Management of community-associated methicillin-resistant Staphylococcus aureus infections in children.
In recent years, community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has emerged as a pathogen in children without established risk factors, and its prevalence in the United States is increasing. Although many CA-MRSA infections are mild, primarily involving the skin and soft tissues, the organism can cause serious, invasive, and life-threatening infections. To provide a comprehensive review of the epidemiology, clinical features, therapy, and prevention of CA-MRSA infections in children, we performed MEDLINE (1966-January 2006) and Cochrane Library searches, and reviewed abstracts for relevance to S. aureus infections. Only articles pertaining to CA-MRSA infections in pediatrics were closely examined. As a genetically distinct pathogen, CA-MRSA is generally susceptible to multiple non-beta-lactam antimicrobials. The optimal treatment for CA-MRSA infections in pediatric patients has not been well studied. Common antibiotics used include clindamycin, trimethoprim-sulfamethoxazole, vancomycin, and rifampin. Rational empiric antimicrobial therapy for infections caused by S. aureus requires consideration of the possibility of methicillin resistance. The local prevalence and susceptibilities of CA-MRSA, severity of infection, and individual risk factors should be considered in selecting treatment.
Le
Jennifer
J
Department of Pharmacy Practice and Administration, College of Pharmacy, Western University of Health Sciences, Pomona, California 91766-1854, USA. jle@westernu.edu
Lieberman
Jay M
JM
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000453:epidemiology; D006801:Humans; D016106:Methicillin Resistance; D015995:Prevalence; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000453:epidemiology; D013211:Staphylococcus aureus
D000900:Anti-Bacterial Agents