once or twice-daily, algorithm-based intravenous cephazolin for home-based cellulitis treatment. Emerg Med Australas. 2012;24(4):383–92.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Michael S. Pulia
    • 1
  • Mary R. Calderone
    • 2
  • John R. Meister
    • 1
  • Jamie Santistevan
    • 1
  • Larissa May
    • 3
  1. 1.Department of Emergency MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonUSA
  2. 2.Department of Emergency MedicineUniversity of MichiganAnn ArborUSA
  3. 3.Department of Emergency Medicine and Medicine-Section of Infectious DiseaseThe George Washington University School of MedicineWashingtonUSA

Personalised recommendations