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concentrations in those who are morbidly obese, have renal dysfunction, or have fluctuating volumes of distribution. The efficacy and safety of targeting higher trough concentrations in children requires further study but should be considered in those with severe sepsis or persistent bacteremia. ÎWhen an alternative to vancomycin is being considered for use, susceptibility should be confirmed and documented in the medical record. ÎFor methicillin-sensitive (MSSA) infections, a β-lactam antibiotic is the drug of choice in the absence of allergy. This tiny cluster of bacteria is methicillin-resistant Staphylococcus aureus (MRSA), seen under a microscope. This strain of the common "staph" bacteria causes infections in different parts of the body - including the skin, lungs, and other areas. MRSA is sometimes called a "superbug" because it is resistant to many antibiotics. Though most MRSA infections aren't serious, some can be life-threatening. *Photo Courtesy of CDC. Comments Pediatric Dose Mupirocin 2% topical ointment Class (Adult/Child) A-III A-II For simple abscesses or boils, incision and drainage is likely adequate, but additional data are needed to further define the role of antibiotics, if any, in this setting. Please refer to Appendix 1 for conditions in which antimicrobial therapy is recommended aſter incision and drainage of an abscess due to CA-MRSA. * Cultures from abscesses and other purulent SSTI are recommended in patients treated with antibiotic therapy, those with severe local infection or signs of systemic illness, patients who have not responded adequately to initial treatment, and if there is concern for a cluster or outbreak (A-III). 1 i n v i t ro S . a u r e u s

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