This study aimed to reassess the antibiotic treatment regimen for invasive community-associated methicillin-resistant Staphylococcus aureus(CA-MRSA) infections at a tertiary children’s hospital.

A retrospective analysis was conducted on cases of invasive clindamycin-resistant MRSA infections in children without underlying diseases between 2021 and 2025. A total of 34 children met the inclusion criteria, with the most common types of diagnosis being osteomyelitis (17 cases) and deep abscess (7 cases).

The median duration of intravenous (IV) antibiotic therapy was 11.5 days (interquartile range [IQR], 6-42 days), and the total treatment duration (IV + oral) was 32 days (IQR, 23-42 days). Overall, 50% of the children were subsequently switched to oral antibiotic therapy. The definitive antibiotics used for treatment included vancomycin (15 cases), TMP-SMX (trimethoprim-sulfamethoxazole, 9 cases), linezolid (7 cases), ceftaroline (2 cases), and doxycycline (1 case). The cure rates of different definitive antibiotic treatment regimens were similar: 73.3% in the vancomycin group, 88.9% in the TMP-SMX group, 50% in the ceftaroline group, and 100% in both the linezolid group and the doxycycline group. Three children died from MRSA infection, among whom 2 were treated with vancomycin and 1 with ceftaroline.

Vancomycin is the most commonly used drug for the treatment of invasive clindamycin-resistant CA-MRSA infections in children. However, in specific cases, TMP-SMX and linezolid may be considered as oral alternative options during the completion phase of treatment. Further research is still needed in the future to optimize the treatment regimen for such infections.