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Abstract

In cases of cellulitis, identification of a specific pathogen is often not possible on clinical grounds, and in our institution the recommended practice for empiric treatment of skin infections is to cover for the usual pathogens, such as Staphylococcus aureus and Streptococcus pyogenes. This article describes the management of a 68-year-old man in whom the choice of appropriate antibiotic treatment for suspected cellulitis was complicated by many factors, including several known risk factors for recurrent cellulitis, multiple comorbid conditions, and the patient’s wish to leave hospital as soon as possible. Given this patient’s clinical syndrome, coverage for methicillin-resistant S. aureus was part of the treatment decision, and to enable a prompt discharge, an effective oral treatment was needed for him to take at home. These and other considerations that guided the selection of omadacycline as appropriate antibiotic therapy for this patient are discussed.

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