Antimicrobial therapy of skin and soft tissue infection in children

I Brook Department of Pediatrics, Georgetown University School of Medicine, Washington, DC.

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Skin and soft tissue infection and cutaneous abscesses are common in children. They may be polymicrobial in nature, especially when located proximal to mucous membranes. A general knowledge of the common causative bacterial organisms in these infections enables the physician to empirically institute antimicrobial therapy before culture results are available. This review assesses the number and types of aerobic and anaerobic bacteria that occur in skin and soft tissue infections in children. Staphylococcus aureus and Streptococcus pyogenes were recovered from infections occurring at all body sites, but predominated in infections of the leg, neck, and hand. Group D streptococci, Enterobacteriaceae, Neisseria gonorrhoeae, Bacteroides fragilis, and Prevotella species were isolated mostly from infections of the external genitalia and perirectal areas; pigmented Prevotella and Porphyromonas and Haemophilus influenzae can be isolated from infections of the head and neck. Management of skin and soft tissue infections in children should include surgical and medical therapy.