Complicated skin and skin structure infections (cSSSIs, or acute bacterial skin and skin structure infections, ABSSSIs) are infections involving the skin, usually caused by or involving Staphylococcus aureus. These infections require inpatient care in the hospital setting and surgical treatment, and often are treated with antibiotics.
In only about 40% of cases of cSSSI is the causative pathogen known. Because cSSSIs are usually serious infections, physicians do not have the time for a culture to identify the pathogen, and so most cases are treated empirically, by choosing an antibiotic agent based on symptoms and seeing if it works. In order to achieve efficacy, physicians will use broad spectrum antibiotics. This practice contributes in part to the growing incidence of antibiotic resistance, a trend exacerbated by the widespread use of antibiotics in medicine in general.
The increased prevalence of antibiotic resistance is most evident in methicillin-resistant Staphylococcus aureus (MRSA). This species is commonly involved in cSSSIs, worsening their prognosis, and limiting the treatments available to physicians. Drug development in infectious disease seeks to produce new agents that can treat MRSA.
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—Jacob Bronowski (1908–1974)