If Staphylococcus aureus is isolated from a skin wound culture, what is the appropriate next step in management?

• A. Begin empiric broad-spectrum antibiotics
• B. Cease antibiotic therapy
• C. Switch to antifungal therapy
• D. Tailor antibiotics based on culture and sensitivity results

Answer: (D)

When Staphylococcus aureus is found in a skin wound, the key step is to tailor antibiotic therapy to the culture and sensitivity results. This means selecting an antibiotic that the isolate is susceptible to, rather than sticking with broad-spectrum coverage or switching to an antifungal. Culture results help distinguish MSSA from MRSA, guiding whether a standard beta-lactam will suffice or whether an MRSA-active agent is needed. De-escalating to a narrow-spectrum drug that targets the organism improves efficacy, reduces toxicity, and helps prevent resistance. Even if initial empiric therapy was started, adjusting to the susceptibility profile is the best next step.