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    Does Rocephin help cure streptococcus?

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Posted on Mon, 7 Aug 2017 in Medicines and Side Effects
Question: my wife is being treated for Strep Equine with Rocophin. Is this the best treatment? XXXXXXX
doctor
Answered by Dr. Panagiotis Zografakis 31 minutes later
Brief Answer:
it should work

Detailed Answer:
Hello,

rocephin should normally be an overkill for this Streptococcus which rarely infects humans. It's so rare that most infectious diseases textbooks don't even mention it! Since your wife has a positive culture, I suppose an antibiogram (antibiotic sensitivity test) was done as well. The antibiogram is the best way to determine the most effective antibiotic, so her doctors must done the right choice.

I hope you find my comments helpful!
Kind regards!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Panagiotis Zografakis 1 hour later
Thanks She was given Invanz Monday as a new try but it made her so sick and nauseous that she begged them to quit that med and go back to Rocophin. So they did. Should she tough it out and try Invanz again? XXXXXXX
doctor
Answered by Dr. Panagiotis Zografakis 17 minutes later
Brief Answer:
I can't say...

Detailed Answer:
Both antibiotics are usually effective against Streptococcus but only the antibiogram may shed some light on this issue. I suppose that Invanz was considered more effective than rocephin but rocephin should be adequately effective (or they wouldn't have given it again to her). The choice may also have to do with the infected site. Do you have access to her tests? Can you upload the antibiogram? Also, what kind of infection does she have? For example meningitis, pneumonia, arthritis, etc...

Kind regards!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Panagiotis Zografakis 36 minutes later
Yes we have access to her tests but they haven't given her the antibiogram as far as we know. I will ask about that Monday when see her DR. All I know about her infection is that it is that Streptococcus Equine and it was so bad in late May that she had her third TKR on that knee. She was in the hospital for 10 days and 20 in rehab. But she doesn't have pneumonia altho she did have fluid on her lungs for a while. She doesn't have any other infections. XXXXXXX
doctor
Answered by Dr. Panagiotis Zografakis 24 minutes later
Brief Answer:
there should be an antibiogram

Detailed Answer:
Thanks for the additional info!

The antibiogram should be there. When the culture is positive the lab doctor commonly proceeds with the antibiogram. If she's so ill, then I doubt that the clinician didn't ask for it!

I didn't quite understand where the focus of infection is. Is it her knee? If that's the case then it's a tough one...

Best wishes for a speedy recovery!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Panagiotis Zografakis 4 hours later
Yes it is in her left knee. She had two TKRs in that knee about 15 years ago. On May 29th 2017 evidently the infection blossomed and the pain was so bad and she couldn't walk so she went to the ER. The part in the femur had been loose and bothering her for some time but her regular Orthopedic surgeon hesitated to operate. The X-ray showed for some time that the upper component was loose. SO in the ER they decided she had to have surgery ASAP. It took about a week for her vital signs to all become satisfactory and then they operated. The surgery went well according to the surgeon but the infection persisted in spite of being treated in the hospital and in Rehab with the latest infectious disease medicine but I am not sure what it was in the hospital. XXXXXXX
doctor
Answered by Dr. Panagiotis Zografakis 2 hours later
Brief Answer:
this is serious, the antibiogram should guide treatment

Detailed Answer:
Infection in a freshly operated knee is serious and has to be treated according to the antibiogram in order for the patient to receive the best possible treatment. Such infections require a lot of time to improve and sometimes there are treatment failures. The prosthetic material may have to be removed in some cases but the doctors will try to cure the infection before going on to a new surgery.

So, coming back to your first question... I can't 'guess' which drug is the best as different strains of the same pathogen may have different sensitivities to certain antibiotics. Rocephina and invanz should both be effective against a Streptococcus but for such a serious infection only the antibiogram should guide treatment. Empiric treatment can be given only until the cultures detect the causative agent. Since they've got a positive culture, an antibiogram should be available.

Kind regards!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Panagiotis Zografakis

Internal Medicine Specialist

Practicing since :1999

Answered : 3691 Questions

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