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Journal of the Dermatology Nurses' Association:
doi: 10.1097/JDN.0b013e31824138f3
Feature Articles

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

Santmyire, Aaron; Riggs, Jennifer S.

Continued Education
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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.

© 2012 Lippincott Williams & Wilkins, Inc.


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