Newland Jason G, Kearns Gregory L
Department of Pediatrics, University of Missouri-Kansas City, Kansas City, Missouri, USA.
Paediatr Drugs. 2008;10(6):367-78. doi: 10.2165/0148581-200810060-00004.
Staphylococcus aureus is an important pathogen that frequently causes clinical disease in children. A wide array of illnesses can be caused by this common pathogen ranging from non-invasive skin infections to severe, life-threatening sepsis. Additionally, as antibacterials have been used to eradicate S. aureus, it has developed resistance to these important therapeutic agents. Methicillin-resistant S. aureus (MRSA) has become an increasing problem in pediatric patients over the past decade. In this review, we discuss the epidemiology, pathogenesis, and treatment options available in treating MRSA infections in children. Specifically, we address the importance of abscess drainage in the treatment of skin and soft tissue infections, the most common clinical manifestation of MRSA infections, and highlight the various agents that are available for treating this common infection. In severe, life-threatening invasive MRSA infections the primary therapeutic option is vancomycin. In cases of MRSA toxic shock syndrome the addition of clindamycin is necessary. In other invasive MRSA infections, such as pneumonia and musculoskeletal infections, the empiric treatment of choice is clindamycin. Finally, newer agents and additional treatment options are discussed.
金黄色葡萄球菌是一种重要的病原体，经常导致儿童临床疾病。这种常见病原体可引发一系列疾病，从非侵袭性皮肤感染到严重的、危及生命的败血症。此外，随着抗菌药物被用于根除金黄色葡萄球菌，它已对这些重要的治疗药物产生耐药性。在过去十年中，耐甲氧西林金黄色葡萄球菌（MRSA）在儿科患者中已成为一个日益严重的问题。在本综述中，我们讨论了儿童MRSA感染的流行病学、发病机制以及可用的治疗选择。具体而言，我们阐述了脓肿引流在治疗皮肤和软组织感染（MRSA感染最常见的临床表现）中的重要性，并强调了可用于治疗这种常见感染的各种药物。在严重的、危及生命的侵袭性MRSA感染中，主要治疗选择是万古霉素。在MRSA中毒性休克综合征病例中，必须加用克林霉素。在其他侵袭性MRSA感染，如肺炎和肌肉骨骼感染中，经验性治疗的首选药物是克林霉素。最后，讨论了新型药物和其他治疗选择。
