Background: Methicillin-resistant Staphylococcus aureus (MRSA) has been increasingly causing skin and soft tissue infections (SSTIs). Only limited studies have made comparisons between incision and drainage (I&D) alone and I&D with adjunctive antibiotic therapy for treatment effects, and most of the studies were conducted before the emergence of MRSA. This study was to evaluate whether antibiotics provide added benefit to I&D alone for purulent MRSA SSTIs.
Methods: This retrospective study collected data on SSTI patients, including patient demographics, treatment strategies, antibiotic susceptibilities of the infecting MRSA isolates, and clinical outcomes over the course of 24 months.
Results: Antimicrobial drug susceptibility rate were 100% for vancomycin, teicoplanin, and linezolid. Among the 211 patients, 7.6% were treated solely with I&D (Group A), 62.6% were treated via I&D with adjunctive antibiotic (Group B), and 29.8% patients received only antibiotics (Group C). The cure rate was highest in Group A (93.8%), followed by Group B (90.9%) and Group C (77.8%). Combining Group B and Group C, patients who were treated appropriately demonstrated a higher cute rate (91.3% vs. 75.4%, p = 0.005). Multivariate analysis showed that Group B was more likely to be successfully treated compared to Group C (odds ratio = 2.51, 95% confidence interval = 1.01-6.25, p = 0.047), whereas no difference between Group A and Group B was found (odds ratio = 2.09, 95% confidence interval = 0.20-22.34, p = 0.542, data not shown).
Conclusion: Surgical intervention is the definitive therapy for purulent SSTIs. Adjunctive antibiotic therapy increased the cure rate and appropriateness of prescription is influential.
Keywords: adjunctive antibiotic therapy; antibiotics susceptibility; incision and drainage; methicillin-resistant Staphylococcus aureus; purulent skin and soft tissue infections.
Copyright © 2014. Published by Elsevier B.V.