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Wound Colonisation — SCE Infectious Diseases MCQ

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EasyAntimicrobial StewardshipWound ColonisationSCE Infectious Diseases

A 42-year-old man presents with a chronic non-healing leg ulcer over the medial malleolus. He has a history of deep vein thrombosis and post-thrombotic syndrome. The ulcer has been present for 8 months despite compression therapy. Wound swab grows MRSA and Pseudomonas aeruginosa. The surrounding skin is not inflamed. Should the colonising organisms be treated with antibiotics?

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Correct answer: A — No; wound colonisation without clinical signs of infection does not require antibiotics — continue wound care and compression

Chronic venous leg ulcers are almost always colonised with multiple organisms. Wound swab cultures from chronic ulcers frequently grow MRSA, Pseudomonas, and other organisms. Without clinical signs of wound infection (increasing pain, expanding erythema, purulent discharge, systemic features), antibiotics are not indicated and will only drive resistance. Management focuses on compression therapy, wound care, and addressing the underlying venous insufficiency. Antibiotics are reserved for clinically infected wounds.

Reference: NICE NG19 2016 – Leg ulcer management; SIGN 2010 – Venous leg ulcers