selleck chem Nutlin-3a patients admitted to the hospital were more likely to receive antibiotics in the ED to which the resultant pathogen was susceptible than those discharged home. Age group was strongly associated with treatment with two or more antistaphylococcal antibiotics, with adult patients more likely than pediatric patients to receive such multiple antibiotic coverage. Black patients Inhibitors,research,lifescience,medical were less likely than non-black patients to receive multi-drug coverage. However, when age and race were considered jointly as correlates, only adult age remained associated with greater “double coverage” usage. There were no demographic or clinical

factors identified in association Inhibitors,research,lifescience,medical with discordance between presence or absence of empiric anti-MRSA antibiotic therapy

and the presence or absence of MRSA among those undergoing culture and receiving antibiotics. Discussion Emergency clinicians routinely make decisions for SSTIs based on incomplete information; treatment guidelines remain vague regarding when antibiotics are indicated, information about local epidemiology is often incomplete, and microbiologic data for individual patients are not available in the time frame of an ED visit. In this Inhibitors,research,lifescience,medical study, we identified a population of ED patients with presumed community-acquired SSTIs in whom S. aureus remained the most common pathogen and for whom antibiotic prescription remained high. Despite the prevalence of S. aureus as the target of therapy, antibiotic regimens varied significantly. Among patients who underwent culture and received antibiotics, discordance between the choice to treat empirically

with anti-MRSA antibiotics and the presence or absence of the resistant organism in culture was Inhibitors,research,lifescience,medical high; patients were often treated narrowly for MRSA infections, or broadly for MSSA infections. The microbiology of skin abscesses does not appear to be our site uniform; resistance patterns from our sample differed between children and adults. Increased Inhibitors,research,lifescience,medical resistance to TMP/SMX – among the most commonly-used antibiotics in SSTIs – was noted, particularly in MSSA isolated from children. AV-951 Though the number of pediatric MSSA infections was a small proportion of the total number of patients, 20 of the 49S. aureus cultures from children were MSSA. The implications of this finding are not immediately clear, but highlight the importance of (a) knowledge of local disease epidemiology, and (b) performance of surveillance cultures in at least some subset of ED patients treated for SSTIs. This epidemiologic surveillance is important in monitoring infections treated in the ED, and may identify emerging resistance before it becomes broadly apparent. Importantly, differences in disease epidemiology were not reflected in the antibiogram distributed by the hospitals’ microbiology laboratory. S.