Clinical 2 – Antibiotics Latest exam (Q&A) Skin & Soft Tissue Infections

Clinical 2 – Antibiotics Latest
exam (Q&A)
Skin & Soft Tissue Infections


1
Q
What is an abscess?
A
 pocket
 contained
 has fluid, inflammatory cells, could have bacteria
2
Q
Describe the main types of skin abscesses
A
 In dermis and deeper structures, painful red nodule with erythema;
furuncles (boils) in hair follicle, inflammatory nodule with overlying
pustule collection in dermis and deeper structures; carbuncles
includes collection of furuncles
 Most commonly back in neck, face, axillae
3
Q
What is the most common pathogen of Skin Abscesses?
A
S. aureus (75% of cases)

,4
Q
What is the approach for treatment of a skin abscess?
A
1) Drainage +/- moist heat compresses x 30 min, 3-4 x daily for small
lesions or surgical incision and drainage for larger lesions
2) Antimicrobial therapy for abscesses > 2 cm, multiple lesions,
extensive cellulitis, systemic signs of infection, indwelling medical
device or immunocompromised
5
Q
What are systemic signs of infection?
A
temp > 38, tachypnea > 24/min, tachycardia > 90/min, WBC > 12000
or < 4000
6
Q
What are the 2 antibiotics for 1st line therapy for Skin Abscesses ?
A
Cloxacillin
Cephalexin
7
Q
What is 2nd line therapy for Skin Abscesses if they have a severe B
lactam allergy?
A

, Clindamycin
8
Q
List 2 important points about Clindamycin
A
 # 1 antibiotic associated with C. dif
- We are seeing increasing resistance in S. aureus
9
Q
What would indicate a severe B lactam allergy?
A
 anaphylaxis
 severe rash
 hives
 angioedema (swelling of tongue, lips, face)
10
Q
What are the risk factors for skin abscesses being MRSA?
A
 MRSA colonization
 close contact with MRSA infection
 previous antimicrobials or S. aureus infection particularly if
treatment failure with regimen that lacked MRSA coverage
11
Q
When is CA-MRSA prevalent?