SSTI Flashcards
what cells contribute to the innate immune system
keratinocytes and langerhan cells (epidermis)
what are the three main bacteria living on the skin?
staphylococcus
corynebacterium
propionibacterium ( most common, gram positive )
are cultures useful in non purulent infections?
no
what should patients with purulent infections get?
incisions & drainage + cultures
what should patients with systemic signs of infections receive
parenteral antibiotics at least until clinical improvements
SIRS
febrile (>100.4 )
hypothermic (<96.8)
RR >24 breath/min
leukocytosis
leukopenic
what are the 3 tenants of infectious diseases
source control x3
Impetigo causative organism
Group A streptococcus
Impetigo Treatment nonpharm
local wound care
Impetigo treatment
mild, low risk of transmission
topical abx
mupirocin or retapamulin BID
Impetigo
mild, multiple
PO abx with GAS and/or MSSA coverage
Penicillin
Amoxicillin-clav
cephalexin
clindamycin
dicloxacillin
Impetigo treatment
expensive lesions and /or failed initial therapy
consider PO MRSA coverage
SMX/TMP
Doxycycline
Linezolid
duration of therapy for Impetigo
5-7 days ( 5 for mild and 7 for more extensive disease)
impetigo is non purulent or purulent
non purulent
ecthyma causative organisms
Group A strept
MSSA/MSRA
Ecthyma treatment
mild
PO abx with GAS and/ or MSSA
Penicillin
Amoxicillin-clav
cephalexin
clindamycin
dicloxacillin
Ecthyma treatment
extensive lesions and/or failed
consider PO MRSA coverage
SMX/TMP
Doxycycline
Linezolid
Erysipelas/cellulitis causative organisms
pain, erythema/redness, warmth, swelling–> fever/chills, malaise, lymphangitis
Group A street
MRSA/MSSA
Group G, C
Erysipelas/cellulitis treatment
without systemic symptom of infections
streptococcus coverage
Penicillin
nafcillin/oxacillin
cephalexin
cefazolin
clindamycin
Erysipelas/cellulitis treatment
cellulitis with MRSA risk factors or critically ill
strep + MRSA coverage
Vanco
Linazolid
Daptomycin
ceftaroline
Clindamycin
what is the duration of ecthyma treatment
7 days
what is the duration for Erysipelas/cellulitis treatment with mild disease & hemodynamic stability treated PO
5 days but can be extended
ecthyma is non purulent or purulent
non purulent
erysipelas/ cellulitis is non purulent or purulent
non purulent