Get your Health question answered in 3 easy steps
A Doctor will be with you shortly
Ask a Doctor Now
139 Doctors are Online

Undergoing treatment for a staff infection of the sinus. Prescribed vancomycin. What is the best course of action?

User rating for this question
Very Good
Answered by

Nephrologist
Practicing since : 2009
Answered : 4361 Questions
Question
My husband 59 is undergoing treatment for a staff infection of the sinus. Test results show the big is resistant most common antibiotics except Cubicin(daptomycin) Vancomycin and another high powered drug. He was on a combination of Cubicin and Invance (iv) for 2 weeks. Blood tests showed an increase in a liver enzyme and low neutrophil count. His Dr. Is now recommending Vancomycin and another antibiotic (iv) infusion 2x a day for a month.
An alternative is surgery. Im concerned that if this round of treatment is ineffective that a resistant infection may develop that is not responsive to anything.
My question is should we opt for surgery now and forgo the antibiotic treatment? Most likely he will need surgery anyway and post surgical antibiotic treatment possibility with the same drugs as above.
What is the best course of action at this point?
He has had the infection for over a year, is a diabetic, overweight, and hypertensive.
Posted Mon, 3 Sep 2012 in Infections
 
 
Answered by Dr. Rakesh Madhyastha 5 hours later
Hello

Thanks for the query

This situation is what we are seeing in our everyday practice, multi resistant bacterial infections are on the rise. I will consider your husband lucky as there are some antibiotics which are still effective against the bacteria

I recommend he undergoes surgery as soon as possible following which he has to receive the course of vancomycin. Here in our set up we give the option of keeping the Iv cannula on and send them home, only to come to the hospital for the two doses of vancomycin.
Please don't avoid Iv medications more do because he is a diabetic and he has higher risk of it converting into a systemic Involvement especially meningitis and encephalitis since the sinuses are involved.
I hope I have answered your query, please get back to me if you have any further ones

I wish him a speedy recovery

Regards
Above answer was peer-reviewed by
 
Follow-up: Undergoing treatment for a staff infection of the sinus. Prescribed vancomycin. What is the best course of action? 1 hour later
I'm sorry but I didn't quite understand if he should go on the two new antibiotics as well as have the surgery? I know he will be put on meds post surgery but should he continue with the recommened course now?
 
 
Answered by Dr. Rakesh Madhyastha 8 minutes later
Hello

I am sorry if I was not clear

Yes, he should be on the two antibiotics and go for surgery. That is the best option for him. Vancomycin is safe in people with raised liver enzymes. Surgery only brings down the bacterial load but does not eliminate it completely so if will need surgery plus antibiotics to prevent recurrence

I hope I was of help

Regards
Above answer was peer-reviewed by
 
Follow-up: Undergoing treatment for a staff infection of the sinus. Prescribed vancomycin. What is the best course of action? 1 hour later
Thank you for your response. I will tell my husband your recommendation. I appreciate your prompt reply. I believe you are correct with this approach. Now we will see what his Dr. Says tomorrow.
 
 
Answered by Dr. Rakesh Madhyastha 4 minutes later
Hello

You are taking the right decision.

I am glad I was of help to you

I wish you husband good health and a speedy recovery

Regards
Above answer was peer-reviewed by
 
Share on Facebook
Share on Twitter
Share on Google+
Question is related to
Diseases and Conditions
Drug/Medication

The user accepted the expert's answer

Ask an Internal Med Specialist

© Ebix, Inc. All Rights Reserved.
All the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. You should always speak with your doctor before you follow anything that you read on this website. Any health question asked on this site will be visible to the people who browse this site. Hence, the user assumes the responsibility not to divulge any personally identifiable information in the question. Use of this site is subject to our Terms & Conditions
Already Rated.
Your rating:

Ask a Doctor