Most U.S. women with endometrial cancer continue to be treated with open hysterectomy surgery despite increased complication rates and financial costs associated with this approach. A disparity in endometrial cancer surgical care exists that is affected by patient race and hospital geography and cancer volumes.

Staphylococcal scalded skin syndrome causes widespread skin denudation primarily in infants < 1 year old. Selection of empiric therapy is complicated by rising rates of antibiotic resistance in community-acquired staphylococcal infections. Consistent with a pre- Pediatric Dermatology BRIEF REPORTwith clindamycin alone or in combination (median 2 [95% CI 1.5-3] days) and those without clindamycin treatment (2 [95% CI 1-6.275] days; P = .79). | D ISCUSS I ONConsistent with a previous report by Braunstein et al, 3 our study found that SSSS-associated isolates demonstrated significantly higher rates of clindamycin resistance and lower rates of methicillin resistance compared to overall staphylococcal infections.Clindamycin, a ribosomal inhibitor, is frequently recommended as a first-line agent in SSSS to decrease toxin production. 4,5 We did not observe any benefit, assessed by length of admission, between patients treated with and without clindamycin. Four patients with resistant isolates received empiric clindamycin monotherapy, yet their clinical course did not differ significantly from patients who received adequate empiric coverage. Overall, we favor cephalosporins and penicillinase-resistant penicillins (eg, oxacillin) for empiric management of SSSS, with consideration of adding MRSA coverage in communities with high MRSA prevalence, for patients presenting with sepsis or severe systemic illness, or given failure to improve following several days of treatment.Limitations of our study include its retrospective nature and small sample size drawn from a tertiary care hospital. Antibiogram data were obtained from adult patients because no pediatric-specific records were available. Finally, our microbiology laboratory does not assay for toxin production, so cultured isolates may not correspond to the pathogenic strain.