Surgery>>>>>The Skin and Subcutaneous Tissue
Question 6#

Initial treatment of non purulent, complicated cellulitis is:

A. Vancomycin
B. β-lactam
C. Linezolid
D. Clindamycin

Correct Answer is B

Comment:

Treatment of nonpurulent, complicated cellulitis can begin with a β-lactam, with methicillin-resistant Staphylococcus aureus (MRSA) coverage added if no response is observed. Empiric MRSA coverage is warranted in all other complicated skin and subcutaneous infections. Vancomycin is the mainstay of therapy, although it is inferior to β-lactams for methicillin-sensitive S. aureus (MSSA) and has a relatively slow onset of efficacy in vitro. Linezolid, daptomycin, tigecycline, and telavancin are other FDA-approved alternatives for MRSA treatment. Clindamycin is also approved for S. aureus; however, resistance may develop, and diarrhea can occur in up to 20% (Clostridium difficile related).