14 August, 2017
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- Centers for Disease Control and Prevention: Strategies for Clinical Management of MRSA in the Community: Summary of an Experts’ Meeting
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Oral Antibiotics for MRSA
Mild MRSA, or methicillin-resistant staphylococcus aureus, infections of the skin can be treated with oral antibiotics such as trimethoprim-sulfamethoxazole, clindamycin, rifampin, minocycline or doxycycline, ciprofloxacin, and linezolid, according to the Centers for Disease Control and Prevention. It is important to note that some varieties of MRSA are becoming resistant to these and other medications as well. If your infection worsens or does not improve, contact your physician.
The CDC names trimethoprim-sulfamethoxazole as an option to treat MRSA for adults or children. Trimethoprim-sulfamethoxazole double strength tablets or liquid, abbreviated TMP/SMX, are also referred to by their brand names, Septra or Bactrim. According to the Washington State Department of Health, the adult dose is 1 or 2 tablets every eight or 12 hours; the dosing for children is based on weight. Medication safety information provided by the manufacturer states that this medication contains sulfamethoxazole, a sulfonamide medication, and is not safe for persons with sulfa drug allergies. Trimethoprim-sulfamethoxazole is not recommended for pregnant women or infants. Side effects of trimethoprim-sulfamethoxazole include rash, sun sensitivity, diarrhea or stomach upset. If you experience a rash while taking trimethoprim-sulfamethoxazole, stop taking the drug immediately and call your doctor. You may be experiencing an allergic reaction to the medication.
The dose of clindamycin used for treating MRSA is 300 to 450 mg every eight hours for adults, and the dose for children is based on weight, according to the Washington State Department of Health. Clindamycin is usually considered safe for pregnant women by the manufacturer and the CDC. Clindamycin is manufactured as capsules or powder for suspension. The children’s liquid form usually has a very unpleasant taste, and will likely require flavoring additives from the pharmacy. Side effects of clindamycin are usually mild, but may include diarrhea or nausea. Do not take clindamycin if you are allergic to the medication.
The antibiotic rifampin can help treat MRSA, but the CDC and the Washington State Department of Health note that it should always used in combination with another medication--usually trimethoprim-sulfamethoxazole--because of high rates of resistance when used alone. The dose of rifampin is 300 mg taken twice per day for at least five days. Side effects listed by the manufacturer include nausea and vomiting, and red discoloration of all body fluids (including tears, saliva, sweat, and urine) throughout therapy. Rifampin is associated with many drug-drug interactions, especially with birth control pills, so be sure your doctor and pharmacist know which other medications you are taking.
Minocycline or Doxycycline
The CDC recommends minocycline and doxycycline to treat MRSA in adults only. Children under the age of 9 should not take minocycline or doxycycline because the medications will permanently discolor developing teeth. The Washington State Department of Health names the adult dosing for either medication as 100 mg taken twice per day. Side effects of minocycline or doxycycline include nausea, vomiting, or diarrhea, according to the manufacturer. Do not take minocycline or doxycycline if you are allergic to them.
The CDC and the Washington State Department of Health note that fluoroquinolone medications are not safe for children, but the dose of ciprofloxacin--one of several fluoroquinolones and the one most commonly used for MRSA--when treating MRSA in adults is 500 to 750 mg taken two times daily. Side effects of ciprofloxacin include headache and stomach upset, according to the manufacturer.
The CDC recommends linezolid, under the brand name Zyvox, to treat MRSA after other medications have failed, primarily because of cost and concerns for the development of resistance. The medication does not have a generic version available as of 2010. The dose of linezolid is 600 mg twice per day. The manufacturer lists the most common side effects of linezolid as diarrhea, nausea, and headache.
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