This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.Methicillin-resistant Staphylococcus aureus (MRSA) has traditionally been associated with hospital-acquired infections. In the late 1990's, emergence of a new strain of MRSA within previously healthy individuals was noted in the community. This strain, termed CA-MRSA, often caused impressive deep-seated infections that usually required incision and drainage. Outbreaks within communities, and recently reported in a national football team, have become widespread. Very few studies hav evaluated the proper treatment of CA-MRSA infections. Traditionally, most skin and soft tissue infections were treated with cephalosporin or penicillin antibiotics (for which CA-MRSA would be expected to be resistant), yet many retrospective studies have reported that widespread treatment failures did NOT occur. Furthermore, changes in treatment practices to antibiotics for which CA-MRSA might be susceptible can be problematic in terms of increased cost, necessity of intravenous infusion, or side effect profile.The purpose of this study is to help define the role of antibiotics in the treatment of pediatric skin infections caused by CA-MRSA. We hypothesize that treatment with cephalexin, a penicillin-like antibiotic to which CA-MRSA would be expected to be resistant, does not result in poorer outcomes than treatment with clindamycin, an antibiotic to which CA-MRSA is most often susceptible. This study will hopefully help pediatricians in the community and outpatient setting choose an appropriate antibiotic in the empiric treatment of a presumed CA-MRSA cutaneous abscess.
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