Treatment of Methicillin-Resistant Staphylococcus Aureus(MRSA) Otorrhea in Pediatric Patients

Lee, Joon Kyoo; Kim, Seung Hyun; Na, Ae Sun; Kim, Chang Guk; Cho, Yong Bum

Abstract

BACKGROUND AND OBJECTIVES
Recently, incidence of community-acquired methicillin-resistant Staphylococcus aureus (MRSA) infection has been increasing. There are problems with children with MRSA otorrhea in visiting otolaryngology clinics, since systemic vancomycin or teicoplanin injection can cause systemic side effects in children and admission and medical costs are higher. In this study, we used the conventional antibiotics orally and topically for the treatment of otorrhea by MRSA infection to compare the therapeutic effects of conventional antibiotics with the systemic vancomycin or teicoplanin. The author also tried to determine the timing of systemic vancomycin injection for the control of MRSA otorrhea. MATERIALS AND METHOD: Twenty-eight pediatric patients with MRSA otorrhea were treated with either conventional antibiotics (20 patients) topically and orally or systemic vancomycin or teicoplanin injection (8 patients). The use of vancomycin or teicoplanin injection was indicated when otorrhea didn't stop despite of 3-4 weeks of conventional treatment and when referred from local clinics, and in case of cholesteatoma, when it came as a result of complication of middle ear disease. RESULTS: The average therapeutic period for the conventionally treated group was 24.7 days. On the other hand, the average period was 12.3 days and 9.8 days for the systemic vancomycin and teicoplanin injection group, respectively. CONCLUSION: The conventional antibiotics treatment, topically or orally applied for the treatment of MRSA otorrhea in children, has advantages in relation to time and economy, although the average therapeutic period was longer than the treatment with systemic vancomycin or teicoplanin injection. The author suggests the usage of conventional antibiotics for 3 weeks prior to the use of systemic vancomycin injection.