Skin and soft tissue infections

3 types: primary infection developing on previously intact skin, secondary infections developing on a skin lesion already present and tertiary infections developing from an underlying systemic infection.

In 2005 skin and skin infections accounted for approximately 14.2 million outpatient visits and more than 850,000 hospital administrations.

Acute bacterial skin and skin structure infections, including cellulitis or erysipelas, major cutaneous abscesses, and wound infections can be life-threatening and may require surgery and hospitalization along with antibiotics.

Skin and skin structure infections frequently resistant to antibiotics.

Skin infections associated with major complications including bacteremia, hospitalization and death.

Usually caused by gram positive cocci, but gram negative and anaerobic bacteria may play a role.

Most infections resolve after antibiotic and/or surgical management.

Most cultures of skin infections are caused by methicillin resistant Stpaphylococcus aureus (MRSA).

Occasionally results in complications such as glomerulonephritis, endocarditis, osteomyelitis, necrotizing fasciitis, toxic shock syndrome and sepsis.

Timely treatment associated with lower morbidity and possibly lower mortality and less likely to develop resistance to antibacterials.

Most widely used drugs in the past were macrolides and beta-lactams, but with lack of effectiveness against Pseudomonas aeruginosa and the emergence of resistance in staphylococcal and streptococcal strains fluoroquinolones and broad spectrum third generation beta-lactams have been proven to be effective agents.

Linezolid only anabiotic approved for complicated skin and skin structure infections caused by MRSA.

Among patients with closed extremity fractures, skin antisepsis with iodine povacrylex in alcohol resulted in fewer surgical site infections, than antisepsis with chlorhexidine gluconate in alcohol.

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