Purulent SSTI

Purulent SSTI

Routine Practices

If Staphyloccus aureus (MSSA), patient should be managed on Contact precautions if the access/wound cannot be contained by a dressing or until draining ceases.

If MRSA, patient should be managed on Contact precautions.

  • Ensure incision and drainage, regardless of severity or presence of cellulitis
  • Obtain purulent specimens for Gram stain, culture, and susceptibility testing, given prevalence of MRSA
  • Up to 25% of purulent cellulitis will be caused by community-acquired MRSA. If 1st-line therapy does not cover MRSA, monitor closely for treatment response and follow-up cultures.
  • TMP-SMX does not cover Streptococcal infections.
  • Use Clindamycin or Doxycycline if Group A strep is strongly suspected despite failure of 1st-line treatment.


Duration of Therapy

  • 5-7 days
  • Antibiotics may not be required if isolated lesion, without cellulits and adequate incision and drainage

More Information

Lancet Infect Dis 2016; 16: e139–52; J Pediatr. 2016 Feb;169:128-134.e1. Epub 2015 Nov 11.
For Treatment of Neonates: CPS Statement “Management of community-associated methicillin-resistant Staphylococus aureus skin abscesses in children"