Drug treatment of skin and soft tissue infections in elderly long-term care residents.

Nursing home-acquired skin and soft tissue infections are common, with an estimated prevalence of approximately 5%. Such infections can be a cause of significant morbidity. The types of organisms that cause primary skin and soft tissue infections in the elderly are diverse, and include bacterial, viral and fungal infections, as well as infestations with scabies or lice. In the elderly, these infections or infestations may present with atypical signs and symptoms, so a high index of suspicion is necessary. These skin and soft tissue infections may complicate an underlying chronic skin disorder (such as a decubitus ulcer), further altering their clinical presentation. Treatment of skin infections and infestations is based on the appropriate diagnostic tests. Once the diagnosis has been confirmed, treatment with the standard drug therapy is usually associated with a favourable clinical outcome. This article summarises the major skin and soft tissue infections in the elderly, and the appropriate drug therapy, with emphasis on special considerations for long-term care residents and the unique environment of the nursing home that allows for the emergence of resistant organisms. These factors make the management of skin and soft tissue infections in this population unique and challenging.