Fast Five Quiz: Staphylococcal Infections

Michael Stuart Bronze, MD


September 08, 2021

According to IDSA guidelines, Gram stain and culture of the pus or exudates from skin lesions of impetigo and ecthyma are recommended to help identify whether S aureus and/or beta-hemolytic Streptococcus is the cause; however, treatment without these studies is reasonable in typical cases. Gram stain and culture of pus from inflamed epidermoid cysts are not recommended.

According to the IDSA, for patients with cellulitis that is associated with penetrating trauma, evidence of MRSA infection elsewhere, nasal colonization with MRSA, injection drug use, or systemic inflammatory response syndrome, vancomycin or another antimicrobial effective against both MRSA and streptococci is recommended. Prophylactic antibiotics (eg, oral penicillin, erythromycin) twice daily for 4-52 weeks, or intramuscular benzathine penicillin every 2-4 weeks, may be considered in patients who have three to four episodes of cellulitis per year despite prevention strategies.

Read more about the workup of S aureus infection.


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