Improving Management of Hospitalized Adults with Cellulitis or Cutaneous Abcess

The goal of this program is to improve patient care for hospitalized adults by implementing an institution-developed clinical practice guideline for the treatment of cellulitis or cutaneous abscess.

The planned intervention will involve the creation and dissemination of a clinical practice guideline that addresses appropriate management of hospitalized adults with cellulitis or cutaneous abscess. This will be followed by quarterly evaluations and education. This guideline has been reviewed by and approved by the members of our Infectious Diseases Division. The algorithm includes recommendations from the IDSA guidelines for both the treatment of MRSA infections and the treatment of skin and soft tissue infections. It prompts the clinician to differentiate between cutaneous abscess and uncomplicated cellulitis since these two distinct clinical entities usually have different causative organisms and treatment choices. Cutaneous abscesses are more likely to be caused by Staphylococcus aureus (either MSSA or MRSA) which could be initially treated with either vancomycin or trimethoprim/sulfamethoxazole. Furthermore, a cutaneous abscess that is drained and does not have surrounding cellulitis may not require antibiotic therapy. Uncomplicated cellulitis is most likely caused by Streptococcus species and could be treated initially with penicillin, cefazolin or clindamycin.