Case 6: Methicillin-Resistant Staphylococcus aureus (MRSA) Skin and Soft Tissue Infections

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You answered:

	Ciprofloxacin (Cipro) is one of the preferred oral regimens.

This answer is incorrect. Community-acquired isolates of MRSA also frequently show resistance to fluoroquinolones, such as ciprofloxacin, and thus ciprofloxacin is not considered a preferred regimen. Preferred antimicrobials for community-acquired skin and soft tissue MRSA infections include trimethoprim-sulfamethoxazole (Bactrim, Septra), doxycycline, minocycline, clindamycin, and linezolid (Zyvox).

	Resistance to methicillin and cephalexin results from production of an altered penicillin-binding protein by S. aureus that has reduced affinity for binding to beta-lactam antibiotics.
	More than 30% of the isolates from skin and soft tissue infections have shown resistance to trimethoprim-sulfamethoxazole (Bactrim, Septra).
	In a patient allergic to trimethoprim-sulfamethoxazole, azithromycin (Zithromax) is considered the preferred alternative.

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