Treatment for ecthyma should be an oral antimicrobial. Bullous and nonbullous impetigo can be treated with oral or topical antimicrobials, but oral therapy is recommended for patients with numerous lesions or in outbreaks affecting several people to help decrease transmission of infection.Gram stain and culture of the pus or exudates from skin lesions of impetigo and ecthyma are recommended to help identify whether Staphylococcus aureus and/or a β-hemolytic Streptococcus is the cause (strong, moderate), but treatment without these studies is reasonable in typical cases (strong, moderate).What Is Appropriate for the Evaluation and Treatment of Impetigo and Ecthyma? Recommendations (Abridged) Impetigo and Ecthyma A detailed description of the methods, background, and evidence summaries that support each of the recommendations can be found in the full text of the guidelines. The panel followed a process used in the development of other Infectious Diseases Society of America (IDSA) guidelines, which included a systematic weighting of the strength of recommendation and quality of evidence using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) system (Table 1). In addition, Figure 2 is provided to simplify the approach to patients with surgical site infections. Figure 1 was developed to simplify the management of localized purulent staphylococcal infections such as skin abscesses, furuncles, and carbuncles in the age of methicillin-resistant Staphylococcus aureus (MRSA). Summarized below are the recommendations made in the new guidelines for skin and soft tissue infections (SSTIs). Keywords: antibiotics, cellulitis, neutropenia, fever, necrotizing fasciitis, immunocompromised host, infection, diagnosis, pathogenic organism, antimicrobials, skin and soft tissue infections, infectious diseases society of america Executive Summary These guidelines emphasize the importance of clinical skills in promptly diagnosing SSTIs, identifying the pathogen, and administering effective treatments in a timely fashion. In addition, because of an increasing number of immunocompromised hosts worldwide, the guideline addresses the wide array of SSTIs that occur in this population. The focus of this guideline is the diagnosis and appropriate treatment of diverse SSTIs ranging from minor superficial infections to life-threatening infections such as necrotizing fasciitis. The panel's recommendations were developed to be concordant with the recently published IDSA guidelines for the treatment of methicillin-resistant Staphylococcus aureus infections. Medical Education Community of PracticeĪ panel of national experts was convened by the Infectious Diseases Society of America (IDSA) to update the 2005 guidelines for the treatment of skin and soft tissue infections (SSTIs).Fellows-In-Training Career & Education Center.myIDSA Practice Managers Community Opt-in Form.Antimicrobial Stewardship Centers of Excellence Program.
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