The prevention and treatment of infections caused by the bacteria called Staphylococcus aureus has become difficult because of the worldwide appearance of drug-resistant strains. Staphylococcus bacteria, or staph, normally live on your skin and in your nose without causing problems, but if these bacteria enter your body through broken skin, they may cause an infection. Staph infections can occur anywhere in your body and can be minor -- such as a boil on your skin -- or more severe -- affecting your heart, lungs, blood, or bone. Most staph infections can be cured with antibiotics such as methicillin. MRSA, or methicillin-resistant Staphylococcus aureus, is a type of staph bacteria that is highly resistant to the antibiotics commonly used to treat staph infections, including methicillin. If bacteria are resistant to an antibiotic, the antibiotic cannot cure the infection. According to the National Institutes of Health, or NIH, about 2 percent of people are carriers of MRSA. Fortunately, newer and stronger antibiotics are available today that can kill MRSA.
Mupirocin
According to the American Academy of Family Physicians, mupirocin is an antibiotic that is used for treating mild cases of MRSA. Mupirocin used in conjunction with drainage of the abscess is usually successful in treating the infection. Mupirocin is also used to help prevent MRSA infections. A study published in “Critical Care” in 2005 showed that intranasal administration of mupirocin significantly lowered the number of MRSA infections in people who were hospitalized. However, there have been reports that some strains of MRSA have become resistant to mupirocin.
Clindamycin
According to the Centers for Disease Control, or CDC, clindamycin is an antibiotic that is useful for treating MRSA infections. A study published in the Journal of the American Board of Family Medicine in 2010 showed that clindamycin was highly effective in treating MRSA skin infections when given along with incision and drainage of the infection. Clindamycin cured the infection in 75 percent of the individuals treated. Like other antibiotics, clindamycin can cause some side effects, including gastrointestinal effects. However, clindamycin is more likely than other antibiotics to trigger overgrowth of bacteria called Clostridium difficile and cause problems ranging from mild diarrhea to life-threatening colitis. Clindamycin is sold under the brand name Cleocin, among others. Clindamycin comes in capsule and liquid form to take by mouth.
Trimethoprim-Sulfamethoxazole
Trimethoprim-Sulfamethoxazole, or TMP/SMX, is another antibiotic that may be beneficial for treating MRSA infections. In a study published in the Journal of the American Board of Family Medicine in 2010, TMP/SMX had a 74 percent success rate in curing MRSA skin infections. TMP/SMX belongs to a class of drugs known as sulfonamides. Sulfonamides are known for a rare but serious side effect known as Stevens-Johnson syndrome, a life-threatening skin condition. This disorder causes a progressive disintegration of skin, sudden and severe liver damage and a serious blood disorder. You should call your doctor at the first sign of a rash or any other unusual effect when taking TMP/SMX. Also, you should avoid taking TMP/SMX in the third trimester of pregnancy. TMP/SMX is available in tablet form and is sold under the brand name Bactrim, among others.
Linezolid
Linezolid, sold under the name brand Zyvox, is effective against MRSA. According to Drugs.com, the effectiveness rate for linezolid ranges from 59 percent to 94 percent for treating MRSA infections. However, linezolid may cause some serious health problems. Lactic acidosis, which occurs when your blood becomes too acidic because of excess lactic acid in your body, is a life-threatening condition that has been reported with the use of linezolid. Serotonin syndrome can occur if you take linezolid with medicines that affect your serotonin levels, such as the selective serotonin reuptake inhibitor antidepressants, or SSRIs. If you develop symptoms such as a high fever, twitching, spasms and incoordination, you may have serotonin syndrome. Linezolid may also cause convulsions, particularly if you have a history of seizures or are prone to seizures. Vision problems possibly leading to blindness may also occur from linezolid, especially if it is taken for longer than the maximum recommended duration of 28 days. Tell your doctor if you notice visual impairment such as changes in visual acuity, changes in color vision or blurred vision.
Considerations
According to the NIH, serious MRSA infections are becoming increasingly difficult to treat. If you have a MRSA infection, your doctor will follow medical treatment guidelines to determine which antibiotic is best for you. When you are taking antibiotics, make sure to take all the doses, even if you feel better before the antibiotic is finished. If you do not finish the full course of the antibiotic, this may cause your infection to come back and increase the probability that the bacteria will develop resistance and will not be treatable by antibiotics in the future. MRSA skin infections can progress to more serious problems, so tell your doctor if your symptoms worsen or if you do not feel better within 48 hours of starting treatment.
References
- National Institutes of Health: MRSA
- American Academy of Family Physicians: MRSA
- “Critical Care”; Use of Intranasal Mupirocin to Prevent Methicillin-Resistant Staphylococcus Aureus Infection In Intensive Care Units; A Muller, et al.; Mar 2005
- “Mikrobiyoloji Bulteni”; Investigation of Mupirocin Resistance in Nosocomial Methicillin-Resistant Staphylococcus Aureus Isolates by Phenotypic and Genotypic Methods; T Us, et al.; Jul 2009
- Centers for Disease Control: Treatment of MRSA Infections
- “Journal of the American Board of Family Medicine”; Trimethoprim-Sulfamethoxazole or Clindamycin for Community-Associated MRSA (CA-MRSA) Skin Infections; CR Frei, et al.; Nov-Dec 2010
- National Institutes of Health: DailyMed for Clindamycin
- Drugs.com: Bactrim
- Drugs.com: Linezolid
