Systemic Antibiotics Effectively Treat Children with Staph Infections

Systematic antibiotics eradicated Staphylococcus aureus colonization and reduced the risk of recurrent infection in children with skin and soft tissue infection (SSTI), according to a recent study.

In their prospective study, the researchers evaluated 383 children who had an S. aureus SSTI that required incision and drainage and who had S. aureus colonization in the anterior nares, axillae, or inguinal folds. Systemic antibiotic prescribing was recorded and colonization samples were collected from 357 participants within 3 months. In addition, the researchers recorded the incidence of recurrent infection over 1 year.

Overall, participants who were prescribed guideline-recommended empiric antibiotics for purulent SSTI were less likely to remain colonized and have recurrent SSTI at follow-up compared with those who did not receiving guideline recommended antibiotics. Those who remained colonized were more likely to report recurrent infection over 12 months.

The researchers found that clindamycin was more effective than trimethoprim-sulfamethoxazole at eradicating S. aureus, with 44% of participants prescribed clindamycin remaining colonized compared with 57% of those prescribed trimethoprim-sulfamethoxazole. Additionally, clindamycin was more effective at preventing recurrent infections, with 31% of participants experiencing recurrence compared with 47% of participants prescribed trimethoprim-sulfamethoxazole.

“Systemic antibiotics, as part of acute SSTI management, impact S. aureus colonization, contributing to a decreased incidence of recurrent SSTI,” the researchers concluded. “The mechanism by which clindamycin differentially affects colonization and recurrent SSTI compared to [trimethoprim-sulfamethoxazole] warrants further study.”

—Melissa Weiss

Reference:

Hogan PG, Rodriguez M, Spenner AM, et al. Impact of systemic antibiotics on Staphylococcus aureus colonization and recurrent skin infection [published online August 24, 2017]. Clin Infect Dis. https://doi.org/10.1093/cid/cix754