Primary Care Management of Pediatric Community-Acquired Methicillin-Resistant Staphylococcus aureus Skin and Soft Tissue Infections

Abstract

Background The prevalence of pediatric community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) skin and soft tissue infections (SSTIs) have been well documented, yet evidence supporting treatment standards for short- and long-term resolutions is equivocal. Objective To review the healthcare challenge of pediatric CA-MRSA SSTIs and describe current evidence concerning treatment of uncomplicated infections. Implications and recommendations for primary care practice are presented. Review of Literature Databases were searched using the keywords CA-MRSA, skin, soft tissue infections, antibiotics, incision and drainage, clindamycin, and trimethoprim-sulfamethoxazole to locate the highest level of evidence available. Further searches were conducted to investigate the epidemiology, history of antibiotic resistance, and past treatment of SSTIs including CA-MRSA. Results When treating a pediatric patient for an uncomplicated CA-MRSA SSTI, the primary care practitioner needs to consider patient history and comorbid conditions, location of the infection, size of lesion, community prevalence of CA-MRSA and its susceptibility, history of antibiotic use, family or close contact history of CA-MRSA, immunocompetence, and physical signs of the patient. Conclusion Treatment changes are paramount in the fight against CA-MRSA, and practitioners must follow the clinical practice guidelines and begin to utilize incision and drainage more frequently and antibiotics less frequently.