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Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
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Management of Pediatric Acute Hematogenous Osteomyelitis, Part II: A Focus on Methicillin-Resistant Staphylococcus

Kailynn J DeRonde1,2, Jennifer E Girotto1,2,3, David P Nicolau4,5

  • 1Department of Pharmacy Practice, School of Pharmacy, University of Connecticut, Storrs, Connecticut.

Pharmacotherapy
|July 11, 2018
PubMed

Insights

Community-acquired Methicillin-resistant Staphylococcus aureus (MRSA) is the leading cause of pediatric osteomyelitis. Clinicians should be aware of established and emerging therapies, including vancomycin, clindamycin, daptomycin, and linezolid, for effective treatment.

Area of Science:

  • Infectious Diseases
  • Pediatric Orthopedics
  • Pharmacology

Background:

  • Methicillin-resistant Staphylococcus aureus (MRSA) is the predominant pathogen in pediatric acute hematogenous osteomyelitis (AHO).
  • The increasing prevalence of community-acquired MRSA necessitates updated therapeutic strategies for pediatric AHO.

Purpose of the Study:

  • To review established and emerging treatment options for pediatric AHO caused by MRSA.
  • To highlight key pharmacokinetic and pharmacodynamic considerations for MRSA treatment in children.

Main Methods:

  • A literature search of the Medline database was conducted from its inception through January 2018.
  • Articles were selected based on their focus on well-established and novel MRSA therapies for pediatric AHO.

Main Results:

  • Vancomycin and clindamycin remain effective traditional treatments for pediatric AHO.
  • Daptomycin, linezolid, and ceftaroline show growing evidence for use when traditional agents are unsuitable.
  • Long-acting lipoglycopeptides demonstrate promising initial pediatric data for future AHO treatment roles.

Conclusions:

  • Clinicians require knowledge of current and novel MRSA therapies for pediatric AHO.
  • A range of effective treatment options exist, with newer agents offering alternatives for complex cases.
  • Emerging therapies like lipoglycopeptides may expand future treatment paradigms for pediatric osteomyelitis.
Keywords:
MRSAacute hematogenous osteomyelitisantibioticspediatrics

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