I'm on the road today and have what feels like seconds between commitments, but there's a brand new piece of research this morning that I think you folks should know about. It's an
early-online release from Pediatrics by researchers from 3 states. It uses a database called the Pediatric Health Information Systems analyze diagnosis codes and antibiotic treatment of kids treated for staph at 25 US children's hospitals from 1999 to 2008, and it finds:
The incidence of methicillin-resistant S aureus (MRSA) infections during this period increased 10-fold, from 2 to 21 cases per 1000 admissions, whereas the methicillin-susceptible S aureus infection rate remained stable. Among patients with S aureus infections, antibiotics that treat MRSA increased from 52% to 79% of cases, whereas those that treat only methicillin-susceptible S aureus declined from 66% to <30% of cases. Clindamycin showed the greatest increase, from 21% in 1999 to 63% in 2008.
To translate, for those not used to reading scientific literature:
- a 10-fold increase in MRSA diagnoses over 10 years
- a 3-fold increase in what was not the most commonly prescribed drug, one useful for the different resistance profile of community infections
- clindamycin (used in mild and also invasive infections) eclipsing vancomycin (last-resort drug for invasive cases) as the most-used drug — which could be a sign of changes in prescribing patterns, changes in seriousness of the cases seen, or a warning that with so much use, clindamycin resistance could emerge more quickly, as happened when vancomycin came off the shelf in the 1990s and began to be used more.
It will take me a while to download and read the paper (hard to do in the car), but that's the topline news. Update to come.
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