Treatment

Dear Mrs. MRSA, 

My husband has been diagnosed with MRSA.  What is the treatment course we can expect?

Sincerely, 

~Stressed in St. Louis 

Dear Stressed, 

• For those people who are colonized with MRSA they can use a special washing powder that will kill the MRSA living on the skin.  Special shampoo is used on the head.  You also apply a cream to the inside of the nose to kill MRSA bacteria there.  This treatment is done for 5 days, and can be done at home.  

• MRSA that is causing an active infection needs to be treated with antibiotics.  Depending on the genetic makeup of the bacteria one is infected with different antibiotics may or may not be successful.  

• The most common antibiotic used to treat MRSA infection is vancomycin.  Other antibiotics that may be used along with vancomycin include rifampin and gentamicin - though this is not always recommended.  

• Skin and Soft Tissue - for an abscess or boil the site will need to be lanced and drained.  However, a more serious and widespread infection like cellulitis will require systemic antibiotics for 5-10 days.  Patients who are sick with other health conditions will probably receive IV vancomycin for 7-14 days.  

• Endocarditis - vancomycin is the recommeded treatment, and certain types of endocarditis require additional antibiotics.  An echocardiogram - sort of like a picture of the heart, is taken.   This helps the provider see the size, shape, and function of the heart.  Valve reconstruction surgery may be indicated for patients with severe damage.  

• Osteomyelitis and joint infection - treatment with vancomycin and possibly rifampin for at least 3 weeks, and possibly longer along with debridement of the bone that is infected.   Debridement is where the health care provider cleans out the dead and infected tissue of a wound so that new, healthy tissue can grow.  

• Blood Infections/ Sepsis - find the original site of infection and treat that, usually with surgical debridement and vancomycin.  

• Pneumonia - drainage of the lungs, along with vancomycin

IV Vancomycin Preparation 

Image Source http://7daypharmacy.net/vancomycin-without-a-prescription.html

The problem with treating MRSA with conventional medical therapies (i.e. antibiotics) is that many times the infection will come back.  If an infection comes back it becomes even harder to treat.  In addition to recurance some patients are allergic to vancomycin.  

As microorganisms evolve to become resistant to antibiotics it is important for the medical community to recognize other treatments for these "superbugs".

Check out this article from BBC News about garlic was used to successfully treat MRSA!  Scientists used a recipe from the Middle Ages to concoct a salve that was 99.9% effective in killing MRSA bacteria in both culture and live mice.  

References 

Lui, C., Bayer, A., Cosgrove, S.E., Daum, R., Fridkin, S.K., Gorwitz, R.J., Kaplan, S.L…. Chambers, H.F.  (2011).  Clinical practice guidelines by the infectious disease society of America for the treatment of methicillin-resistant staphylococcus aureus infection in adults and children.  The Oxford University Press, 1, 1-38.  doi: 10.1093/cid/ciq146