September 01, 2011
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Dose-dependent relationship found for CA-MRSA, antibacterials

Schneider-Lindner V. Arch Pediatr Adolesc Med. 2011;doi:10.1001/archpediatrics.2011.143.

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Exposure to antimicrobials increases the risk for community-associated methicillin-resistant Staphylococcus aureus, but about half of the children in a United Kingdom research database were listed as having methicillin-resistant S. aureus in the community without having been prescribed antibacterial medications, according to a new study.

Researchers from the Sir Mortimer B. Davis–Jewish General Hospital in Montreal looked at rates of antibacterial drug prescribing between 30 and 180 days before the index data. They compiled their data from a database that included children aged 12 months to 19 years between 1994 and 2007.

Children who had been prescribed an antibacterial drug had a 3.5-fold increased risk for an MRSA infection compared with age- and practice-matched controls.

The researchers said the average annual incidence of MRSA was 4.5/100,000 children per year, for children of all ages. Of the 297 cases and 9,357 controls, 52.5% and 13.6%, respectively, received antibacterials during a 150-day exposure window.

The risk of a diagnosis increased with the number of prescriptions, with the RR highest for fluoroquinolones, at 14.8 (95% CI, 3.9-55.8).

“While close to half of children were diagnosed as having MRSA in the community without prior antibacterial drugs, such agents are associated with a dose-dependent increased risk, concordant with findings in adults,” the researchers concluded.

Disclosure: The researchers report no relevant financial disclosures.

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