Madam, Gram-positive aerobes are the most common organisms in hospitalized patients with skin and soft-tissue infections (SSTIs). Staphylococcus aureus is the most common Gram-positive aerobe. Among these infections with methicillin-resistant S. aureus (MRSA) is the most common pathogen.¹ The increased prevalence of MRSA has been noted in the hospital as well the community setting and with the exponential use of antimicrobial agents antimicrobial resistance have become a major limiting factor in their use for the eradication of skin and soft tissue infections. During the last six year interval, the SENTRY data discloses an increase in the proportion of MRSA from 26% to 47 %, which is remarkable. This means that the challenge posed by MRSA is enormous.² The over all prevalence of MRSA is 59 % in skin and soft tissue infections ranging between 15 to 79%.³ However, these percentages reflect the prevalence of MRSA in developed countries like United States, this reflects that situation can be even more grave in Pakistan which means an absolute urgency to find the prevalence of MRSA strains in skin and soft tissue infections in a Health system that is still very much in development and also to design appropriate guidelines that could be beneficial in the eradication of complications of skin and soft tissue infections due to MRSA. A study reflects a percentage of 5.5% and 2.5% postoperative surgical wound infections in orthopaedic theatres of a tertiary care government and a private hospital in Karachi.⁴ However, the actual burden can be a lot more and this data only represents orthopaedic theatres. Surgeons have played a remarkable role in the treatment of infection for two centuries now. With the advent of 19th century along with anesthaesia and asepsis, horizons of surgical therapy have really broadened. The discovery of antimicrobial agents has done marvels but at the same time these agents have developed resistance, one of the major limiting factors in their usage.
The recommendations made by the American Society of Infectious disease have made significant progress and have now been used globally for the treatment of surgical wound infections.⁵
The American Society of Infectious disease also confirms and supports the role of surgical abscess drainage along with these antimicrobial agents, an entity that has been underscored.

The following table represents the regime for skin and soft tissue infections.
These guidelines not only help in the eradication of MRSA strains causing skin and soft tissue infections but will also help in reducing significant mortality in our country.
 
Muhammad Haseeb Zubair,1 Saba Alvi,2
Muhammad Habib Zubair3
4th Year Students, Karachi Medical and Dental College,1,2
Dow Medical College, DUHS, Karachi.3

1.Stevens DL. Treatments for skin and soft-tissue and surgical site infections due to MDR Gram-positive bacteria. J Infect 2009; 59 Suppl-1: S32-9.
2.Dawn RS. Skin and soft-tissue infections caused by methicillin-resistant Staphylococcus aureus. N Engl J Med 2007; 357: 380-90.
3.Movan GJ, Krishnadasan A, Govwitz RJ, Fosheim GE, McDougal LK, Carey RB, et al. Methicillin-Resistant S. aureus Infections among Patients in the Emergency Department. N Engl J Med 2006; 355: 666-74.
4.Jamali AR, Mehboob G, Majid A, Bhatti S, Minhaas S, Raaja A, et al. Postoperative Wound Infections in Orthopaedic Surgery.J Coll Physicians Surg Pak 2001; 11: 747-9.
5.Lewis F, Fry DE. Surgical Infection. Selected readings in General Surgery (SRGS) 2009; 35: 7.