Children DO present to ER with MRSA pneumonia, though it is not common.
The risk of MRSA pneumonia INCREASES in cases where the child has a preceding viral infection, especially influenza A.
The antibiotic coverage (cephalosporin and vancomycin) was reasonable, especially if the patient had a preceding measles infection, for the above reason.
The physician doing the condemning has an agenda.
Coverage with a broad spectrum antibiotic and vancomycin is reasonable.
Question: What was the bug that was cultured that killed the child? Does anyone even know? Was it not covered by the given antibiotics?
EVEN IF the causative organism was resistant to the antibiotics chosen by the ER doctor, then, you probably still could not make the case that the care was substandard.
HARD LESSON: Children who are immunosuppressed following a deadly measles infection and who get a secondary bacterial pneumonia are still at risk of dying EVEN if they receive the macrolide (azithromycin) that the condemning doctor advocates.
This child could have died even if he or she had received every antibiotic in the USP.
This is not necessarily a medical error.
MRSA very unlikely just coming to the ER as she did from the community. To ignore the second type of antibiotic — and then take the better part of a day to give her the right antibiotic after it had been confirmed by testing is negligence bordering on manslaughter.