Discussions that mention septra

Infectious Diseases board

[QUOTE=jellybean3009;3620463]Can anyone on the board tell me which antibiotic cured your staph infection?

Hi, the antibiotic which kills staph all depends on which staphylococcus you have.

The most common cause of infections with Staphylococcus in the community is Staphylococcus aureus. All Staphylococci are inherently resistant to naturally occuring, first generation penicillins such as Penicillin V (penvee) or amoxicillin. Then you get in to the Methicillin SENSITIVE Staph aureus (MSSA) or Methicillin RESISTANT Staph aureus (MRSA).

MSSA can generally be treated with semi-synthetic or Staphylococcal-penicillins which are special penicillins which were designed specifically to get by Staph aureus' defenses and kill it. These include: oxacilln, cloxacillin, fluoxacillin and dicloxacillin. You can also use cephalosporins such as cephalexin, cefazolin, cefuroxime, cefoxitin, ceftriaxone, cefixime etc, and vancomycin. Those are the usual choices. For more garden-variety infections you can also use: Septra (bactrim), levoflox/moxifloxacin, doxycycline/tetracycline/minocycline, clindamycin, azithro/clarithromycin etc. For very severe infections, you will see things like: IV clox/ox/diclox, vancomycin (good first choice if you don't know whether it's MRSA or MSSA) piperacillin/tazobactam, ticarcillin, carbenicillin, meropenem, imipenem, etc. etc.

MRSA is a bit harder to treat because it is resistant to what MSSA is resistant to, but it is also resistant to al of the semi-synthetic penicillins (i.e. oxacilln and the like), pip/taz, ticar, carbenicillin, almost ALL of the cephalosporins, and it is even resistant to our nuclear bomb antibiotics such as mero and imipenem!! However, there is a new cephalosporin called ceftibiprole which can treat MRSA (not available in the states).

Otherwise, in hospital, vancomycin is used to treat MRSA, and oral agents which are active usually (though you should always confirm with the lab) are: septra, rifampin, doxycycline, linezolid etc.

So those are MRSA and MSSA which are versions of Staphylococcus AUREUS. There is also a group of Staphylococci which are collectively termed the "Coagulase Negative Staphylococci" (CNSt). They are different because they are very similar to MRSA in that they are very resistant to many antibiotics. They normally live on the skin, and aren't too much of a problem unless you have a foreign object in your body such as a prosthetic heart valve or an indwelling intravenous line. Vancomycin is usually the first agent used when an invasive CNSt infection is suspected. After that, you have to check the lab report to see which antibiotics can be used, as they vary. Things CNSt is often sensitive to includes: doxycycline, levofloxacin (sometimes), septra, rifampin and so on.