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Staphylococcus Aureus Antibiotic Patterns in Pediatric AD

Publish date:

First-generation cephalosporins are appropriate empiric therapy for skin infections in most pediatric patients with atopic dermatitis (AD), a new study found. Researchers conducted a retrospective study over a 5-year period to characterize the staphylococcus aureus (S aureus) strains recovered from pediatric patients with AD, which clinically apparent bacterial skin infections treated in an academic medical center. Among the findings:

  • Methicillin-sensitive S. aureus (MSSA) was more prevalent than methicillin-resistant S. aureus (MRSA) in the study group (77.8% vs 22.2%).
  • There was no correlation between MRSA and age, sex, race, or dilute bleach bath use.
  • Patients with AD had lower rates of MSSA susceptibility to doxycycline and MRSA susceptibility to trimethoprim-sulfamethoxazole compared with pediatric patients presenting to the emergency department.

Citation:

Briscoe CC, Reich P, Fritz S, Coughlin CC. Staphylococcus aureus antibiotic susceptibility patterns in pediatric atopic dermatitis. [Published online ahead of print May 24, 2019]. Pediatr Dermatol. doi: 10.1111/pde.13867.

Commentary:

Methicillin-resistant staph aureus (MRSA) has become well known to both medical providers and the lay public. The idea of a "staph infection" often causes significant distress to patients and caregivers. But in patients with atopic dermatitis (AD), who are frequently colonized with staph, it has been reported that MRSA is less likely than "regular" staph. This article confirms that sensitive staph is almost 4 times more common than MRSA in atopic patients. This was true with or without bleach bath use, which adds to recent reports that there is no long-term benefit to chronic use of bleach baths. If active infection in an atopic is suspected, unless there is a past history of MRSA, then initial treatment with a cephalosporin is reasonable. — Joseph Fowler, Jr., MD, Clinical Professor of Dermatology, University of Louisville, KY

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