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Doctors' Answers to "Frequently Asked Questions" - Staph Infections

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

[posted 03/8/2000]
Question: A friend of mine has developed MRSA in a wound from surgery. Her dr. is treating her with Macrodantin. I worked as a nurse for 10 years and have never heard of an oral antibiotic that would get rid of MRSA, only IV Vancomycin. Could you please tell me the current treatments for MRSA. Will oral antibiotics help or just make the bacteria more resistant? She has a home health nurse that comes daily who could administer the IV antibiotics if the dosage schedule was agreeable. What are your thoughts? Thank you.

Answer: Never heard of this one, but it might depend on the drug's sensitivity. This drug is primarily used for urinary tract infections and rarely for any other purpose due to its pharmokinetics. Ask for an ID consult.

[posted 08/22/1999]
Question: I recently got a staph infection and am currently going to an infusion center, after spending a week in the hospital for 1.5 grams of vancomycin, which is being injected through a central IV line.
I have a rather weak immune system, but I can't seem to figure out when or how I contracted this nasty infection. The infection localized in my ankle. Approximately two weeks before, I gave myself
a bruise on my ankle. Approximately three weeks before the diagnosis, I got a cat scratch on my knee. Also, back in November of 98, I had a surgery. This was an ankle fusion and they stretched my tibula.
I had 4 pins in my leg which were constantly draining. The doctor decided to take the pins out in February of 99 and placed a cast on my leg. February was the last time I had stepped into a hospital.

My questions are Can staph infections be dormant for months? (It's August now) Do staph infections localize to the area that I get cut, scraped or bruised on? And my last question is.. can I even get a
staph infection from a bruise?

Answer: Probably the scar tissue created in this area is the responsible agent. There is impairment of your immune system in this area due to the scarring. Also, there may have been seeding from the surgery to remove the pins, deep osteomyelitis can hide for awhile. Staph can invade your skin at any time, through minute openings. Occasionally, athletes get strep/staph infections following heavy exercise.

Staph Infection [posted 1/11/99]
Question: Our son has a recurrent staph infection on his legs, which demonstrates some improvement with use of identified antibiotics only to have the staph return after a few weeks. Possible acne condition is suspected along with the recurrent staph. Trying Accutane now - any other suggestions?

Answer: Daily washing with betadine or some equivalent surgical scrub solution.

Timentin Medication for Staph Infection [posted 12/02/98]
Question: I am trying to find information about a medication I am taking through I.V. for a staff infection for about 3 weeks from a foot surgery, I just started this medication Thursday 10/15 in the hospital till 10/17 ( the whole day Saturday). Well now I just had to start it at home on Tuesday night through I.V. and I am having the hardest time finding info. on the World Wide Web, and I didn't want to call on my pharmacist, so maybe you can help?? Hopefully. I am looking for side effects and why am I on this medication. The name is TIMENTIN by Smith Klein and Beecham.

Answer: Timentin is a combination of ticarcillin and clavulanate potassium. The clavulanate is used to decrease the resistance of bacteria to the ticarcillin. Ticarcillin is very much similar to penicillin in terms of side effects and allergies. It is structurally different;but, belongs to the same family. This would be rash, diarrhea, occasional nausea, thrush infections etc.

Staph. Aureus
Question: I have a daughter who was diagnosed with Staph. Aureus in her vagina. Can you tell me what this is, how to prevent it, and the dangers involved and how to treat it? She was given 200 mg of Augmentin antibiotics (chewable).

Answer: Staph. Aureus is a common bacteria found on the skin and cutaneous surfaces of the body. It is a common cause of skin infections, especially after a cut, abrasion, etc. However, it is usually not found in the vagina. Some Staph can produce a toxin which can result in different syndromes, the best known being Toxic Shock Syndrome. The way that this bacteria finds its way into the vagina is not perfectly clear, but many women use tampax or equivalent and this is clearly a risk factor. Birth control pills are thought by some to increase the risk. Due to the potential for toxin producing Staph, there is usually an effort to eliminate them from the vagina.

Chronic Staph
Question: What is the treatment for chronic nasal staph infection? Will Rifampin eliminate or just mask the infection?

Answer: Rifampin is the drug of choice and tends to eliminate over 90% of carriers.

Staph Infection
Question: Please tell me as much as possible about a bacterial infection, "Staphaureous", which I've been told I may have. Also , can it result in long term coughing, hoarseness, and a squeaky voice?

Answer: Staph aureus is short hand for Staphococcal Aureus. This is a cocci(spiracle) organism that is fairly common. It is found on the skin and many surfaces in the office and home. It is nicely positioned to cause skin infections. This bacteria acquires antibiotic resistance fairly easily and has become difficult to kill-- regular penicillin is usually ineffective. While it can cause bronchitis and respiratory infections, these are much less common than skin infections. The bacteria does have the ability to damage tissues after infections, but early treatment usually prevents this.

Recurring Staph Infections
Question: I was recently on work assignment outside of the U.S. (Bonaire, Netherlands Antilles) for 9 weeks. In the tropical conditions I sweated continuously. During that time I contracted a staph infection which initially manifested itself as up to 14 boil-like skin eruptions with puss centers, infection in my left eye which reddened to deep cherry red and became completely swollen shut, and a drained swollen left outer ear which was also draining from a point inside the cartilage crease in my external ear , and small blister like sites within the hair line at the base of my neck that drained a clear sticky substance into my hair, causing it to mat as if there were syrup in my hair. The local Dutch doctor prescribed Amoxicillin combined with something I can't recall (350 mg) 3x daily, and antibiotic eye drops (Tobrex--Tobramycin .03%). The Amoxicillin lasted for one week. The eye returned to normal, and the sites began to clear up. Two weeks later, I continued to have evidence of the infections on my body(smaller infection sites forming). I returned to the states where my physician prescribed 500 mg of Amoxicillin, which I took for 2 weeks. Since then, I have had to return to him 2 times for additional skin eruption sites-- boils on the buttocks and calf of my leg and formation and drainage of the blister-like sites on the back of my neck. I was given additional Amoxicillin. Last week I returned again after a weekend of draining from blister-like spots in the hair on the back of the neck. By the time he saw me Monday morning, the sites had cleared completely! These hair blisters itch intensely. Sites on the skin itch intensely just prior to the boil-like eruptions forming. I have now been put on 10 mg of Claritin, as he has no idea why I continue to have these skin eruptions. He feels it may be allergy related. The Claritin is to determine simply if they stop during the one month time I will be on this medication. After on Claritin for one week, I awoke this morning with sticky draining from a site in my left ear, and my eye had drained and crusty substance was on the eye. It is beginning to turn cherry red, just as the original staph infection. Can you give me some advice?

Answer: Amoxicillin is really not a very potent antibiotic for staph infections. You'd be better off using a cephalosporin or some other drug. Secondly, have these actually been cultured? Direct the antibiotics towards the bacteria which is cultured. Thirdly, check your IgA levels-- low levels will result in recurrent infections.

Staph infection on the face
Question: I have a staph infection on my face and back. I have red patches and some acne. What do you suggest? I am a 31 year old female.

Answer: Staph infections will require systemic antibiotics to clear. Focusing on keeping the face clean will help, but will not eliminate the problem. Most people have staph on the skin - an infection is quite a different matter.

Persistant Infection
Question:My son (two years old)has been getting boils once a month for the past year. His Pedi/Doc. says its a Staph infection in his nose and suggested it should be treated with antibiotics applied in his nose three tims a day for ten days and a antibiotic bath soap used with newborns for 3 days. We have been chasing down this problem for too long do you have any suggestions?

Answer: Boils of the skin are usually caused by gram positive organisms. Your physician is trying to decrease the number and virulence of the staph or strep bacteria on your sons skin by using antibiotic soap. In general, this is a cheap and usually effective treatment and doesn't involve giving antibiotics systemically which can always cause diarrhea-a major problem in a young child. Another possibility which is uncommon;but, occasionally present is an immune disorder. In children, these are usually inherited and center around the white blood cells ability to phagocize(eat) and digest bacteria. If your son continues with these infections, a visit to a pediatric infectious disease consultant might be in order.

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