Which antibiotics are recommended to treat methicillin-sensitive Staphylococcus aureus (MSSA) skin and soft-tissue infections (SSTIs)?

Updated: Jun 14, 2019
  • Author: Thomas E Herchline, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

The IDSA indicates the following adult antibiotic regimens may be used to treat methicillin-sensitive Staphylococcus aureus (MSSA) skin and soft-tissue infections (SSTIs) [2] :

  • Nafcillin or oxacillin 1-2 g IV q4h (IV agent of choice; inactive against methicillin-resistant S aureus [MRSA])

  • Cefazolin 1 g IV q 8h (for penicillin-allergic patients but not those with immediate hypersensitivity reactions)

  • Clindamycin 600 mg/kg IV q8h or 300-450 mg PO tid (may have cross-resistance and emergence resistance in erythromycin-resistant strains; induces resistance in MRSA)

  • Dicloxacillin (PO agent of choice for MSSA) or cephalexin (for penicillin-allergic patients but not those with immediate hypersensitivity reactions) 500 mg PO qid

  • Doxycycline or minocycline 100 mg PO bid

  • Trimethoprim-sulfamethoxazole (TMP-SMZ) 1-2 double-strength (DS) tablets PO bid


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