the Management of Skin and Soft Tissue Infections

- Introduction

This practice guideline provides recommendations for the diagnosis and management of skin and soft tissue infections (SSTIs) in all age groups. These recommendations take on new importance because of a dramatic increase in the frequency and severity of infections and the emergence of resistance to many of the antimicrobial agents commonly used to treat SSTIs in the past, ⁽¹⁾.

These infections have diverse etiologies that depend, in part, on different epidemiological settings. As a result, obtaining a careful history that includes information about the patient's immune status, geographic locale, travel history, recent trauma or surgery, previous antimicrobial therapy, lifestyle, hobbies, is essential when developing an adequate differential diagnosis and an appropriate index of suspicion for specific etiological agents. In some cases, this information is insufficient and biopsy or aspiration of tissue may be necessary. In addition, radiographic procedures may be critical in a small subset of patients to determine the level of infection and the presence of gas, abscess, or a necrotizing process. Last, surgical exploration or debridement is an important diagnostic, as well as therapeutic, procedure in patients with necrotizing infections or myonecrosis and may be important for selected immunocompromised hosts, ⁽²⁾.