Anybody else get a kick out of the media pumping up MRSA?

[WVUPharm2007]

WTF is up with the media recently and MRSA? They are treating it like it's the black freakin' plague that is bound to doom us all. I mean, sure, drug resistance is concerning....but it's not like we're all gonna die here....

---

Members don't see this ad.

 

[Caverject]

funny...I've been thinking the same thing as of late...

 

[firefighter9015]

It's crazy. Yea sure, its a bad bug to have, but in normal healthy people, is it really that big of a killer????

 

[WVUPharm2007]

It's crazy. Yea sure, its a bad bug to have, but in normal healthy people, is it really that big of a killer????

If you get septic...but...you know...septic anything kinda sucks....

 

[Caverject]

there is roughly on average over 125,000 mrsa infections every year according to the CDC...yeah if you let it get out of control, it will be very bad news. Any patient complaining of a spider bite should really be thinking mrsa infection...but this is nothing new

 

[mrsturtle]

No they are not making too much of it. It has just been new to the news. It is a scary disease that we need to be aware of and the ways that it can be controlled.

My 14 son got hit playing football in PE at the first of September. He was a normal, active very healthy kid. He got whiplash and bruising in the gluts. No scratches, no cuts, just bruising. 16 days later- he spent 14 days in the hospital from ca-MRSA. MRSA set up in the gluts (got in the muscle from the bruising) he had 3 abscesses as big as racquetballs inside the gluts, puss covering the outside of iliopsoas muscles, it spread to his blood. Then spread to his other leg, ankle and shoulder. Then he developed several large blood clots in is iliac vein, pieces broke off (with puss in them) and set up pustules in his lungs. After being home less than 3 weeks he is back in the hospital with infection in the ilio-sacral joint and bones. He has missed 5 weeks of school, can't sit in a chair for more than 30 mins and must use crutches to walk. He is being treated by doctors from one of the best pediatric hospitals in the country and they say he is lucky and yes the media attention is warranted, maybe not so sensationalized, but it is not bad.

I have watched my child fight for his life; the media attention is not unwarranted.

 

[mrsturtle]

It's crazy. Yea sure, its a bad bug to have, but in normal healthy people, is it really that big of a killer????

Talk to an infectious disease specialist and they will tell you YES.

 

[WVUPharm2007]

Yeah, but Staph aureus has been around forever.....it's not like it's any more or less aggressive now that it as a species has apparently completely evolved into beta lactam resistance....and it's not like there aren't drugs for it.

 

[mrsturtle]

Yeah, but Staph aureus has been around forever.....it's not like it's any more or less aggressive now that it as a species has apparently completely evolved into beta lactam resistance....and it's not like there aren't drugs for it.

fewer drugs are working against MRSA, the drug of choice has been vancomycin, but they are finding strains that are vancomycin resistant. MRSA is very aggressive. It spreads quickly.

General question to all:

As a health care professional what would you suggest/tell to a patient that came to you and asked about MRSA (They had seen the news stories and were concerned)? What precaution if any would you suggest? What would you tell a patient that asked about stories saying that MRSA will kill more people in USA than AIDS? (CNN.com had such a story last week).

 

[Jbuprepharm]

I would tell them to wash their hands often, seriously

 

[WVUPharm2007]

fewer drugs are working against MRSA, the drug of choice has been vancomycin, but they are finding strains that are vancomycin resistant.

This is true...though there are more drugs than vanc that can take it out.

MRSA is very aggressive. It spreads quickly.

Yeah, but is it worse than MSSA?

As a health care professional what would you suggest/tell to a patient that came to you and asked about MRSA (They had seen the news stories and were concerned)? What precaution if any would you suggest? What would you tell a patient that asked about stories saying that MRSA will kill more people in USA than AIDS? (CNN.com had such a story last week).

Bathe regularly, don't share towels....basic sanitation....

I read that "MRSA worse than AIDS" thing, but I'd like to see the actual study....I mean, don't get me wrong, Staph infections have a history of mortality, but it's like the new avian flu. People are worrying about it way too much.

 

[tussionex]

i think any media coverage that scares people out of abusing antibiotics is perfectly fine! antibiotic overuse is getting worse and worse!

 

[WVUPharm2007]

i think any media coverage that scares people out of abusing antibiotics is perfectly fine! antibiotic overuse is getting worse and worse!

I s'pose that is also a good point.

 

[Observer]

WTF is up with the media recently and MRSA? They are treating it like it's the black freakin' plague that is bound to doom us all. I mean, sure, drug resistance is concerning....but it's not like we're all gonna die here....

Typical of the media. It likes to get the public whipped up. We had SARS, Avian Flu, West Nile Fever, Anthrax, Smallpox, the list goes on and on, none of which amounted to a hill of beans.

Meanwhile, your average American is stuffing his face and a couch potato, setting himself up for a host of chronic illnesses that will definately shorten his life.

 

[psychoandy]

i think any media coverage that scares people out of abusing antibiotics is perfectly fine! antibiotic overuse is getting worse and worse!

we have premixed vanco in d5w stocked on pretty much every floor...scared me once i actually learned about vanco and mrsa and other wonderful things.

conversely, maybe i should start buying stock in whoever makes zyvox...even though yes i know you can use old standbys like smx-tmp, zyvox is hot and new and everyone loves it even though its like 80 bucks a dose...

 

[firefighter9015]

General question to all:

As a health care professional what would you suggest/tell to a patient that came to you and asked about MRSA (They had seen the news stories and were concerned)? What precaution if any would you suggest? quote]

Basic hygiene rules apply as to all infectious diseases. Wash your hands, etc, etc. Also, if you have a spot that looks like a spider bite, get it checked out. My friend got a MRSA infection and it looks just like a spider bite. We were actually in Ecuador when she developed it, and we all thought that she had a spider bite. When we got back to the states it was MRSA (on this note, Bactrim does work, that was the only antibiotic that we could get, we had docs with us who suspected that it was MRSA and started her on Bactrim)

 

[Priapism321]

conversely, maybe i should start buying stock in whoever makes zyvox...even though yes i know you can use old standbys like smx-tmp, zyvox is hot and new and everyone loves it even though its like 80 bucks a dose...

It's that young up and coming company Pfizer, their stock is probably cheap.

 

[mustang sally]

It has been a big deal in my area because a football player died from it. There have also been outbreaks in several of the county school systems around here, although no one else has died to my knowledge. I don't worry about sending my son to school or anything, but it does cross my mind every time they talk about what all schools are having problems on the news.

 

[mrsturtle]

we have premixed vanco in d5w stocked on pretty much every floor...scared me once i actually learned about vanco and mrsa and other wonderful things.

conversely, maybe i should start buying stock in whoever makes zyvox...even though yes i know you can use old standbys like smx-tmp, zyvox is hot and new and everyone loves it even though its like 80 bucks a dose...

Just got the hospital bill, Zyvox-$187.00 every time it was hung. (He had it 2x day for 10 days) Hope anyone that needs it has insurance that will cover it.

 

[Epic]

fewer drugs are working against MRSA, the drug of choice has been vancomycin, but they are finding strains that are vancomycin resistant. MRSA is very aggressive. It spreads quickly.

General question to all:

As a health care professional what would you suggest/tell to a patient that came to you and asked about MRSA (They had seen the news stories and were concerned)? What precaution if any would you suggest? What would you tell a patient that asked about stories saying that MRSA will kill more people in USA than AIDS? (CNN.com had such a story last week).

That's not true.

There are more treatment options for MRSA than ever before. Also, it's not accurate to say more strains are Vanco resistant. There are very few cases of VRSA... but there are many vancomycin treatment failures due to increasing MIC and low tissue concentration of vanco where an institution hasn't raised the therapeutic range of vanco.

Also, we need to differentiate between community acquired MRSA vs hospital acquired MRSA. Besides the fact they are both gram positive cocci and resistant to beta lactams, they are 2 different bugs with different treatment options. For ca-MRSA, with more options than ha-MRSA, I would not cosider Vanco or Linezolid as the treatments of choice...especially with Linezolid being bacteriostatic.

Vanco, Linezolid, Tigecycline, Synercid, and Daptomycin are available for ha-MRSA treatment...and Ceftobiprole and a long acting glycopeptide is getting ready to hit the market.

For ca-MRSA, there are more choices... including macrolides, tmp-smz, and quinolones (no for peds).

ca-MRSA can be more virulent...but nothing like the flesh eating Strep from a few years ago..

 

[Epic]

More seriously, non judicious use of Linezolid has stemmed Linezolid Resistant VRE. Linezolid was and still is the drug of choice for VRE...except due to its marketing effort by one of the most efficient marketing force called Pfizer, we've seen a proliferation of Zyvox use for many different infections..espeically against pneumonia and now ca-MRSA.

Now we have LRVRE. Linezolid Resistant Vancomycin Resistant Enterococcus.

Not a whole lot of treatment options there. Thanks Pfizer.

 

[Epic]

we have premixed vanco in d5w stocked on pretty much every floor...scared me once i actually learned about vanco and mrsa and other wonderful things.

conversely, maybe i should start buying stock in whoever makes zyvox...even though yes i know you can use old standbys like smx-tmp, zyvox is hot and new and everyone loves it even though its like 80 bucks a dose...

Zyvox aint going to increase Pfizer stock... it's an old news.

 

[Epic]

Typical of the media. It likes to get the public whipped up. We had SARS, Avian Flu, West Nile Fever, Anthrax, Smallpox, the list goes on and on, none of which amounted to a hill of beans.

Meanwhile, your average American is stuffing his face and a couch potato, setting himself up for a host of chronic illnesses that will definately shorten his life.

Completely agree.

 

[WVUPharm2007]

Now we have LRVRE. Linezolid Resistant Vancomycin Resistant Enterococcus.

Not a whole lot of treatment options there. Thanks Pfizer.

I've seen the LRVRMRSA....that's fun to say.

Lur-vur-mur-suh...even better if you talk like a pirate saying that.

 

[Epic]

I've seen the LRVRMRSA....that's fun to say.

Lur-vur-mur-suh...even better if you talk like a pirate saying that.

LRVRSA or LRVRE? You know the difference between SA and E..right?

There really haven't been very many documente VRSA

 

[Epic]

you better hurry and google..

 

[WVUPharm2007]

LRVRSA or LRVRE? You know the difference between SA and E..right?

There really haven't been very many documente VRSA

To hell there haven't....I've seen a few (emphasis on few) myself.

Though I haven't actually seen zyvox and vanc resistant SA....I just wanted to make a ridiculously huge acronym....but I bet the rates by which linezolid is going worthless on us will be concerning here by the start of the next decade.

If you spent a day at this LTC pharmacy's IV room, you'd be frightened. They send out cubicin like it's candy. And what can they do? If they bitch at the medical staff too much, they might lose their business...kind of a stupid situation. I like how in the Cubicin package insert, they actually make a note to say that there are no theorized mechanisms available in which resistance would develop. Yeah, I bet there aren't...because nobody uses your drug, *****s.....

 

[SpirivaSunrise]

you better hurry and google..

Oh...he knows...he's graduating in a few weeks. He better know.

 

[WVUPharm2007]

you better hurry and google..

who the f googles pharmacy crap. Who cares about VRE, anyway. It's not as much of a problem.....if it were it CLEARLY would be grounds for a dateline NBC special....and the media keeps me informed of everything that's important...

 

[Epic]

who the f googles pharmacy crap. Who cares about VRE, anyway. It's not as much of a problem.....if it were it CLEARLY would be grounds for a dateline NBC special....and the media keeps me informed of everything that's important...

 

[WVUPharm2007]

Oh...he knows...he's graduating in a few weeks. He better know.

Yup...you give them a cephalosporin for it!

I'm gonna pass me that test!!!!!111!!!


A few weeks ago, I had that one weird E. faecium UTI I posted about that was resistant to everything on the little sensitivity report except chloramphenicol....including zyvox, vanc, and 20 other things...see, I even have practical experience....

 

[WVUPharm2007]

MRSA does SOUND scarier than VRE when you say them.

Hey, z, I found 6 cases of VRSA on one website. Check it out.

 

[Epic]

Drug rep needs not contribute to this thread.

 

[SpirivaSunrise]

Drug rep needs not contribute to this thread.

So why you talkin'

 

[confettiflyer]

My favorite part was when I read "MRSA, pronounced mur-suh."

It's an acronym, not a full on word, c'mon now. It's like writing "MSNBC, pronounced em-sun-buc."

 

[CaliCPhT]

My favorite part was when I read "MRSA, pronounced mur-suh."

It's an acronym, not a full on word, c'mon now. It's like writing "MSNBC, pronounced em-sun-buc."

MRSA is very commonly called "mur-suh" in the health care world. There are several acronyms that spell words that people frequently say. OSHA (I never hear people say O-S-H-A) is one common example.

 

[SpirivaSunrise]

MRSA is very commonly called "mur-suh" in the health care world. There are several acronyms that spell words that people frequently say. OSHA (I never hear people say O-S-H-A) is one common example.

Same with JCAHO..you either say Jay-Co, or Joint Commission...not J-C-A-H-O. Although it annoys the hell out of me when people spell it JACHO

 

[confettiflyer]

MRSA is very commonly called "mur-suh" in the health care world. There are several acronyms that spell words that people frequently say. OSHA (I never hear people say O-S-H-A) is one common example.

hmm good point about OSHA...I'm used to hearing the full name that's why, and when that football kid died, all I started hearing was mur-suh. Then I got all

 

[JamesL1585]

WTF is up with the media recently and MRSA? They are treating it like it's the black freakin' plague that is bound to doom us all. I mean, sure, drug resistance is concerning....but it's not like we're all gonna die here....

Its very ironic to me that MRSA is getting national attention, this summer I did an extensive 3 month research on ways to control MRSA, by basically taking out its toxic affect without destroying the bacteria (so in that way it wouldnt matter if it gained resistance to antibiotics or not), we had a positive assay right at the end of my part in the experiment, so further experimentation is underway... Eventually someone will finish this up and put a closed case to this little bug!

 

[Lexian]

More seriously, non judicious use of Linezolid has stemmed Linezolid Resistant VRE. Linezolid was and still is the drug of choice for VRE...except due to its marketing effort by one of the most efficient marketing force called Pfizer, we've seen a proliferation of Zyvox use for many different infections..espeically against pneumonia and now ca-MRSA.

Now we have LRVRE. Linezolid Resistant Vancomycin Resistant Enterococcus.

Not a whole lot of treatment options there. Thanks Pfizer.

I think Linezolid has superior penetration into the lung when compared to Vanco which in theory makes it a more attractive option when treating pneumonia. At the same time, while Daptomycin is becoming the next big thing for MRSA and VRE it is inactivated by surfactants in the lung making it a poor choice for pneumonia.

So while pharmaceutical companies do try and get their drugs approved for everything, I think in a lot of cases we need that to figure out if they really are useful clinically in different cases. What makes Linezolid especially sexy is that it's IV/PO and the bioavailability is excellent as a PO making it a great discharge abx. For vanco? Get a PICC line, weekly trough, a home infusion kit, weekly chem panel...joy.

 

[ButlerPharm.D.]

I'm surprised that no one has recommended educating our patients about the proper use of antibiotics and the signs/symptoms of infection. As I'm sure all of use are aware, the improper use of antibiotics is the real reason that we have seen increasing incidences of MRSA infections.

 

[KARM12]

I'm surprised that no one has recommended educating our patients about the proper use of antibiotics and the signs/symptoms of infection. As I'm sure all of use are aware, the improper use of antibiotics is the real reason that we have seen increasing incidences of MRSA infections.

Thanks Captain Obvious.

 

[Epic]

Thanks Captain Obvious.

wow... female Zpacksux...

 

[Epic]

I think Linezolid has superior penetration into the lung when compared to Vanco which in theory makes it a more attractive option when treating pneumonia. At the same time, while Daptomycin is becoming the next big thing for MRSA and VRE it is inactivated by surfactants in the lung making it a poor choice for pneumonia.

So while pharmaceutical companies do try and get their drugs approved for everything, I think in a lot of cases we need that to figure out if they really are useful clinically in different cases. What makes Linezolid especially sexy is that it's IV/PO and the bioavailability is excellent as a PO making it a great discharge abx. For vanco? Get a PICC line, weekly trough, a home infusion kit, weekly chem panel...joy.

All true and accurate. This is why when we add pharmacoeconomics piece, it becomes difficult to decide which is the best route. And we're never sure of long term consequences of our action today.

Though, collective wisdom says judicious use of newer antibiotic and more efficacious use of tried and true will be most beneficial.

 

[KARM12]

wow... female Zpacksux...

I'm sorry, it slipped...

 

[eeyore spice]

Same with JCAHO..you either say Jay-Co, or Joint Commission...not J-C-A-H-O. Although it annoys the hell out of me when people spell it JACHO

I say it how it's spelled. J'kay-ho.

Helpful hint: Don't refer to officers as "J'kay-hoes," at least not in front of anyone with a stick up their rectum.

 

[Observer]

I say it how it's spelled. J'kay-ho.

Helpful hint: Don't refer to officers as "J'kay-hoes," at least not in front of anyone with a stick up their rectum.

 

[Epic]

I say it how it's spelled. J'kay-ho.

Helpful hint: Don't refer to officers as "J'kay-hoes," at least not in front of anyone with a stick up their rectum.

It's no longer called the JCAHO. It's simply the Joint Commission. The JC.

 

[Farmercyst]

It's no longer called the JCAHO. It's simply the Joint Commission. The JC.

Yeah, I filled an albuterol script for a lady who said she was on the Joint Commission. I was like, really, the JCAHO. She said, we just go by TJC now. She wanted to make sure I knew that I should go into hospital pharmacy instead of staying at the Sav-on I was on externship at. I thought it was funny thing was she had allergy induced athsma and no rescue inhaler, epi, or antihistamine with it.

 

[SexyPlexi]

My coworker JUST told me that her ROOMMATE just got back from the doctor and she has MRSA in her eye.

She is, of course, freaking out. I would be too.