From the Guidelines
Skin staph infections are typically treated with antibiotics, and the first-line treatment often includes incision and drainage of any abscesses, as well as oral antibiotics such as clindamycin, trimethoprim-sulfamethoxazole, or a tetracycline. The choice of antibiotic depends on the severity of the infection and the presence of methicillin-resistant Staphylococcus aureus (MRSA) 1. For outpatients with purulent cellulitis, empirical therapy for CA-MRSA is recommended pending culture results, and options include clindamycin, trimethoprim-sulfamethoxazole, or a tetracycline 2, 3, 4, 5.
Some key points to consider in the treatment of skin staph infections include:
- Incision and drainage of any abscesses is a crucial step in the treatment of skin staph infections, especially for simple abscesses or boils 2, 3, 4, 5.
- Oral antibiotics such as clindamycin, trimethoprim-sulfamethoxazole, or a tetracycline are commonly used to treat skin staph infections, and the choice of antibiotic depends on the severity of the infection and the presence of MRSA 2, 3, 4, 5, 1.
- For more severe infections or those caused by MRSA, alternative antibiotics such as linezolid or tedizolid may be necessary 1.
- It's essential to complete the full course of antibiotics as prescribed, even if symptoms improve, to prevent antibiotic resistance 2, 3, 4, 5, 1.
- If symptoms worsen or don't improve after a few days of treatment, it's crucial to consult a healthcare provider for reevaluation 2, 3, 4, 5, 1.
In terms of specific antibiotic regimens, the following options are recommended:
- Clindamycin (300-450 mg orally three times daily for 7-10 days) 2, 3, 4, 5
- Trimethoprim-sulfamethoxazole (1-2 double-strength tablets twice daily for 7-10 days) 2, 3, 4, 5
- A tetracycline (such as doxycycline or minocycline) (100 mg orally twice daily for 7-10 days) 2, 3, 4, 5
- Linezolid (600 mg orally twice daily for 7-10 days) 1
- Tedizolid (200 mg orally once daily for 7-10 days) 1
It's essential to note that the treatment of skin staph infections should be individualized based on the patient's clinical response and the severity of the infection 2, 3, 4, 5, 1.
From the FDA Drug Label
DOSAGE AND ADMINISTRATION Bacteriologic studies to determine the causative organisms and their susceptibility to oxacillin should always be performed. Duration of therapy varies with the type of severity of infection as well as the overall condition of the patient, therefore it should be determined by the clinical and bacteriological response of the patient In severe staphylococcal infections, therapy with oxacillin should be continued for at least 14 days. RECOMMENDED DOSAGES FOR OXACILLIN FOR INJECTION, USP Oxacillin 250 to 500 mg IM or IV every 4 to 6 hours (mild to moderate infections) 1 gram IM or IV every 4 to 6 hours (severe infections)
The treatment for Staphylococcus (Staph) skin infection is oxacillin. The recommended dosage is:
- 250 to 500 mg IM or IV every 4 to 6 hours for mild to moderate infections
- 1 gram IM or IV every 4 to 6 hours for severe infections. Therapy should be continued for at least 14 days in severe staphylococcal infections, and for at least 48 hours after the patient has become afebrile, asymptomatic, and cultures are negative 6.
DOSAGE AND ADMINISTRATION The penicillinase-resistant penicillins are available for oral administration and for intramuscular and intravenous injection. In severe staphylococcal infections, therapy with penicillinase-resistant penicillins should be continued for at least 14 days. RECOMMENDED DOSAGES FOR DICLOXACILLIN SODIUM, USP IN MILD TO MODERATE AND SEVERE INFECTIONS Dicloxacillin 125 mg every 6 hours (mild to moderate infections) 250 mg every 6 hours (severe infections)
Alternatively, dicloxacillin can be used to treat Staphylococcus (Staph) skin infection. The recommended dosage is:
- 125 mg every 6 hours for mild to moderate infections
- 250 mg every 6 hours for severe infections. Therapy should be continued for at least 14 days in severe staphylococcal infections 7.
From the Research
Treatment Options for Staphylococcus Skin Infections
- Topical treatment with retapamulin, fusidic acid, and mupirocin has been shown to be effective in reducing bacterial loads in skin lesions 8
- Systemic treatment with linezolid and vancomycin may be used to manage more severe infections, although topical treatment may be more effective in some cases 8, 9
- Clindamycin may be used as an empiric treatment for stable patients without bacteremia, while linezolid and vancomycin are alternatives for more ill patients 9
- Mupirocin 2% ointment has been proven to be effective and safe in the treatment of primary and secondary skin infections, including those caused by Staphylococcus aureus 10, 11
Specific Treatment Recommendations
- For impetigo and other primary skin infections, 2% mupirocin ointment has been shown to be effective 10, 11, 12
- For more severe infections, such as those requiring hospitalization, systemic antibiotics like vancomycin may be necessary 9
- For patients with methicillin-resistant Staphylococcus aureus (MRSA) infections, topical treatment with retapamulin or mupirocin may be effective alternatives to systemic treatment with linezolid or vancomycin 8
Considerations for Treatment
- The choice of treatment should be based on the severity of the infection, the presence of any underlying conditions, and the susceptibility of the infecting organism to antibiotics 9, 12
- Topical treatment may be preferred for mild to moderate infections, while systemic treatment may be necessary for more severe infections 8, 9