Tags

Type your tag names separated by a space and hit enter

Management and outcome of children with skin and soft tissue abscesses caused by community-acquired methicillin-resistant Staphylococcus aureus.
Pediatr Infect Dis J. 2004 Feb; 23(2):123-7.PI

Abstract

BACKGROUND

Although the epidemiology of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) has been explored in many investigations, management of this emerging infection has not been well-studied. For non-methicillin-resistant Staphylococcus aureus skin and soft tissue abscesses, incision and drainage is generally adequate therapy without the use of antibiotics, but this has not been established for CA-MRSA.

METHODS

Children presenting to Children's Medical Center of Dallas for management of skin and soft tissue abscesses caused by culture-proved CA-MRSA were prospectively followed. We analyzed data from the initial evaluation and from two follow-up visits that focused on the management and outcome of CA-MRSA infection. Retrospective chart review was performed 2 to 6 months after the initial visit.

RESULTS

Sixty-nine children were identified with culture-proved CA-MRSA skin and soft tissue abscess. Treatment consisted of drainage in 96% of patients and wound packing in 65%. All children were treated with antibiotics. Five patients (7%) were prescribed an antibiotic to which their CA-MRSA isolate was susceptible before culture results were known. Four patients (6%) required hospital admission on the first follow-up; none of these patients had received an antibiotic effective against CA-MRSA. A significant predictor of hospitalization was having a lesion initially >5 cm (P = 0.004). Initial ineffective antibiotic therapy was not a significant predictor of hospitalization (P = 1.0). Of the 58 patients initially given an ineffective antibiotic and managed as outpatients, an antibiotic active against CA-MRSA was given to 21 (36%) patients after results of cultures were known. No significant differences in response were observed in those who never received an effective antibiotic than in those who did.

CONCLUSIONS

Incision and drainage without adjunctive antibiotic therapy was effective management of CA-MRSA skin and soft tissue abscesses with a diameter of <5 cm in immunocompetent children.

Authors+Show Affiliations

Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

14872177

Citation

Lee, Michael C., et al. "Management and Outcome of Children With Skin and Soft Tissue Abscesses Caused By Community-acquired Methicillin-resistant Staphylococcus Aureus." The Pediatric Infectious Disease Journal, vol. 23, no. 2, 2004, pp. 123-7.
Lee MC, Rios AM, Aten MF, et al. Management and outcome of children with skin and soft tissue abscesses caused by community-acquired methicillin-resistant Staphylococcus aureus. Pediatr Infect Dis J. 2004;23(2):123-7.
Lee, M. C., Rios, A. M., Aten, M. F., Mejias, A., Cavuoti, D., McCracken, G. H., & Hardy, R. D. (2004). Management and outcome of children with skin and soft tissue abscesses caused by community-acquired methicillin-resistant Staphylococcus aureus. The Pediatric Infectious Disease Journal, 23(2), 123-7.
Lee MC, et al. Management and Outcome of Children With Skin and Soft Tissue Abscesses Caused By Community-acquired Methicillin-resistant Staphylococcus Aureus. Pediatr Infect Dis J. 2004;23(2):123-7. PubMed PMID: 14872177.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Management and outcome of children with skin and soft tissue abscesses caused by community-acquired methicillin-resistant Staphylococcus aureus. AU - Lee,Michael C, AU - Rios,Ana M, AU - Aten,Monica Fonseca, AU - Mejias,Asuncion, AU - Cavuoti,Dominick, AU - McCracken,George H,Jr AU - Hardy,R Doug, PY - 2004/2/12/pubmed PY - 2004/3/12/medline PY - 2004/2/12/entrez SP - 123 EP - 7 JF - The Pediatric infectious disease journal JO - Pediatr Infect Dis J VL - 23 IS - 2 N2 - BACKGROUND: Although the epidemiology of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) has been explored in many investigations, management of this emerging infection has not been well-studied. For non-methicillin-resistant Staphylococcus aureus skin and soft tissue abscesses, incision and drainage is generally adequate therapy without the use of antibiotics, but this has not been established for CA-MRSA. METHODS: Children presenting to Children's Medical Center of Dallas for management of skin and soft tissue abscesses caused by culture-proved CA-MRSA were prospectively followed. We analyzed data from the initial evaluation and from two follow-up visits that focused on the management and outcome of CA-MRSA infection. Retrospective chart review was performed 2 to 6 months after the initial visit. RESULTS: Sixty-nine children were identified with culture-proved CA-MRSA skin and soft tissue abscess. Treatment consisted of drainage in 96% of patients and wound packing in 65%. All children were treated with antibiotics. Five patients (7%) were prescribed an antibiotic to which their CA-MRSA isolate was susceptible before culture results were known. Four patients (6%) required hospital admission on the first follow-up; none of these patients had received an antibiotic effective against CA-MRSA. A significant predictor of hospitalization was having a lesion initially >5 cm (P = 0.004). Initial ineffective antibiotic therapy was not a significant predictor of hospitalization (P = 1.0). Of the 58 patients initially given an ineffective antibiotic and managed as outpatients, an antibiotic active against CA-MRSA was given to 21 (36%) patients after results of cultures were known. No significant differences in response were observed in those who never received an effective antibiotic than in those who did. CONCLUSIONS: Incision and drainage without adjunctive antibiotic therapy was effective management of CA-MRSA skin and soft tissue abscesses with a diameter of <5 cm in immunocompetent children. SN - 0891-3668 UR - https://www.unboundmedicine.com/medline/citation/14872177/Management_and_outcome_of_children_with_skin_and_soft_tissue_abscesses_caused_by_community_acquired_methicillin_resistant_Staphylococcus_aureus_ L2 - https://doi.org/10.1097/01.inf.0000109288.06912.21 DB - PRIME DP - Unbound Medicine ER -