Since the advent of community-associated methicillin-resistant Staphylococcus aureus, the frequency of skin and soft-tissue infections (SSTIs) has significantly increased among children in primary care settings (CA-MRSA). According to recent treatment recommendations, CA-MRSA is the primary cause, incision and drainage (I&D) is the prior therapy, and antibiotics are not prescribed for uncomplicated patients; it’s unclear how the epidemic has affected primary care pediatricians’ practice patterns, or the obstacles they confront in offering recommended therapies. A total of 29 primary care doctors in the San Francisco Bay Area participated in 3 focus groups. Two investigators used modified grounded theory to evaluate the transcripts and categorize them into significant themes. Since the discovery of CA-MRSA, there have been effective modifications in clinical practice. Increased SSTI office visits, patients with multiple recurrences, and transmission within homes are among them. Furthermore, due to media reports fueling anxieties about CA-MRSA, the participants reported increased visits for minor skin complaints.
Participants prescribed antibiotics for SSTIs regularly, but few did I&D. Few people knew about the new SSTI treatment guidelines. Concerns about side effects and a lack of local epidemiologic data indicating that CA-MRSA is the predominant cause were barriers to prescribing antibiotics with CA-MRSA activity. Lack of expertise, money, and doubt about the importance of I&D were all obstacles to executing it. Increased time demands for follow-up visits and patient education, as well as a lack of evidence-based interventions for preventing repeated infections and household transmission, were significant clinical obstacles. CA-MRSA has impacted how SSTIs are presented and treated, particularly case numbers and recurrences. Improved transmission of treatment guidelines and epidemiologic data can help overcome barriers to offering indicated medicines. More research is needed to increase the evidence base for treatment and preventative methods.