What is the treatment for Staphylococcal (Staph) skin infection?

From the Guidelines

For a typical staphylococcal skin infection, start with topical antibiotic treatment using mupirocin 2% ointment, applied to the affected area three times daily for 5 days, as recommended by the Infectious Diseases Society of America 1.

Key Considerations

• Keep the area clean and dry, and cover it with a sterile bandage if it's oozing or in an area prone to friction.
• If the infection is more widespread or severe, oral antibiotics may be necessary.
• For patients with methicillin-resistant Staphylococcus aureus (MRSA) infections, oral antibiotics such as clindamycin, trimethoprim-sulfamethoxazole, or doxycycline may be used, as recommended by the Infectious Diseases Society of America 2.
• Incision and drainage is the primary treatment for cutaneous abscesses, and antibiotic therapy may be recommended in certain cases, such as severe or extensive disease, or rapid progression in presence of associated cellulitis 3.

Oral Antibiotic Options

• Cephalexin 500 mg taken orally four times daily for 7-10 days is often prescribed for patients with methicillin-susceptible Staphylococcus aureus infections.
• For patients allergic to penicillin, clindamycin 300-450 mg taken orally three times daily for 7-10 days is an alternative.
• Trimethoprim-sulfamethoxazole, doxycycline, or linezolid may be used as empirical therapy for CA-MRSA infections, pending culture results 4.

Prevention and Control

• Wash your hands frequently and avoid sharing personal items to prevent spread.
• If symptoms worsen, you develop a fever, or the infection doesn't improve after 2-3 days of treatment, seek medical attention immediately.
• Staphylococcal bacteria can quickly multiply and spread, so prompt and appropriate treatment is crucial to prevent more serious complications.

Recent Guidelines

• The 2018 WSES/SIS-E consensus conference recommends the use of linezolid, trimethoprim-sulfamethoxazole, or a tetracycline (doxycycline or minocycline) for oral antibiotic coverage of MRSA in patients with skin and soft-tissue infections 4.
• The Infectious Diseases Society of America recommends incision and drainage as the primary treatment for cutaneous abscesses, with antibiotic therapy recommended in certain cases 3.

From the FDA Drug Label

Vancomycin Hydrochloride for Injection, USP is indicated for the treatment of serious or severe infections caused by susceptible strains of methicillin-resistant (β-lactam-resistant) staphylococci Its effectiveness has been documented in other infections due to staphylococci, including septicemia, bone infections, lower respiratory tract infections, skin and skin structure infections.

The treatment for Staphylococcal (Staph) skin infection is vancomycin.

• It is effective for the treatment of skin and skin structure infections caused by susceptible strains of staphylococci.
• When staphylococcal infections are localized and purulent, antibiotics (such as vancomycin) are used as adjuncts to appropriate surgical measures 5.

From the Research

Treatment Overview

• The treatment of Staphylococcal (Staph) skin infections typically involves a combination of cleansing with antibacterial agents, removal of crusts, application of warm compresses, and the use of topical or systemic antibiotics, depending on the severity of the infection and the type of pyoderma involved 6.
• Antibiotic choice is predicated by the infection severity, local susceptibility patterns, and drug-related safety, tolerability, and cost 7.
• Definitive antibiotic therapy is warranted, although there are no compelling data demonstrating superiority of any one antibiotic over another 7.

Antibiotic Therapy

• Empiric therapy should be given to cover methicillin-resistant S aureus, as many disease-causing S aureus strains are methicillin resistant 7.
• Bacterial wound cultures are important for characterizing local susceptibility patterns 7.
• Response to therapy is expected within the first days; 5 to 7 days of therapy is typically adequate to achieve cure 7.

Alternative Therapeutic Approaches

• Targeting the quorum-sensing signaling pathway or anti-toxin therapy is a promising therapeutic approach supportive of primary antibiotic therapy 8.
• Using vaccines to control S aureus cutaneous infections is an alternative strategy with potential effectiveness 9.

General Management

• Early recognition and timely intervention are the hallmarks of appropriate management 10.
• Initial empiric therapy should be directed towards a broad spectrum of pathogens that include staphylococcus and streptococcus 10.