MRSA Skin Infection — SCE Dermatology MCQ

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ModerateCutaneous InfectionMRSA Skin InfectionSCE Dermatology

A 60-year-old woman on Prednisolone for bullous pemphigoid develops a painless rounded ulcer on her lower leg with a punched-out border and yellowish base. Wound swab grows MRSA. What is the most appropriate empirical oral antibiotic for MRSA skin infection?

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Correct answer: A — Doxycycline or Trimethoprim (guided by local resistance patterns)

For outpatient management of MRSA skin and soft tissue infection, Doxycycline or Trimethoprim are the recommended oral agents based on typical MRSA antibiotic susceptibility profiles in the UK. Local resistance patterns should guide choice. Flucloxacillin and Cefalexin are ineffective against MRSA (methicillin resistance confers resistance to all beta-lactams). Clindamycin is another option but carries higher C. difficile risk. For severe MRSA infection requiring IV treatment, Vancomycin, Teicoplanin, or Linezolid are used. Wound care alongside antibiotics is essential — decolonisation with Chlorhexidine body wash and Mupirocin nasal ointment should be considered.

Reference: NICE NG141; PHE MRSA Guidelines; BAD