Management of skin and soft-tissue infection - Polling results

The management of skin and soft-tissue abscess remains controversial. A healthy debate is ongoing about whether drainage alone or drainage with systemic therapy is the appropriate treatment for affected patients. As noted by the discussants of our Clinical Decisions article and by the many respondents, the same body of literature can be used to support various treatment approaches. A common theme emerged from the participants who chose incision and drainage plus either type of systemic antimicrobial therapy: the antimicrobial spectrum of the agent (anti-MRSA or anti-MSSA) should be chosen on the basis of the patient's exposures and the local epidemiologic data. Although community-acquired MRSA has become increasingly prevalent in many parts of North America, it remains uncommon in some parts of the continent and in many other parts of the world. As infectious organisms evolve and migrate, so must our treatment strategies. Comments from the interactive feature will remain available at www.nejm.org, along with data on the voting results. We thank you for your participation, and we look forward to hearing from you again soon about another challenging case. Copyright © 2008 Massachusetts Medical Society. All rights reserved.