What is the treatment for a mild Staphylococcus (Staph) infection in a child?

Treatment of Staph Infection in a 7-Year-Old Child at Home

For mild Staphylococcus infections in a 7-year-old child, mupirocin 2% topical ointment is the first-line treatment for minor skin infections such as impetigo or secondarily infected skin lesions, while oral clindamycin or trimethoprim-sulfamethoxazole (TMP-SMX) are recommended for more extensive infections requiring systemic therapy. 1

Assessment and Initial Management

• For minor skin infections (impetigo) and secondarily infected skin lesions (eczema, ulcers, lacerations), apply mupirocin 2% topical ointment 1
• For abscesses, the primary treatment is incision and drainage, which may be sufficient for small, uncomplicated abscesses 1
• For small furuncles (boils), applying moist heat can help promote drainage 1

Oral Antibiotic Options for Mild to Moderate Infections

If the infection requires systemic therapy (multiple lesions, fever, or spreading infection), recommended oral antibiotics include:

• Clindamycin - effective against both Staphylococcus aureus (including MRSA) and beta-hemolytic streptococci 1
• Trimethoprim-sulfamethoxazole (TMP-SMX) - effective against MRSA but has limited activity against streptococci 1
• Amoxicillin-clavulanate - appropriate for mild infections when methicillin-susceptible S. aureus is suspected 2, 3

Important Considerations for Children

• Tetracyclines (doxycycline, minocycline) should NOT be used in children under 8 years of age 1
• Duration of therapy is typically 5-10 days, individualized based on clinical response 1, 4

When to Seek Medical Attention

Oral antibiotics may not be sufficient and medical attention should be sought if:

• The infection shows signs of systemic illness (fever, lethargy) 1
• There is severe or extensive disease involving multiple sites 1
• The infection is rapidly progressing or worsening despite appropriate oral antibiotics 1
• The abscess is in an area difficult to drain completely (face, hand, genitalia) 1
• The child has underlying medical conditions or immunosuppression 1

Prevention of Recurrent Infections

• Keep draining wounds covered with clean, dry bandages 1
• Maintain good personal hygiene with regular bathing and handwashing with soap and water 1
• Avoid sharing personal items (towels, razors, linens) that have contacted infected skin 1
• Clean high-touch surfaces (counters, doorknobs, bathtubs) with commercially available cleaners 1

Decolonization Strategies for Recurrent Infections

If infections recur despite hygiene measures, consider decolonization:

• Nasal decolonization with mupirocin twice daily for 5-10 days 1
• Dilute bleach baths (1 teaspoon per gallon of water, 15 minutes twice weekly) 1
• Evaluate and treat household contacts who show symptoms of infection 1

Common Pitfalls to Avoid

• Not obtaining cultures when using antibiotics or when there's no response to initial treatment 1
• Using tetracyclines in children under 8 years of age 1
• Inadequate drainage of abscesses - surgical drainage is essential for proper treatment 1
• Not considering MRSA when selecting empiric therapy, especially in areas with high MRSA prevalence 1, 4
• Prolonged antibiotic courses when shorter durations (5-7 days) are typically sufficient 4