What antibiotic will cover Methicillin-resistant Staphylococcus aureus (MRSA) and Streptococcal pharyngitis (strep throat) in a 5-year-old child?

From the Guidelines

For a 5-year-old with suspected MRSA and strep throat, clindamycin is the recommended antibiotic as it effectively covers both pathogens. The typical dosage for children is 10-13 mg/kg/dose given three times daily for 10 days, not exceeding 1.8 grams per day 1. For a 5-year-old weighing approximately 18-20 kg, this would be about 180-260 mg per dose. Clindamycin is available as oral solution (75 mg/5 mL) for easier administration in children. Before starting treatment, a throat culture should be obtained to confirm the diagnosis and antibiotic susceptibility. Potential side effects include diarrhea, nausea, and rash; parents should be advised to complete the full course even if symptoms improve quickly. Clindamycin works by inhibiting bacterial protein synthesis, making it effective against both MRSA, which is resistant to many common antibiotics, and Group A Streptococcus, the cause of strep throat 1.

Some key points to consider when treating a child with suspected MRSA and strep throat include:

• The importance of confirming the diagnosis through a throat culture to ensure appropriate antibiotic treatment 1
• The potential for clindamycin to cause side effects such as diarrhea, nausea, and rash, and the need for parents to be aware of these possible side effects 1
• The need for consultation with a pediatrician to confirm the dual infection and determine the most appropriate treatment, especially if the child has a penicillin allergy 1
• The effectiveness of clindamycin in treating both MRSA and Group A Streptococcus, making it a suitable choice for children with suspected dual infection 1

It is essential to note that the treatment of MRSA and strep throat requires careful consideration of the potential risks and benefits of different antibiotic regimens, as well as the need for careful monitoring of the child's response to treatment. By following the recommended treatment guidelines and consulting with a pediatrician, parents can help ensure the best possible outcome for their child.

From the FDA Drug Label

The cure rates by pathogen for microbiologically evaluable patients are presented in Table 18. Table 18 Cure Rates at the Test-of-Cure Visit for Microbiologically Evaluable Adult Patients with Complicated Skin and Skin Structure Infections Pathogen Cured ZYVOX n/N (%) Oxacillin/Dicloxacillin n/N (%) Staphylococcus aureus 73/83 (88) 72/84 (86) Methicillin-resistant S aureus 2/3 (67) 0/0 (-) Streptococcus agalactiae 6/6 (100) 3/6 (50) Streptococcus pyogenes 18/26 (69) 21/28 (75)

The antibiotic that will cover MRSA and strep throat in a 5-year-old is linezolid (PO), as it has shown effectiveness against both Methicillin-resistant Staphylococcus aureus (MRSA) and Streptococcus pyogenes in clinical trials 2.

• Key points:
  • MRSA: linezolid has a cure rate of 67% in microbiologically evaluable adult patients.
  • Strep throat (Streptococcus pyogenes): linezolid has a cure rate of 69% in microbiologically evaluable adult patients. However, it is essential to consult a pediatrician or a qualified healthcare professional to determine the best course of treatment for a 5-year-old patient, as the provided information is based on adult and some pediatric studies, and the dosage and treatment regimen may vary depending on the patient's age, weight, and medical condition.

From the Research

Antibiotic Treatment for MRSA and Strep Throat in a 5-Year-Old

• The provided studies do not directly address the treatment of MRSA and strep throat in a 5-year-old with a single antibiotic.
• However, the studies discuss the treatment of strep throat, which can be caused by Group A Streptococcus (GAS) 3, 4, 5.
• Penicillin or amoxicillin are commonly recommended for the treatment of strep throat in children 4.
• For MRSA infections, the treatment typically involves antibiotics such as clindamycin or linezolid 6, 7.
• Linezolid has been shown to be effective in inhibiting toxin production in GAS infections and may be considered as an alternative to clindamycin 6, 7.
• However, there is no clear evidence to support the use of a single antibiotic that covers both MRSA and strep throat in a 5-year-old.

Considerations for Antibiotic Choice

• The choice of antibiotic should be based on the specific infection being treated and the susceptibility of the causative organism 3, 4.
• The use of antibiotics with narrow spectrums of activity is generally recommended to minimize the risk of resistance and side effects 3, 4.
• In cases where MRSA is suspected, antibiotics such as clindamycin or linezolid may be considered 6, 7.
• However, the treatment of strep throat typically involves penicillin or amoxicillin, and the use of broader-spectrum antibiotics such as clindamycin or linezolid may not be necessary 4.