Friday, October 19, 2007
The low down on MRSA
Over the past week, I have received more questions about MRSA than just about any other topic. MRSA has also been called the "superbug". At its most basic level, MRSA is a type of staph bacteria called Staphylococcus aureus. This is a bacteria that is normally found on all of our skin. Yes, if you were to take some skin scrapings right now and look under a microscope, you would probably find some of the staphylococcus bacteria. The problem arises when that bacteria becomes resistant to antibiotics. That's when it becomes "Methicillin-resistant Staphylococcus Aureus" or MRSA.
Here are a couple things to keep in mind. While the bacterium is resistant to Methicillin, there are other more powerful antibiotics, such as Vancomycin, which can still be effective. The key is to make the diagnosis early and to complete a full course of antibiotic treatment. That can get rid of the bacteria entirely. Some clues that you might have it include wounds that aren't healing - usually more than one at a time. These are obviously wounds that don't seem to get better even with normal antibiotic treatment.
A larger issue may be whether or not we are developing new antibiotics fast enough. There is no question that antibiotic resistance develops as a result of our increased and sometimes inappropriate use of antibiotics. So, there is a real need for new antibiotics. The problem is these new antibiotics are incredibly expensive to develop and take years of clinical testing before they are approved. After that, doctors will only prescribe them in rare cases, when other antibiotics don’t work. That makes drug companies less enthusiastic about developing the new medications.
There in lies a dilemma. Obviously, it would make sense for society to do everything possible to prevent antibiotic resistance. As we learned, however, that ship may have already sailed. There were around 90,000 cases of MRSA in 2005 and almost 19,000 deaths. And, we are already starting to hear of infections resistant to all the antibiotics that exist.
How will we take care of antibiotic resistant infections if there are no new medications in the pipeline? Keep in mind, this is not a theoretical question -- this is starting to happen already.
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