| Course | DNP 642 Applied Pharmacotherapeutics for Pediatrics |
|---|---|
| Module | Module 3 |
| Paper type | Pediatric pharmacotherapy case study |
| Length | About 436 words, 4 pages |
| Format | APA 7 student paper |
| School | Arizona State University |
| Program | Doctor of Nursing Practice |
| Updated | October 2026 |
Free sample paper for DNP 642 Module 3
Reading the Culture Report: Choosing an Antibiotic for a Child With an MRSA Skin Abscess
Student Name
Edson College of Nursing and Health Innovation, Arizona State University
DNP 642: Applied Pharmacotherapeutics for Pediatrics
Instructor Name
Month Day, Year
Reading the Culture Report: Choosing an Antibiotic for a Child With an MRSA Skin Abscess
The Scenario
A 6-year-old girl, 21 kg, has a 3 cm tender, fluctuant swelling on her buttock with 2 cm of surrounding redness, present for four days. She is afebrile and well appearing. The abscess is incised and drained in clinic, and pus is sent for culture. Two days later the report returns.
| Organism | Staphylococcus aureus, methicillin resistant (MRSA) |
|---|---|
| Oxacillin | Resistant |
| Erythromycin | Resistant |
| Clindamycin | Susceptible (D-test positive) |
| Trimethoprim-sulfamethoxazole | Susceptible |
| Tetracycline | Susceptible |
| Vancomycin | Susceptible |
Interpreting the Results
Oxacillin resistant. This defines MRSA. Beta-lactams such as cephalexin and amoxicillin-clavulanate will not work.
Erythromycin resistant, clindamycin susceptible, D-test positive. When a staphylococcus is resistant to erythromycin but appears susceptible to clindamycin, the laboratory performs a D-test. A positive result means inducible clindamycin resistance: the organism can switch on resistance during treatment, and clindamycin may fail. Clindamycin should not be used for this isolate.
Trimethoprim-sulfamethoxazole susceptible. This is an effective oral option for MRSA skin infections.
Tetracycline susceptible. Doxycycline may be an option, but in a young child it is usually reserved for situations without a good alternative.
Vancomycin susceptible. Vancomycin is intravenous and reserved for severe or systemic infection, which she does not have.
Is an Antibiotic Needed After Drainage?
Drainage is the main treatment. The IDSA guideline recommends incision and drainage for abscesses and antibiotics when there are signs of systemic infection or other risk features (Stevens et al., 2014). Two later trials support giving antibiotics more often. In a trial of 1,265 mostly adult patients with drained abscesses, trimethoprim-sulfamethoxazole raised the cure rate from 73.6% to 80.5% (Talan et al., 2016). In a trial of 786 patients, including 281 children, with abscesses up to 5 cm, both clindamycin and trimethoprim-sulfamethoxazole cured about 82% to 83% of patients, compared with 68.9% with placebo, with the benefit limited to staphylococcal infections (Daum et al., 2017).
Medication Choice
For this child, I would prescribe oral trimethoprim-sulfamethoxazole, dosed by weight from a pediatric reference, for a short course, typically 5 to 10 days depending on response. Clindamycin is excluded by the positive D-test, and doxycycline is less suitable at her age. Before prescribing, I would confirm she has no sulfa allergy and no known G6PD deficiency, and counsel about rash and the need for fluids.
Plan and Teaching
Wound care: keep the wound covered, change dressings daily and wash hands afterward. Return precautions: fever, spreading redness or new abscesses. Recurrence prevention: do not share towels or razors, keep nails short, and consider household decolonization if abscesses recur. Follow-up in two to three days to check healing.
References
Daum, R. S., Miller, L. G., Immergluck, L., Fritz, S., Creech, C. B., Young, D., Kumar, N., Downing, M., Pettibone, S., Hoagland, R., Eells, S. J., Boyle, M. G., Parker, T. C., & Chambers, H. F. (2017). A placebo-controlled trial of antibiotics for smaller skin abscesses. New England Journal of Medicine, 376(26), 2545-2555. https://doi.org/10.1056/NEJMoa1607033
Stevens, D. L., Bisno, A. L., Chambers, H. F., Dellinger, E. P., Goldstein, E. J. C., Gorbach, S. L., Hirschmann, J. V., Kaplan, S. L., Montoya, J. G., & Wade, J. C. (2014). Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clinical Infectious Diseases, 59(2), e10-e52. https://doi.org/10.1093/cid/ciu296
Talan, D. A., Mower, W. R., Krishnadasan, A., Abrahamian, F. M., Lovecchio, F., Karras, D. J., Steele, M. T., Rothman, R. E., Hoagland, R., & Moran, G. J. (2016). Trimethoprim-sulfamethoxazole versus placebo for uncomplicated skin abscess. New England Journal of Medicine, 374(9), 823-832. https://doi.org/10.1056/NEJMoa1507476
What the DNP 642 Module 3 instructions ask for
The posted syllabus sets Assignment 4, a case study, in the week on bacterial, viral, fungal and protozoal infections, COVID-19 and sexually transmitted infections. Students are given a scenario with laboratory and microbiology results to interpret and must determine the appropriate medication for treatment. Its points come out of the 150 the syllabus sets aside for assignments and cases. Expect to explain what each result means, including resistance patterns and any special tests, justify your drug choice against alternatives, address safety checks and give a plan for monitoring and family teaching. Pediatric dosing should come from a reliable reference such as a pediatric dosage handbook. Work from the scenario faculty provide rather than a general review of the infection.
How this DNP 642 Module 3 example is built
The answer restates the composite scenario with the culture report in a table. An interpretation section explains every line of the report, with particular attention to the positive D-test and what it means for clindamycin. A section on whether antibiotics are needed after drainage weighs the IDSA guideline against two later randomized trials. The medication choice is justified against alternatives, with safety checks named. A plan section gives wound care, return precautions and recurrence prevention. Three sources support it: the IDSA guideline and two trials in the New England Journal of Medicine. Doses are left to a pediatric reference. A short paragraph names the safety checks done before prescribing. Wound care is spelled out.
Reading the DNP 642 Module 3 grading rubric
Expect the rubric to reward accurate interpretation of each laboratory and microbiology result, recognition of inducible resistance, an appropriate drug choice with reasons, awareness of age-related cautions and safety checks, evidence from guidelines and trials and practical family teaching. Answers earn more when they explain why alternatives were rejected, not only which drug was chosen. Citing trial results with their numbers shows evidence-based reasoning. Including follow-up and recurrence prevention demonstrates complete care. Accurate, referenced dosing is expected if the assignment asks for doses. Faculty may also look for awareness that most uncomplicated abscesses need drainage first, so the antibiotic is an addition, not a substitute, and for a clear follow-up plan.
DNP 642 Module 3 help: mistakes that cost marks
A common slip is choosing clindamycin because the report says susceptible, without noticing the D-test. Read every line and footnote. Another is treating the infection with antibiotics alone and forgetting drainage and wound care. If you would like help interpreting the culture in your own scenario, send the desk the report and your draft. Check allergies and age cautions before naming a drug. Use a pediatric dosage handbook for weight-based doses. Include when the child should return. Read the footnotes on the susceptibility report, since tests such as the D-test often appear there, and say in one line why each rejected drug was rejected.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official Arizona State University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
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DNP 642 Module 3 questions, answered
Where can I find a free DNP 642 Module 3 sample paper?
The complete DNP 642 case study sample on a child's MRSA abscess, interpreting the culture report and choosing an antibiotic, is on this page.
What does a positive D-test mean?
It means inducible clindamycin resistance; clindamycin may fail even though the report lists it as susceptible.
Are antibiotics needed after draining a skin abscess?
Drainage is the main treatment, but trials found adding trimethoprim-sulfamethoxazole or clindamycin raised cure rates.
Which oral antibiotics treat MRSA skin infections in children?
Trimethoprim-sulfamethoxazole and clindamycin, if susceptible without inducible resistance, are common choices, with doxycycline in selected cases.
What does the DNP 642 case study involve?
Interpreting laboratory and microbiology results in a scenario and choosing the appropriate medication for treatment.