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Volume 48, Number 5, October 2015

Management and outcome of adults with skin and soft tissue infection caused by methicillin-resistant Staphylococcus aureus in a tertiary hospital in central Taiwan 


Soon-Hian Teh, Chih-Yu Chi, Po-Chang Lin, Cheng-Mao Ho, Chia-Hui Chou, Chia-Ta Tsai, Jen-Hsien Wang, Mao-Wang Ho


Received: April 30, 2014    Revised: August 26, 2014    Accepted: August 28, 2014   

 

Corresponding author:

Mao-Wang Ho, Corresponding author. Division of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, 2 Yu-Der Road, Taichung 40447, Taiwan.
 



 

Background and purpose: 

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. 



 

Key words:

adjunctive antibiotic therapy, antibiotics susceptibility, incision and drainage, methicillin-resistant Staphylococcus aureus, purulent skin and soft tissue infections