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Antibiotic management of Staphylococcus aureus infections in US children's hospitals, 1999-2008

Joshua C Herigon1, Adam L Hersh, Jeffrey S Gerber

  • 1Children's Mercy Hospital and Clinics, Section of Infectious Diseases, 2401 Gillham Rd, Kansas City, MO 64108, USA.

Pediatrics
|May 19, 2010
PubMed

Insights

Antibiotic prescribing for pediatric Staphylococcus aureus infections shifted significantly, with clindamycin becoming the most common treatment due to rising MRSA rates. Continuous monitoring of bacterial susceptibility is crucial.

Area of Science:

  • Pediatric Infectious Diseases
  • Antimicrobial Stewardship
  • Clinical Pharmacy

Background:

  • Antibiotic management for Staphylococcus aureus (S aureus) infections in children requires understanding evolving resistance patterns.
  • The emergence of methicillin-resistant S aureus (MRSA) has altered treatment strategies.
  • Trends in pediatric S aureus treatment are not well-characterized.

Purpose of the Study:

  • To describe trends in antibiotic management for S aureus infections in hospitalized children.
  • To analyze changes in antibiotic use from 1999 to 2008.

Main Methods:

  • Retrospective study using the Pediatric Health Information Systems database.
  • Included inpatients with S aureus infection codes (1999-2008) at 25 US children's hospitals.
  • Examined trends in vancomycin, clindamycin, linezolid, trimethoprim-sulfamethoxazole, cefazolin, and oxacillin/nafcillin use.

Main Results:

  • S aureus infections increased, with MRSA rising tenfold (2 to 21 per 1000 admissions).
  • Antibiotics treating MRSA increased from 52% to 79%; those treating only methicillin-susceptible S aureus declined.
  • Clindamycin use surged from 21% to 63% between 1999 and 2008.

Conclusions:

  • Antibiotic prescribing patterns for pediatric S aureus infections have significantly changed.
  • The rise of community-associated MRSA has driven shifts towards agents like clindamycin.
  • Ongoing surveillance of S aureus susceptibility is essential for effective treatment.
Abstract

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