The American journal of emergency medicine
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Skin and soft tissue infections (SSTIs) are common and contribute significantly to morbidity and healthcare costs in emergency departments (EDs). The rise of antimicrobial resistance, particularly due to community-acquired methicillin-resistant Staphylococcus aureus (MRSA), complicates treatment decisions. Objective physical examination findings suggesting need for empiric MRSA coverage are sometimes ignored. Improving initial antimicrobial selection in the ED, especially regarding MRSA, could enhance antimicrobial stewardship. ⋯ Several factors, not always aligned with clinical guidelines, influenced the decision to initiate MRSA coverage in the ED. Understanding these determinants may improve antimicrobial stewardship and reduce costs. Future research should focus on patient outcomes based on methicillin-sensitive S. aureus (MSSA) versus MRSA coverage decisions and educational initiatives to improve guideline compliance.