Table 2 Summary of major themes identified about the impact of CA-MRSA on primary care pediatric practices for SSTIs.

How has your practice changed since the emergence of CA-MRSA?

   Bacterial Epidemiology

Majority is CA-MRSA.

   Clinical Presentation

Increased case numbers but not severity.

Increased recurrences, household transmission and incidence among infants.

Substantial patient fear of CA-MRSA.

   Clinical Management

Medical Management

Antibiotics are highly important and routinely prescribed.

Some increased empiric prescribing of antibiotics that treat CA-MRSA.

Surgical Management

Variable perception of importance of I&D.

Diagnostic Testing

Increased use of bacterial culture.

Prevention and Follow-up

More aggressive follow-up.

Uncertainty about role of decolonization.

What is your knowledge about SSTI treatment recommendations and how do you stay updated?

Limited awareness of published recommendations from CDC and AAP.

What are the barriers to compliance with current recommendations?

Internal Barriers

   Lack of awareness of current guidelines.

   Inexperience with antibiotics that treat CA-MRSA.

   Lack of self-efficacy with I&D.

   Skepticism about treatment with I&D alone.

External Barriers

   Concerns about antibiotic compliance.

   Lack of epidemiologic data about resistance patterns for SSTIs.

   Lack of resources to perform office I&D.

   Delays in receiving culture results.