Management of Skin Abscesses in the Era of Methicillin-Resistant Staphylococcus aureus

• Published in: The New England journal of medicine Vol. 370; no. 11; pp. 1039 - 1047
• Main Authors: Singer, Adam J, Talan, David A
• Format: Journal Article
• Language: English
• Published: Waltham, MA Massachusetts Medical Society 13.03.2014
• Subjects: Abscess - diagnosis; Abscess - therapy; Abscesses; Anti-Bacterial Agents - therapeutic use; Antibiotics; Bacterial diseases; Biological and medical sciences; Combined Modality Therapy; Drainage; Drug resistance; Family physicians; General aspects; Human bacterial diseases; Humans; Infectious diseases; Medical sciences; Methicillin; Methicillin-Resistant Staphylococcus aureus; Pediatrics; Skin; Staphylococcal infections, streptococcal infections, pneumococcal infections; Staphylococcal Skin Infections - diagnosis; Staphylococcal Skin Infections - therapy; Staphylococcus aureus; Staphylococcus infections; Therapeutic Irrigation; Ultrasonic imaging; Ultrasound; Wound healing; Infection; Medicine; Clinical management; Abscess; Bacteriosis; Bacteria; Micrococcales; Micrococcaceae; Skin; Staphylococcal infection; Staphylococcus aureus
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMra1212788

The incidence of abscesses is increasing, and community-acquired methicillin-resistant Staphylococcus aureus (MRSA) has become common. This review explains the role of ultrasonography and provides guidance on the management of skin abscesses and the use of antibiotics. Abscesses are one of the most common skin conditions managed by general practitioners and emergency physicians. The incidence of skin abscesses has increased, 1 – 5 and this increase has coincided with the emergence of community-associated methicillin-resistant Staphylococcus aureus (MRSA). In many parts of the world, MRSA infections are now the most common cause of skin abscesses. 6 Community-associated MRSA has also been found to cause severe infections — including necrotizing pneumonia, necrotizing fasciitis, purpura fulminans, and severe sepsis — in nonimmunocompromised hosts; however, its apparently increased virulence as compared with that of health care–associated strains and methicillin-susceptible S. aureus is incompletely understood. . . .