Purulent skin and soft tissue infections are often due to MRSA and require which management approach?

• A. Oral antifungals.
• B. Topical antibiotics.
• C. Incision and drainage plus antibiotics with MRSA activity (e.g., TMP-SMX, doxycycline, or clindamycin).
• D. Observation only.

Answer: (C)

Purulent skin and soft tissue infections caused by MRSA need both source control and targeted therapy. Draining the abscess is essential because it removes the purulent material and lowers the bacterial load, often allowing healing to begin and enhancing the effect of antibiotics. Relying on observation alone misses the physical collection of pus, and topical antibiotics don’t penetrate an established abscess to treat the infection. Oral antifungals wouldn’t work against bacteria, so they are not appropriate here. Therefore, the best management is incision and drainage plus antibiotics that have activity against MRSA, such as TMP-SMX, doxycycline, or clindamycin.