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Trimethoprim-Sulfamethoxazole Effective in Community-acquired MRSA in Children: Presented at PAS
By Rabiya S. Tuma, PhD
SAN FRANCISCO, CA -- May 10, 2006 -- Trimethoprim-sulfamethoxazole (TMP-SMX) is effective in treating skin and soft tissue infections in children caused by community acquired methicillin-resistant Staphylococcus aureus (CA-MRSA), according to research presented here at the annual meeting of the Pediatric Academic Societies (PAS).
David Y. Hyun, MD, clinical postdoctoral fellow in pediatrics and infectious disease, Baylor College of Medicine, Houston, Texas, and colleagues performed a chart review of 201 cases of children with laboratory confirmed non-invasive CA-MRSA infections who were admitted to Texas Children's Hospital between November 1, 2004 and October 31, 2005. Of those, 79 were discharged with a TMP-SMX prescription and 1 of those required further hospitalization or emergency room care.
All CA-MRSA samples isolated from infected sites were susceptible to TMP-SMX. By comparison, 84.4% were susceptible to clindamycin, 1 had an intermediate level of response, and 11 were resistant to it. The 1 patient who was readmitted to the hospital after 33 days required another incision and drainage. The bacteria isolated from the infected site remained susceptible to TMP-SMX.
All patients received parenteral antibiotics during hospitalization, although Dr. Hyun said data on the use of parenteral TMP-SMX was not available in this chart review. The mean duration of hospitalization was 2.7 days (range 1-8). Fifty-two patients (66%) had no fever during hospitalization. Seventy-five (95%) underwent incision and drainage.
The mean dose of TMP-SMX at discharge was 9.3 mg/kg/day of suspension form, but 9 patients were given a prescription for a double strength tablet to be taken twice daily and 1 patient received a single strength tablet twice daily. The mean duration of TMP-SMX therapy was 8.3 days.
More than 90% of CA-MRSA infections in children are skin and soft-tissue infections, yet only limited data has been available regarding the efficacy of TMP-SMX in this setting. The researchers concluded that prospective studies are needed to determine the drug's efficacy as both an oral and parenteral agent against CA-MRSA infections.
"TMP-SMX appears to be effective in treating skin and soft tissue infections in children caused by community acquired-MRSA," Dr. Hyun said.
[Presentation title: Trimethoprim-Sulfamethoxazole in the Management of Community-Acquired Methicillin-Resistant Staphylococcus aureus Skin and Soft Tissue Infections. Abstract 3526.167]
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