MRSA presents treatment challenges in pediatric patients - - ModernMedicine.
Dermatologists, primary care physicians and emergency department physicians typically give two treatments, performing incision and drainage and prescribing antibiotics, when they see patients with skin and soft tissue infections where methicillin-resistant Staphylococcus aureus (MRSA) infection is present. This trend continues, despite recommendations from the Centers for Disease and Control and Prevention and the Infectious Diseases Society of America to perform only incision and drainage to treat MRSA infections in uncomplicated skin and soft tissue infections, according to the associate chief of dermatology at Phoenix Children's Hospital. "Most dermatologists and general physicians tend to 'double-dip,'" says Harper Price, M.D., dermatologist and fellowship director, Phoenix Children's Hospital. "We perform I and D (incision and drainage) and give antibiotics as well most of the time. The evidence in the literature clearly shows that incision and drainage is superior to antibiotics in uncomplicated cases — meaning those patients without systemic signs of illness or rapid progression of skin lesions, associated immunosuppression and extremes of age. "If you do both (treatments), it is no better than giving a placebo instead of an antibiotic," she says. "Incision and drainage is the hallmark of treatment, but I think we are all worried about these superbugs and a patient not doing well with incision and drainage and not following up (with a clinician)."
