Although the epidemiology of methicillin-resistant strains acquired in the S. aureus (MRSA) community has been described in many studies, the management of patients with such problematic infections is not known. has not been studied enough. In case of skin and soft tissue abscesses caused by methicillin-sensitive strains of S.aureus (MSSA), incision and drainage are generally adequate treatment measures without the use antibiotics, but this position has not been confirmed for situations where community-acquired strains were MRSA causative agents.

A prospective study involved children contacting the Dallas Children's Medical Center with confirmed abscesses of skin etiology (MRSA). The data obtained during the call and during the following two follow-up visits were analyzed. A retrospective visit was made within 2 to 6 months of the initial call.

Cultural confirmation of the etiology (MRSA strains acquired in the community) of skin and soft tissue abscesses was obtained in 69 children. Treatment consisted of drainage (96%) and wound tamponade (65%), in addition, all children received antibiotics. Only 5 patients (7%) initially (before receiving the results of the culture study) received an antibiotic to which the isolated strain of MRSA acquired in community proved to be sensitive. Four patients (6%) had to be hospitalized during the first follow-up visit; none of these patients received an antibiotic effective against the community-acquired MRSA isolate. A reliable prognostic sign of subsequent hospitalization was the size of the initial abscess greater than 5 cm (p = 0.004), while inadequate initial antibiotic therapy was not (p = 1.0). Of the 58 patients who initially received inadequate antibacterial therapy and were seen on an outpatient basis, 21 children (36%) received treatment taking into account the sensitivity of the selected pathogen. At the second follow-up visit (one week later than the first), there was no statistically significant difference in treatment outcomes between the groups of patients who received an active antibiotic against the MRSA strain acquired in the community and not having received one.

Thus, incision and drainage are sufficient measures for the treatment of immunocompetent children with skin and soft tissue abscesses caused by strains of MRSA of community origin and not exceeding 5 cm in diameter. It is not necessary to conduct additional antibacterial therapy for these patients.