Question: My mother has what looks to be a severe skin infection, both under her right breast and under her loose skin that is her right lower abdominal quadrant where she has excess fat and skin that hangs down right above her pelvic area. She has had this before (and on left and right sides before, but never this infected) and was able to treat it with ointments such as hydrocortisone and A & D ointment and even tried antifungal ointments used for jock itch.

This time the area is looking much more infected covering her right lower abdomen under that roll/flap of skin that hangs down, as well as under her right breast. It is severely infected to the point in my opinion that it will soon break open and start to be an open bleeding rash with or without pus. Currently, it looks severely infected and just close to starting up with pus and/or an open, oozing wound.

In the past she has had a MRSA infection that started with a small cut on her knee that grew to a dime sized hole growing/progressing inward from a pretty hard fall in a neighbors doorway threshold by catching her toe and falling forward. By the time i came to visit weeks later she had mention it growing into a hole instead of healing and going away. Very symptomatic of an infected bedsore. However, she does not have diabetes and it was her knee. This time I was quite concerned that the rash is so bad that she is going to have it become an open would and end up with the MRSA infection going rampant again and her having to go through months of IV Vancomycin as well as debridement sessions which of course I do not want for her. I plan to have her see her regular doctor tomorrow. I have explained the current severity as well as potential severity as to why I DON'T want her waiting until her GYN visit 5 days from now. I have Doxycycline Hyclate that I use for Rosacea with adult onset acne problems. I currently have more Doxycycline Hyclate than I can possibly use up as I lowered my dosage and would like to start her on it ASAP since its such a wide spectrum medication that handles bacterial skin infections. I need to know a dosage amount I can give her orally to get her started in a hurry before I end up having to take her to the ER. I've explained how serious this is with her hx of MRSA (about 3 years ago) and it looks pretty bad and widespread enough that I hate to see her having to end up back in debridement again over such large areas of her body, let alone more private parts of her body. My Doxycline Hyclate is in 100 mg capsules. Should I start her on 100 mg, 2 capsules BID to try to hit it hard? or with her hx of MRSA, possibly TID?

After researching a bit more on PDR.net I see the the most given is 200 mg BID for most severe situations except such things as Anthrax which is the 200 mg BID for 60 days. This I do understand now. My biggest concern is the MRSA once it does or IF it does become an open wound. She has no medication allergies except PCN (and anything with PCN derivatives obviously).

Just so you know, a bit about me (her 55 yr old daughter). I am currently living with her and am signed as being able to talk on her behalf. We have Power of Attorney for me in her Living Will. Anyway, she is right here with me as well should you have further questions.

I have a history of being a Medical Administrative Assistant for 30 years, and have recenrtly completed a course to receive my Medical Assistant diploma and I have BLS certification too. Currently, I am in the process of working toward getting a diploma in Medical Office Administration that includes some billing and coding. This is why I know enough where to look for answers. I have used PDRs since in my 20s and my first jobs at Loma XXXXXXX University Medical Center working as Physician support both in the Patient care arena as well as in Academic support for my Physicians teaching endeavors.

Just an FYI, my mothers previous MRSA experience was an open wound on her knee that resulted with her being hospitalized, arthroscopicsurgery to go in and flush out her previous total knee replacement to try to ensure the MRSA did not get into her joint and cause a need for re-replacement on that knee. Thankfully, that was not required. After a stint of 3 days in-house, she was released to return to the outpatient clinic to begin arduous treatments of IV Vancomycin and knee debridement appointments 2 times per week. This went on for about 3-4 months before they got it under control. Hence, my concern this time..... as you can imagine! :-)

Thank you for your time in allowing me this lengthy descriptive request for confirmation answers.

XXXX
(daughter of XXXX)
*note* I am handling this online "stuff" as my mother is absolutely NOT computer savy and refuses to be taught.