Do you routinely recommend transition to dual PO antibiotic coverage for strep species and MRSA, for patients with purulent cellulitis and in the absence of culture data?   

I typically do cover both Strep and MRSA- Bactrim + 1st generation cephalosporin (e.g.Keflex or cefirdoxil) is a good combo. Single-drug options include Clindamycin and Doxycycline. Linezolid is also a good single-drug option.

I use mostly Linezolid because: It’s now much cheaper. Even if on serotonin drugs, I can half the serotonin dose while they are on it. Covers pretty much all Strep and Staph, including MRSA. Protein synthesis inhibition may reduce toxins (like clinda in Strep fasciitis). There is no ren...