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Guidelines
Purulent SSTI

Purulent SSTI

Applies to the following:

  • Abscesses, Furuncles, Carbuncles, and Boil (with or without cellulitis)
  • Deep Soft Tissue Abscess

Mild, without cellulitis (outpatient)

Incision and drainage (I&D) alone

Moderate, with or without cellulitis

Cephalexin
​

PO for outpatients

OR

Cefazolin
​

IV for inpatients

If there are risk factors for MRSA or failed 1st-line outpatient treatment despite adequate adherence:

Severe, with or without cellulitis

For deep soft tissue abscess (e.g. pyomyositis), broader coverage may be required depending on location of abscess, or patient risk factors (e.g. immunocompromised)

Confirmed or Suspected MRSA (Outpatient)

If there are risk factors for MRSA or failed 1st-line outpatient treatment despite adequate adherence

Trimethoprim-Sulfamethoxazole
​

TMP-SMX does not cover Streptococcal infections

OR

Clindamycin
​

Use Clindamycin if Group A strep is strongly suspected despite failure of 1st-line treatment, and < 8 years old

OR

Doxycycline
​

If ≥8 years old