Common Antibiotics May be Best First Treatment for Children with MRSA-related Infections

Penicillin and other antibiotics in the beta-lactam family work as well as other antibiotics to treat methicillin-resistant Staphylococcuss aureus (MRSA) infections in the skin and soft-tissue of children and may help prevent further resistance to antibiotic treatment, according to a new study funded by the Agency for Healthcare Research and Quality.

The study, published in the June 2009 issue of Pediatrics, compared treatment outcomes for three different antibiotics – beta-lactums (which include penicillin, cephalosporins, carbapenems and monobactams), clindamycin, and trimethoprim-sulfamethoxazole (TMP -SMZ). The study concluded that children treated with clindamycin for skin and soft tissue infections potentially caused by MRSA did not show greater improvement compared to those treated with beta-lactam therapy. Children treated with TMP-SMZ were less likely to show improvement.

Among the study’s findings:

· Beta-lactams may still be the best first line initial therapy for skin and soft tissue infections possibly caused by MRSA.

· Community-acquired MRSA may not be the cause of skin and soft tissue infections even when MRSA is prevalent.

· The use of beta-lactams may help prevent further resistance to antibiotic treatment of skin and tissue infections.

· Beta-lactam therapy is more palatable to children than clindamycin because it is not associated with side effects, such as nausea and mild diarrhea. It is also not as expensive as other treatments.

The authors of this study recommend further research to establish a higher level of evidence and to confirm study results.

This study was funded by a cooperative agreement through an AHRQ grant to the Centers for Education and Research on Therapeutics (CERTs) research network, which is part of the agency's Effective Health Care Program. The Effective Health Care Program sponsors the development of new scientific knowledge through studies on the outcomes of healthcare technologies and services.