Clinical Outcomes of Parenteral Antibiotics Used in Staphylococcus Aureus-Related Skin and Soft Tissue Infections in Pediatric Hospitalized Patients

This study aimed to determine the clinical and laboratory characteristics of hospitalized pediatric patients with skin and soft tissue infections (SSTIs) associated with Staphylococcus aureus and to compare parenteral antibiotic therapies in terms of clinical outcomes. This single-center retrospective study analyzed patients aged 1 month to 18 years who were treated for S. aureus-associated SSTIs at Ankara Bilkent City Children's Hospital between September 2019 and September 2022. A total of 89 patients were included. Infections were caused by methicillin-susceptible (S. aureus, MSSA; n=54, 60.7%) and methicillin-resistant (S. aureus, MRSA; n=35, 39.3%). Compared to the MSSA group, the MRSA group had significantly higher rates of central venous catheter-related infections, prior hospitalizations, and complications (34.1% vs. 11.1%, 62.9% vs. 24.1%, and 28.6% vs. 5.6%, respectively; p=0.010, p=0.010, p=0.003). No significant difference in clinical outcomes was observed between patients treated with vancomycin or teicoplanin in the MRSA group. In the MSSA group, clinical outcomes were similar between patients who received beta-lactam/beta-lactamase inhibitors and third-generation cephalosporins. However, those treated with ampicillin-sulbactam had lower recurrence and complication rates compared to those treated with piperacillin-tazobactam (0% and 0% vs. 25% and 25%, respectively; p=0.029). Teicoplanin may be a reasonable option for treating MRSA-related SSTIs due to comparable clinical outcomes to vancomycin. For MSSA-related SSTIs, beta-lactam/beta-lactamase inhibitors such as ampicillin-sulbactam, piperacillin-tazobactam, and third-generation cephalosporins may also be appropriate treatment options with satisfactory results.