Discussions that mention septra

Infectious Diseases board


I agree with the thought that the antibiotic treatment isn't long enough. Sorry janewhite, don't mean to be adversarial, but I DO agree that patients can keep re-COLONIZING themselves with a certain strain of MSSA or ca-MRSA, but when you get repeated invasive infections with one of the two, something else is going on that cleaning the house or decolonizing yourself won't fix.

There are a number of possibilities:

#1. Yes, as someone mentioned before, the antibiotic treatment is not long enough. This is especially true for deep seated infections as those which occur in cartilage or bone (i.e. vertebral discitis or osteomyelitis).

#2. The antibiotic which is being used is not appropriate to destroy the bacteria. In Canada, usually less than 10% of our Staphylococcus aureus is resistant to semi-synthentic penicillins (such as oxacillin or cloxacilin), but in the states, in some places up to 40% are resistant!! The cefazolin injection you received will destroy methicillin SENSITIVE staph (MSSA) but it will NOT kill methicillin resistant (MRSA). That is probably why they put you on bactrim (septra in Canada) because that will kill both MSSA and MRSA.

#3. With invasive Staph aureus infections, you must always rule out a reservoir of infection. The reservoir can be inhibited by antibiotics, but as soon as you stop them, the infection comes back. Because you had an infection in your scrotum and then you had an infection on your butt could be an indication that the bacteria entered your bloodstream and then settled in the tissue of your buttock. In this case it is IMPERATIVE to rule out something called bacterial endocarditis. Staph aureus LOVES to grab on to heart valves and stick there forming a reservoir of infection which constantly "seeds" the bloodstream. It can usually be cured with 6 weeks of IV antibiotics depending on how big the valvular vegetation is. Have the doctors done an echocardiogram on you?

#4. Along the same idea as #3, assuming the bacteria didn't enter the bloodstream, if there is a large abscess or dead/necrotic tissue in the areas that were getting infected, they will have to be removed surgically because no amount of antibiotics will penetrate that area.

#5. Another important reservoir of infection is vertebral osteomyelitis which should be ruled out if you are having back pain.

#6. Finally, certain immune deficiencies, i.e. mostly diseases of primary immune system (i.e. neutrophil/macrophage) dysfunction which can result in repeated Staphylococcal infections. I have a feeling this is NOT what is going on in you.