title: Changes in prescriptive practices in skin and soft tissue infections associated with the increased occurrence of community acquired methicillin resistant Staphylococcus aureus.
abstract: BACKGROUND
  Over 30% of the US population is colonized with methicillin resistant Staphylococcus aureus (MRSA). People within the community, without factors associated with Hospital Acquired (HA) MRSA, present with skin and soft tissue infections (SSTIs). Community Acquired MRSA (CA-MRSA) is resistant to antibiotics typically prescribed for SSTI. Many SSTIs are treated with antibiotics that are ineffective against drug resistant strains.
  
  
  OBJECTIVE
  This study examines the incidence of SSTIs associated with CA-MRSA, to determine if an increase in SSTI's is associated with changes in prescribing patterns for MRSA.
  
  
  METHODS
  A secondary analysis of the National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS) data was used to detect incidence of SSTIs based on ICD-9 coding between the periods of 1997-2002 and 2003-2008. Antibiotic prescribing patterns were examined for treatment.
  
  
  RESULTS
  Incidence of SSTIs increased by 84.7% from 1997-2002 to 2003-2008. Antibiotics prescribed for methicillin sensitive S. aureus decreased while treatment with MSRA antibiotics increased.
  
  
  CONCLUSIONS
  There is an increased incidence of SSTI within the community, suggesting that CA-MRSA may be a contributing factor. Health care providers are recognizing the increased incidence of CAMRSA, and are treating SSTI with appropriate antibiotics.
authors.affiliation: Biology Department, Queensborough Community College, 222-05 56th Avenue, M213, Bayside, NY 11364, USA. Electronic address: cmeddlestorres@qcc.cuny.edu.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Meddles-Torres
authors.forename: Shuang
authors.initials: S
authors.lastname: Hu
authors.forename: Corrine
authors.initials: C
authors.lastname: Jurgens
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017714:Community-Acquired Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D008875:Middle Aged; D018461:Soft Tissue Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D013207:Staphylococcal Skin Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: CA-MRSA; Community Acquired MRSA; Community acquired; MRSA; MSSA; Methicillin resistance; NAMCS; NHAMCS; National Ambulatory Medical Care Survey; National Hospital Ambulatory Medical Care Survey; SSTI; Staphylococcus aureus; methicillin resistant Staphylococcus aureus; methicillin sensitive Staphylococcus aureus; skin and soft tissue infections