Primary care clinicians' perspectives on management of skin and soft tissue infections: an Iowa Research Network study

J Rural Health. Summer 2011;27(3):319-28. doi: 10.1111/j.1748-0361.2010.00347.x. Epub 2010 Nov 15.


An estimated 95,000 people developed methicillin-resistant Staphylococcus aureus (MRSA) infections during 2005 of which 14% were community-associated and 85% were hospital or other health setting associated, and 19,000 Americans died from these infections that year.

Purpose: To explore health care providers' perspectives on management of skin and soft tissue infections to gain a better understanding of the problems faced by busy providers in primary care settings.

Methods: Focus group meetings were held at 9 family physician offices in the Iowa Research Network. Seventy-eight clinicians including physicians, nurses, nurse practitioners, and house officers attended. Meeting audiotapes were transcribed and coded by 3 investigators, and a MRSA-management taxonomy was developed.

Findings: The main themes that emerged from the focus groups included epidemiology, diagnosis, treatment, management, prevention, special populations, and public relations. The incidence of MRSA infections was perceived to have increased over the past decade. However, diagnosis and treatment protocols for physicians in the outpatient setting have lagged behind, and no well-accepted diagnostic or treatment algorithms were used by physicians attending the focus groups.

Conclusion: The clinicians in this study noted considerable confusion and inconsistency in the management of skin and soft tissue infections, particularly those due to MRSA.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use
  • Attitude of Health Personnel
  • Community-Acquired Infections / diagnosis
  • Community-Acquired Infections / drug therapy
  • Community-Acquired Infections / epidemiology*
  • Female
  • Focus Groups
  • Humans
  • Iowa
  • Male
  • Methicillin-Resistant Staphylococcus aureus*
  • Middle Aged
  • Physicians, Primary Care / psychology*
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Primary Health Care / organization & administration*
  • Rural Health Services / organization & administration*
  • Rural Population / statistics & numerical data
  • Soft Tissue Infections / diagnosis
  • Soft Tissue Infections / drug therapy
  • Soft Tissue Infections / epidemiology*
  • Staphylococcal Skin Infections / diagnosis
  • Staphylococcal Skin Infections / drug therapy


  • Anti-Bacterial Agents