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Emergency Medicine


Answer 4
  1. TMP-SMX orally. Oral TMP-SMX is the appropriate treatment for a well-appearing patient with CA-MRSA. CA-MRSA isolates have high rates of susceptibility to TMP-SMX, rifampin, vancomycin, and linezolid.7,8 Many isolates of CA-MRSA are resistant to fluoroquinolones and erythromycin; thus, these antibiotics are not recommended to treat CA-MRSA infection. In most areas, clindamycin and doxycycline are potential treatment options. It is important for clinicians to be aware of local organism susceptibility patterns to appropriately treat MRSA infection.

    REFERENCES
    7. convened Experts’ Meeting on Management of MRSA in the Community. Strategies for clinical management of MRSA in the community: summary of an experts’ meeting convened by the Centers for Disease Control and Prevention. 2006. Available at www.cdc.gov/ncidod/dhqp/pdf/ar/CAMRSA_ExpMtgStrategies.pdf. Accessed 28 Nov 2007.

    8. Abrahamian FM, Shroff SD. Use of routine wound cultures to evaluate cutaneous abscesses for community-associated methicillin-resistant Staphylococcus aureus. Ann Emerg Med 2007;50:66–7.

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