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

Santmyire, Aaron; Riggs, Jennifer S.

Journal of the Dermatology Nurses' Association: January/February 2012 - Volume 4 - Issue 1 - p 20–25
doi: 10.1097/JDN.0b013e31824138f3
Feature Articles

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.

Aaron Santmyire, FNP-BC, MSN, Appalachian Spring Dermatology, Fairmont, West Virginia.

Jennifer S. Riggs, PhD, RN, School of Nursing, University of Alabama at Birmingham.

The authors declare no conflicts of interest.

Correspondence concerning this article should be addressed to Aaron Santmyire, FNP-BC, MSN, Rt 1 Box 37, Wiley Ford, WV 26767. E-mail: aaron.santmyire@agmd.org

© 2012 Lippincott Williams & Wilkins, Inc.