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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
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MRSA Treatment
Jun 13, 2005

Hi Doc,

I know this question is probably outside the realm of this forum, [I'd love to see a Complications or Management of HIV Infection forum here) but I thought maybe I'd ask anyway.

I've had recurring staphylococal infections for the past year - 4 this year, each MRSA. Each has been an abscess, 3 on the back of legs, 1 on the back near shoulder blade (this was the worst one). Each time I have taken large quantities of Bactrim DS after a culture indicated susceptibility to the drug. Each was also lanced and drained. I had one other start to pop up but I hibiclensed the hell out of it until it resolved on its own for the most part. The treatment for the most recent one seems to have taken away the remaining blemish that was under the skin.

I've also done the nasal Bactroban on 2 occasions and routinely have monitoring done with skin swabs when I have my normal labs done. Additionally I shower daily with hibiclens.

I'm currently completing treatment for the latest infection. I did 10 days initial Bactrim DS qid, then upped it to 6 a day for another 8 days. To "eradicate" the infection, my doctor has me taking 2 Bactrim DS daily for an additional 10 days plus Rifabutin 150mg on Monday-Wednesday-Friday-Sunday-Tuesday (5 total doses) plus another 10 day round of nasal Bactroban.

I've looked online for any liturature to support this course of treatment and wondered if you have heard of anyone else doing this before?

I am undetectable, 400 CD4, 21% CD4 and am taking the following medications daily: Truvada, Reyataz/r, Valtrex, Allegra, Marinol.

Just curious if you have heard of this being tried before and thought it might be of interest to some of the other readers experiencing MRSA.

Response from Dr. Henry

What might work depends partly on the sensitivity pattern of the MRSA. Sometime a tetracycline type drug might work. Adding rifampin can be helpful but that can lead to drug interaction problems that need to be addressed with your HIV doc and a pharmacist. KH

lymphadenopothy treatment
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