Table 2.

Examples of Drug-Specific Considerations for Use of Oral Antibiotics for Treatment of SSTIs in Emergency Department Setting

Drug(s)	Examples of drug-specific considerations
TMP/SMX	Generally, TMP/SMX is associated with high in vitro susceptibility rates among Staphylococcus aureus isolates, but some experts question its clinical role in SSTIs based on high treatment failure rates and supportive mechanistic concerns10 Sulfonamide allergy Comorbidities (eg, renal impairment)
Clindamycin	High nonsusceptibility rates among MRSA isolates (nearly 60% in some regions)11 Gastrointestinal effects including Clostridioides difficile superinfection
Tetracyclines (minocycline, doxycycline, omadacycline)	Gastrointestinal intolerance
Fluoroquinolones (delafloxacin)	Consider in cases of water exposure to cover Pseudomonas aeruginosa and related gram-negative rods Warnings include tendinitis and tendon rupture, peripheral neuropathy, and central nervous system effects12 Fluoroquinolone class as a whole carries a formidable list of warnings from FDA13
Oxazolidinones (linezolid, tedizolid)	Linezolid has safety and tolerability concerns when used in both the short term (eg, hypoglycemia) and longer term (eg, thrombocytopenia, neuropathy)14,15 Potentially clinically relevant drug-drug interactions between linezolid and commonly prescribed serotonergic agents resulting in serotonin syndrome14 Compared to linezolid, tedizolid appears to be associated with a lower incidence of adverse effects including hematologic toxicities, as well as substantially lower potential for drug interactions with serotonergic agents16

Abbreviations: FDA, US Food and Drug Administration; SSTI, skin and soft tissue infection; TMP/SMX, trimethoprim/sulfamethoxazole; MRSA, methicillin-resistant Staphylococcus aureus.