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Suggest Treatment For Staph Infection
Question: My 20 year old son has a pimple that keeps coming back in his nostril. The walk in clinic that he goes to near his community college and work place told him it was a staph infection. This has happened 3 times.
This last episode, the Dr. gave him an ointment to put on when it first appears. This week, two pimples appreared on his face, not in the nostril this time. One in on his cheek near his eye, the other is on his chin. He is putting the ointment on them, but we are concerned that maybe this is not enough. We would like to find out more about this "staph" infection. His employer will not let him work the concessions with these sores on him, they only schedule him to clean and usher in the theatre. This cuts down his hours and is making it difficult to pay his rent and tuition. We is scared and depressed. Can you give us any advice or lead us to a direction we should go. Right now, he does not have medical insurance. Trying to find a policy he can afford just working part time and going to school. He lives 3 and 1/2 hours from us so there is not much we can do this far away, but hoped I could find some answers for him. Thank you for your help.
This last episode, the Dr. gave him an ointment to put on when it first appears. This week, two pimples appreared on his face, not in the nostril this time. One in on his cheek near his eye, the other is on his chin. He is putting the ointment on them, but we are concerned that maybe this is not enough. We would like to find out more about this "staph" infection. His employer will not let him work the concessions with these sores on him, they only schedule him to clean and usher in the theatre. This cuts down his hours and is making it difficult to pay his rent and tuition. We is scared and depressed. Can you give us any advice or lead us to a direction we should go. Right now, he does not have medical insurance. Trying to find a policy he can afford just working part time and going to school. He lives 3 and 1/2 hours from us so there is not much we can do this far away, but hoped I could find some answers for him. Thank you for your help.
Brief Answer:
Most likely he is a carrier of staph in his nostril area
Detailed Answer:
Hello. Thank you for writing to us
I have gone through your query and I have noted down your concern.
Most likely he is a staphylococcus aureus carrier. Approximately 30% of population carry staph. at various sites like nostrils, axilla, umblicus, perianal area etc. This carrier state can be a source of repeated skin and soft tissue infections in the surrounding region.
Though an empirical course of an Oral antibiotic would reduces the carrier bacterial population and help resolve the infection but staph. aureus usually multiplies soon after and again colonise the region. Other measure include taking a pus sample for culture and sensitivity and identifying antibiotic sensitivity of isolated bacteria and then guiding specific antibiotic therapy according to that.
In addition to oral antibiotics and general measures like maintence of good hygiene, clean surroundings, using an antibacterial soap etc using a 2% mupirocin ointment, twice daily, just inside the nares for 5 days helps eradicate carrier state in this region, for at least 3 months.
Rifampicin along with a penicillin group of oral antibiotics is also an effective option for eradicating carrier state.
Regards
Most likely he is a carrier of staph in his nostril area
Detailed Answer:
Hello. Thank you for writing to us
I have gone through your query and I have noted down your concern.
Most likely he is a staphylococcus aureus carrier. Approximately 30% of population carry staph. at various sites like nostrils, axilla, umblicus, perianal area etc. This carrier state can be a source of repeated skin and soft tissue infections in the surrounding region.
Though an empirical course of an Oral antibiotic would reduces the carrier bacterial population and help resolve the infection but staph. aureus usually multiplies soon after and again colonise the region. Other measure include taking a pus sample for culture and sensitivity and identifying antibiotic sensitivity of isolated bacteria and then guiding specific antibiotic therapy according to that.
In addition to oral antibiotics and general measures like maintence of good hygiene, clean surroundings, using an antibacterial soap etc using a 2% mupirocin ointment, twice daily, just inside the nares for 5 days helps eradicate carrier state in this region, for at least 3 months.
Rifampicin along with a penicillin group of oral antibiotics is also an effective option for eradicating carrier state.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
You stated in your answer,
"...using a 2% mupirocin ointment, twice daily, just inside the nares for 5 days helps eradicate....."
Do you mean he should put the ointment inside his nostrils or on the the pimples/blisters that are popping up on his face?
"...using a 2% mupirocin ointment, twice daily, just inside the nares for 5 days helps eradicate....."
Do you mean he should put the ointment inside his nostrils or on the the pimples/blisters that are popping up on his face?
Brief Answer:
2% mupirocin cream
Detailed Answer:
Hi.
Apply at both places i.e at the pimple itself as well as just inside the nostrils i.e vestibule of nose, because thats where the bacteria colonises and causes infection in surrounding area.
In addition he must also take an Oral antibiotic e.g either Amoxicillin 500 mg + clavumanic acid 125 mg (Augmentin 625 mg), thrice daily for a week Or Cephalexin 500 mg (Keflex 500 mg) thrice daily for a week.
Regards
2% mupirocin cream
Detailed Answer:
Hi.
Apply at both places i.e at the pimple itself as well as just inside the nostrils i.e vestibule of nose, because thats where the bacteria colonises and causes infection in surrounding area.
In addition he must also take an Oral antibiotic e.g either Amoxicillin 500 mg + clavumanic acid 125 mg (Augmentin 625 mg), thrice daily for a week Or Cephalexin 500 mg (Keflex 500 mg) thrice daily for a week.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
The first three times these pimples occurred, the doctor wrote him a prescription for Sulfamethoxazole-TMP DS tablet. The last time he went back, he asked for multiple refills because his insurance was ending and he knew he would not be able to afford to go back and pay for an office visit just to get a prescription. She would not write him a prescription of the oral antibiotic, she only gave him the prescription for the mupirocin ointment and 3 refills.
You say he should have an oral antibiotic also. I don't understand why she would not give him that as well. I will tell him to call and see if she will write him a prescription for the oral antibiotic without seeing him. Now that he does not have insurance, the office visit will cost him way more than $35. If she won't write him the prescription, is there another way for him to get the antibiotic?
You say he should have an oral antibiotic also. I don't understand why she would not give him that as well. I will tell him to call and see if she will write him a prescription for the oral antibiotic without seeing him. Now that he does not have insurance, the office visit will cost him way more than $35. If she won't write him the prescription, is there another way for him to get the antibiotic?
Brief Answer:
Topical mupirocin may be enough though it may take a bit longer
Detailed Answer:
Hi.
Oral antibiotics are prescription medications and would be available only on prescription. Nevertheless, the mupirocin ointment may be enough all by itself, for just 2 lesions, although, I would have given an Oral antibiotic in addition to topical because oral antibiotics help resolve the infection faster as compared to just topical antibiotics.
Regards
Topical mupirocin may be enough though it may take a bit longer
Detailed Answer:
Hi.
Oral antibiotics are prescription medications and would be available only on prescription. Nevertheless, the mupirocin ointment may be enough all by itself, for just 2 lesions, although, I would have given an Oral antibiotic in addition to topical because oral antibiotics help resolve the infection faster as compared to just topical antibiotics.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
He would like to know if his room mates could catch this from him? Or his girlfriend, They are not sexually active but do kiss.
Brief Answer:
There is a risk of infection in close contacts
Detailed Answer:
Hi.
A nasal carrier does pose an increased risk of infections to its close contacts.
Regards
There is a risk of infection in close contacts
Detailed Answer:
Hi.
A nasal carrier does pose an increased risk of infections to its close contacts.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Are there any specific cautions they should heed in order to not catch this? Do they need any medications to prevent them from catching it? Can they catch it from just touching the same doorknob or the tv remote control? How contagious is this? If he takes a shower and the water rolls across his face (the staph pimple) then rolls down his body, will it cause pimples to break out all over his body? Does he need to shower with antibacterial soap? How can he get the answers to all his questions like this? We don't know where to get info for just day to day controlling and containing this! He doesn't want anyone else to get this,he calls it his death sentence. He wants to know if it will be passed on to his children? Please give us these answers or direct us to someone who can. Thank you!
Brief Answer:
Answers to specific queries
Detailed Answer:
Hi.
Mupirocin 2% ointment, twice daily for 5 days, need to applied just inside the anterior nares to eradicate carrier state. This is the only precaution. This will reduce the chances of recurrent infections by reducing the resident bacterial flora.
A carrier individual has more chances of skin and soft tissue infections, as compared to others due to the omnipresent infecting organism, hence the need to eradicate carrier state.
The site of recurrent infections in a carrier, is commonly around the site of carriage i.e in or around the nose in those who are nasal carrier not elsewhere, neither does it spread through shower/ water.
Of course, a person who is a carrier can unknowingly deposit the infecting organism at sites like door knobs, towels etc and this can lead to a slightly higher risk of skin infections in other people in his/her surroundings but that does'nt mean that all individuals in contact with him will certainly develop skin infections! There is a higher risk of infection in contacts, they may Or may not develop infections/ boil etc.
Yes, using an antibacterial soap, regularly also reduces the chances of infection. Carrier state is not genetic and I don't think his children would acquire it.
To summarise, the carrier state can be wasily eradicated by using mupirocin ointment, tiwce daily in anterior nares for 5 days.
Regards
Answers to specific queries
Detailed Answer:
Hi.
Mupirocin 2% ointment, twice daily for 5 days, need to applied just inside the anterior nares to eradicate carrier state. This is the only precaution. This will reduce the chances of recurrent infections by reducing the resident bacterial flora.
A carrier individual has more chances of skin and soft tissue infections, as compared to others due to the omnipresent infecting organism, hence the need to eradicate carrier state.
The site of recurrent infections in a carrier, is commonly around the site of carriage i.e in or around the nose in those who are nasal carrier not elsewhere, neither does it spread through shower/ water.
Of course, a person who is a carrier can unknowingly deposit the infecting organism at sites like door knobs, towels etc and this can lead to a slightly higher risk of skin infections in other people in his/her surroundings but that does'nt mean that all individuals in contact with him will certainly develop skin infections! There is a higher risk of infection in contacts, they may Or may not develop infections/ boil etc.
Yes, using an antibacterial soap, regularly also reduces the chances of infection. Carrier state is not genetic and I don't think his children would acquire it.
To summarise, the carrier state can be wasily eradicated by using mupirocin ointment, tiwce daily in anterior nares for 5 days.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your answers. Just one more question, when you say
"the carrier state can be easily eradicated by using mupirocin ointment, twice daily in anterior nares for 5 days."
Do you mean this will get rid of this infection in his body or just keep it controlled? If you have any links to any info online that may be helpful to us, please share that. We are searching and reading but not sure what is realiable sources.
Thank you again for your help.
"the carrier state can be easily eradicated by using mupirocin ointment, twice daily in anterior nares for 5 days."
Do you mean this will get rid of this infection in his body or just keep it controlled? If you have any links to any info online that may be helpful to us, please share that. We are searching and reading but not sure what is realiable sources.
Thank you again for your help.
Brief Answer:
Supporting scientific articles
Detailed Answer:
Hi.
Intranasal application of mupirocin ointment is the simplest and easiest method to eliminate nasal carrier state of staphylococcus. Though there is a chance of re-colonisation after a few weeks but that is not the case in all patients.
You may find the following articles/links useful:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC0000/
http://www.nhs.uk/conditions/Staphylococcal-infections/Pages/Introduction.aspx
http://www.ncbi.nlm.nih.gov/pubmed/0000
Regards
Supporting scientific articles
Detailed Answer:
Hi.
Intranasal application of mupirocin ointment is the simplest and easiest method to eliminate nasal carrier state of staphylococcus. Though there is a chance of re-colonisation after a few weeks but that is not the case in all patients.
You may find the following articles/links useful:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC0000/
http://www.nhs.uk/conditions/Staphylococcal-infections/Pages/Introduction.aspx
http://www.ncbi.nlm.nih.gov/pubmed/0000
Regards
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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