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Chapter 73. Skin and Skin Structure Infections

Student Questions

Which of the following treatment strategies for impetigo is true?

A. Topical antibiotics, like mupirocin, should be utilized first because of their enhanced efficacy.

B. Macrolide antibiotics, such as erythromycin, are typically preferred first-line because of their low rates of staphylococcal and GAS resistance.

C. Because of the potential for severe complications associated even with mild impetigo, IV antibiotic therapy is the most appropriate treatment option.

D. First-generation cephalosporins and penicillinase-stable penicillins are considered first-line treatment when oral therapy is indicated.

Answer: D

Option A: Incorrect. While topical antibiotics may be used alone in very mild cases, oral therapy is preferred when antibiotics are indicated for impetigo.

Option B: Incorrect. Macrolides have high rates of staphylococcal and GAS resistance.

Option C: Incorrect. Severe complications from impetigo, which would require IV antibiotic therapy are rare.

Option D: Correct. First-generation cephalosporins and penicillinase-stable penicillins provide coverage for staphylococcal and streptococcal species, the most common causes of impetigo.

A 54-year-old obese male with type 2 diabetes mellitus is diagnosed with a carbuncle. Following assessment, which of the following strategies would be the first step in treating this infection?

A. Daily cleansing with soap and water

B. Warm moist compresses

C. Application of a topical antibiotic

D. Incision and drainage

Answer: D

Option A: Incorrect. Incision and drainage are indicated for treatment of carbuncles, whereas adequate skin hygiene, such as daily cleansing, is a prevention strategy for recurrence.

Option B: Incorrect. Warm compresses may be a sole treatment strategy for folliculitis and mild furuncles, not carbuncles.

Option C: Incorrect. Oral therapy is most appropriate for carbuncles when antibiotics are indicated.

Option D: Correct. Incision and drainage is indicated for the treatment of carbuncles.

Which of the following antibiotics is most appropriate for the initial treatment of CA-MRSA ABSSSI in an otherwise healthy individual?

A. Clindamycin

B. Amoxicillin-clavulanate

C. Cephalexin

D. Moxifloxacin

Answer: A

Option A: Correct. Clindamycin (as well as trimethoprim-sulfamethoxazole, doxycycline, and linezolid) is one of the recommended oral options that provides CA-MRSA coverage.

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