MRSA is going to end the world…

Another typical example of the media getting a hold of a medical concept and completely instilling fear and chaos into the unwashed masses.
mrsa.jpg
Everyone is playing chicken little throwing MRSA around and implying that its somehow a death sentence if you get it. This magical strain of staph is resistant to everything short of a blowtorch and will not only kill you, but kill your children and make your minority cousins horribly disfigured.
Lets be realistic here. MRSA is nowhere nearly as bad as people are making it. For those at home living in a box, MRSA stands for Methicillin-resistant Staphylococcus aureus. Yes, it sounds extremely scary. People think that MRSA is resistant to everything, and there is no hope of treatment.
They are wrong. They are in fact extremely wrong.
First off, I have never ever seen a MRSA case that has been resistant to everything under the sun. Yes, MRSA is resistant to all of the penicillins/cephalosporins, but we aren’t living in the dark ages here, we have a shitpot more antibiotics than those two classes. Of the dozens and dozens of Culture and Sensitivty reports that I have gotten trying to get Zyvox covered, I have found that in 99% of the cases the “evil” MRSA infection is perfectly suspectible to the Fluroquinolones (Levaquin/Cipro/etc), Tetracycline, Clindamycin, Rifampin, SMZ/TMP, etc. If you want to go IV route, Vancomycin.
Seriously, its not that big of a deal. The problem is that people want to throw Zyvox at everything instead of doing a proper C&S report to determine what else they can use other than the biggest bacteria bazooka that is on the market (at $60/tablet no less). Give them Zyvox, send them home and forget about them. Right, you try to explain that to the insurance company when they are staring at the C&S report that I faxed them showing that clindamycin has exactly the same efficacy as Zyvox in this case. Retarded I tell you, utterly retarded. The PA’s that I have gotten for Zyvox involved a ton of confirmed type-1 allergic reactions to what was effective. If you have drug allergies then you start stripping of available agents and things get a bit complicated.
So I blame the media here (as always) for clipping out only choice words that will cause the most fear and panic (read: ratings) and have patients come in to me in a tizzy thinking their life is over because they have a stupid minor MRSA infection.

Recent Entries

21 Comments

  1. steph says:

    Nicely done, sir. You’re makin’ us look good.

  2. Drug Dealer in Training says:

    I have two words for you: Thank you. Thank you for telling it like it is. Thank you for reinforcing what I have been saying ever since this whole MRSA thing got blown out of proportion. I’m so sick of having people tell me that a friend of their cousin twice removed on their mothers side had MRSA and ended up having their intestines spontaneously explode. My God, people. Get it together. Quit taking rumors and turning them into gospe and quit being so gullible. So, in short AP, thank you for validating my opinions/thoughts/feelings.

  3. DrRx says:

    For the most part, agree that the media is making this into a shit-storm as usual. However, I wouldn’t go saying that MRSA is just some benign, ‘take this levaquin tablet and call me in the morning’-type thing either. Yep, we’ve got more abx than we did in the past, but ask yourself WHY we have more abx than we had in the past? Because we HAVE to! MRSA is a threat, not because we can’t treat it, but because what it represents. Of course, you and I both know what it represents… It represents more than the beginning (more like towards the end) of a path of destruction…. OK, maybe destruction is too harsh a word, but definitely a re-emergence of a pattern that used to exist before WWII and the advent of PCN… That pattern being, the forced evolution of bugs that laugh in the face at our attempts to thrwart them. It was LONG, LONG, LONG before your fight to prevent the non-coverage, or inappropriate use of Zyvox…. Going all the way back to docs handing out PCN, E-mycin, clinda, etc… literally like candy! To patients that wanted a ‘tangible’ benefit to having sat through a visit with a physician and wanted something to give them the psychological comfort that they were taking ‘proactive’ action to get better…. That action being abx-popping… Now, through selective abx-induced pressures, little-by-little, the bugs have developed resistance to that inappropriate use, and MRSA is just ONE example of the human race reaping the outcomes of that inappropriate and unregulated use….
    So to me, MRSA and VRE, etc…represent a big deal… And that’s just the bugs that we actually KNOW about (mandated tracking). Believe me, there’s other stuff out there…stuff those C&S’s don’t even show because we lack the proper testing or growth conditions….

  4. debbie says:

    And zyvox is some class of an MAO Inhibitor and doctors just precribe it willy-nilly and give no warnings about dietary restrictions or not to take it with SSRI’s. It falls to the pharmacist so that important bit of teahing.

  5. Birdie says:

    I have mixed feelings about your opinion of MRSA.
    On the one hand, you’re right – it’s not the end of the world, and it’s rarely fatal in normally healthy people. I’ve been living with MRSA since March 2002 and I’m not dead yet. 😉
    On the other hand, I wouldn’t call MRSA a “stupid minor infection” either. It’s been very difficult trying to treat and manage this infection.
    I’ve completely given up trying to “cure” my MRSA – I merely wish to contain it at this point. I slathered on the Bactroban – topically and up the nose – for MONTHS. I did the Levaquin/Rifampin combination drug course THREE times for a total of 12 weeks of very strong antibiotic assault. Wow, did that tear my insides up!
    I am already Hearing Impaired so I’m pretty fearful of the Vancomycin route. I don’t want to lose what little hearing I have left, so I’m hoping to never have to need it.
    As of now, I manage to barely contain the MRSA with Tea Tree Oil and a sterilizing hospital grade body wash.
    Living with this infection has not been easy. At times it’s been so bad that large portions of my skin were blistered and RAW and I looked like a burn patient. Parts of my face looked like it was peeling off. It was quite painful as you can imagine and the scarring that all these repeated “flares” cause is significant as well.
    So yes, I agree that MRSA is certainly no death sentence and people have overreacted about it. But I disagree that it is a stupid minor infection. At best my skin is very sensitive, lumpy, and always on the verge of a flare. During the worst flares I have to stay in my home because I can’t bear the stares of everyone who sees me.
    It significantly impacted my leisure time and summer vacation as well because there was no way I was wearing a bathing suit while taking my kids to the water park. My skin was so blistered I can’t even imagine the pain of a sunburn on top of the MRSA.
    So, I either disappoint my kids by cancelling or cover up and sweat myself into heat exhaustion. I chose the dehydration/heat stroke route.
    I suppose I shouldn’t care what others think but it is difficult to live a normal life when others stare at you and stay at least 10 feet away – treating you like a leper. The societal damage MRSA inflicts is not minor or stupid. It’s quite lonely during the worst of it.
    I am lucky to have my MRSA partially managed now, but I can tell you with authority that calling this infection “not that big of a deal” sounds misinformed and even offensive to someone like me who is going on their 6th year of fighting this damn thing.
    I can see how the frustration of dealing with the fat-cat drug industry controlling your profession has shaped your point of view but I hope you can understand how my personal MRSA struggle has shaped mine.

  6. Sarah says:

    Media (mis)information doesn’t stop with MRSA. I have easily gotten angry with media time and again concerning SCHIP as they throw that 83,000 income limit around as though it is somehow meaningful in the SCHIP bill. 83,000? synonymous with 400% poverty level, and not guaranteed coverage in any way on any SCHIP bill past, present, and well we can’t predict the future can we?

  7. liz says:

    You are very right. MRSA can be bad but it is treatable and even without IV antibiotics–especially when community acquired. My younger brother had a horribly swollen leg. It was HUGE and black and blue. He is a soccer player and we thought it might be broken as he had taken a pretty hard hit and he couldn’t walk on his leg. Turns out-cellulitis and the cuplrit MRSA. A mere 10 days of SMX/TMP PO bid treated the resistant infection. Of course-the pharmacist in me called him twice a day to tell him to take his meds because one has to take the antibiotic to get rid of the infection.

  8. Linda says:

    Thank you, thank you, thank you.
    My dad had MRSA this summer and it barely phased him (with the proper antibiotics), but everyone freaked out. People wouldn’t go to see him, touch him, be in the same room with him.
    Except me. And I never did get MRSA.
    But then, don’t we all have a little MRSA on our bodies?
    Thanks for the info. Always informative.

  9. Melissa says:

    I agree. Last week some guy came into our pharmacy waving some ugly hole in his hand at my face and then mentions to me that it is “MRSA” and he said it as if he was trying to pronounce it as a word, not an abbreviation. Anywho, he also mentioned that “once you have it, you can never get rid of it” which I know is completely untrue. He wasn’t filling a prescription for an antibiotic, but just for Percocet, which we found he had just gotten at another pharmacy the day before for #20. We refused to fill it and afterwards I thought to myself that his gross hole had the appearance of a cigarette burn.

  10. I hear MRSA this and MRSA that all the time. Good point regarding the “bazooza” for treatment. Most of the toothless wonders that get antibiotics from my pharmacy can’t afford that stuff, oh wait, they have WELFARE!! The magic “insurance plan” that I get to pay for from my tax dollars. Any way, I digress.
    Be glad that the media only knows about MRSA and not things like VRSA (handfull of actual cases in the literature), MDR pseudomonas or acinetobacter for all our sakes.

  11. John Roman says:

    You don’t have to post this … But to be honest myself .. if I had some surgery and then I had a funky post infection and it came back MRSA Id go with the zyvox . infact id take the zyvox if i even suspected it was mrsa before the labs came back. C&S is great but what happens on a plate isnt what happens in the body.

  12. Kelly says:

    I agree with Birdie — to dismiss it as “no big deal” sounds naive. My dad developed an antibiotic resistant staff infection in both of his artificial knees. It was horrendous and we almost lost him a couple of times. His kidneys shut down in reaction to one of the antibiotics. Infections in artificial joints require that the joints be removed since there is no blood source to carry antibiotics to the site and destroy the bug. He was in a nursing home for a few months, hooked up to IV antibiotics. The bug had destroyed some of his bone that held the artificial joint. Fortunately there was a enough there for a revision, however there is not enough bone for any further revision in the future.

  13. rph3664 says:

    MRSA is nothing new and was first recognized in 1960. Methicillin, which I have only seen ordered once because it causes kidney tubule necrosis, was released in 1959 and MRSA was first diagnosed the very next year.
    The hospital where I work is dispensing a lot more vancomycin the past few days, and I can’t help but think this is why.
    I was in retail when Zyvox was released to much fanfare, and one of the managers asked us if we were going to carry it. We replied that anyone who would need Zyvox is probably not going to be out walking around, nor would we want them to, but we would special order it if we needed it.
    We were using it a lot at the hospital for a while, but the P&T committee decided to track and document its use and we’re seeing a lot less of it now.

  14. vince says:

    I LOVE YOUR BLOG
    i have a new site i just got up,please take a look at it
    http://www.ihateinsurancecompanies.com
    please post some of your insurance stories there (ITS FREE), i really need posts,also id love to linkup with your site

  15. Leslie says:

    I love this post. Mainly because I’m in a lab that deals with S. aureus research. Unfortunately, people also think that just plain S. aureus is also bad and don’t believe that it in part of our natural flora being the great bacterial hosts that we are. I had a co-worker at my pharmacy flat out refuse to believe that he had any staph on him. Next he’ll be telling me he has no E. Coli in his intestines either.

  16. Tony says:

    Old people
    What I hate the most is when old people wake up at 2:48 in the morning to tryyyy to pinch a loaf, even though they have been npo for the last week they just want to try. They don’t get off the subject until the nurse pumps them with everything under the sun to achieve the desired affect. A couple hours go by and after a handful of bed changes and ass wipes now they want something to make them stop. WTF?
    I’m sure you figured this out,but i’m a nursing assistant,yeeepee. (that last part was sarcasm) im sure you figured that out also.

  17. TrustMe says:

    We’re going down. This blog explains it all:

    http://whenistheworldgoingtoend.blogspot.com/

  18. Scott says:

    Come on, do you really hear yourself? Do you sit on the frontlines of a heavily populated region massively infected with MRSA? 5 years ago, the infection rate was approximately 100,000. Today it’s over 5 million.
    To date, MRSA is currently SURPASSING the death rate of AIDS in civilized countries (not including 3rd world).
    If that isn’t enough to scare you, a new airborne strain HAS BEEN confirmed but is being squashed as much as possible until they can learn more about it. Read read read and read some more.

    The medical biz is BIG on getting you to prescribe the cheapest alternative to the approach, and hassle you to do so. So instead of being angry at them, you choose to be angry at patients.

    I work for a ‘large healthcare supplies’ organization – fortune 500. I can tell you that we are already taking precautions, having meetings, seminars etc for what we believe is the next human plague.
    And do you think they are warning us for our well beings?

    No – here is the spin. We at “global conglomerate’ believe while this is a critical threat to the worlds population, when the critical levels reach the general public, must be posed to operate in that environment and be able to position ourselves to be the number one provider of solutions to help rectify this future crisis as we are most capable with our facilities to do such a thing ” Paraphrased of course.

    They believe, based on very expensive reports that MRSA ,…IS …the next plague. I wish I could show you the emails. They want to be capable of being the benefactors of the future ‘treatments’ that will come out.

    Here’s a sad thought. Researchers working on vaccines have all but given up as NO COMPANY wants to spend a penny on a vaccine, but companies are lined up to create the next super drug that by itself could kill us, cripple us, and turn our brains to mush as most of these super antibiotics are doing, in order to profit in the long term rather than waste money on a cure or at least prevention that will only serve to lower their bottom line. EXECS have shareholders to answer to.
    Imagine if company A is creating the next super drug that will generate BILLIONS while company B is investing in the prevention/cure for a disease. Which company do YOU think is going to be around ? Better, which EXECS do you think will be around years from now?

    Open your mind and think, quit being bobbleheads for big biz. They are not the giant evil corporations many think, they are big evil companies because of the competition in healthcare. Eliminate profits in healthcare unless cures are presented and see how fast actual CURES are presenting.

  19. Hailey says:

    Rising cases of MRSA among autistics is undoubetely linked to hospital acquired infections due to hospitals failing to adequately treat patients with autism. For example, the unbelievable systematic doping and restraining of patients with open cuts in hospital settings without the slightest concern of protecting open wounds during hospital stays and the epidemic of staff at hospitals following proper procedures to curtail hospital acquired infections by following proper infection control: ie…wearing gloves, changing IV tubing and needles, providing proper wound care, etc….INVESTIGATION of how hospitals are failing autistic patients is long overdue. Autistic patients are increasingly neglected in medical settings. Follow up is slim, if any. Undetected infections often a result of failure to test and treat. Botched exams. Blood tests revealing infections often missed and not identified until parents or caregivers push for results, leaving patient suffering with prolonged infections that could’ve otherwise been promptly treated. Makes you wonder if there’s some underlying motive by medical professionals to “rid the population” of so many people….Interesting that the elites never seem to get MRSA.

  20. h8asia.com says:

    whoah this blog is fantastic i like reading your posts.
    Stay up the great work! You already know, lots of individuals are
    hunting around for this information, you could aid them
    greatly.

Leave a Reply

 

The Angry Pharmacist is Stephen Fry proof thanks to caching by WP Super Cache

%d bloggers like this: