Patient selection: nonpurulent skin or soft tissue infection in the Emergency Department
Criteria for oral antibiotic failure - any of the following within 48 hours:
(1) hospitalization
(2) change in the class of oral antibiotic
(3) change to intravenous antibiotic therapy
Risk factors for failure of oral antibiotic failure:
(1) tachypnea at triage (OR 6.3)
(2) chronic skin ulcer (OR 4.9)
(3) history of MRSA colonization or infection (OR 4.8)
(4) cellulitis within the past 12 months (OR 2.2)
where:
• Tachypnea at triage is suspicious for systemic infection.
• Cellulitis within the past 12 months suggests recent antibiotic exposure, which is a risk factor for resistant bacteria.
• The antibiotic choice will affect the success rate.
The presence of one or more of these findings may be an indication to either avoid oral outpatient therapy or treat the infection aggressively.
