John S. James, AIDS Treatment News

In the last few months doctors have seen a large increase in aggressive, antibiotic-resistant ‘staph’ (Staphylococcus aureus) skin infections in gay men in some areas — and a separate epidemic in certain prisons. Symptoms include boils or blisters; treatment can be difficult, and sometimes requires hospitalisation. One HIV doctor in Los Angeles who used to see about one case a year is now seeing two a week. In the past this infection occurred mainly in hospitals.

Physicians should note a 1 February 2003 review in the British Medical Journal (“Old Drugs for New Bugs,” BMJ 2003; volume 326, pages 235-236) on evidence for the value of older antimicrobials for resistant bacteria, including staph. It suggests using co-trimoxazole (Bactrim or other brand names) as an alternative to vancomycin for resistant S aureus (also called MRSA). In one case co-trimoxazole was used successfully after a patient had failed the new and very expensive antibiotic linezolid (Zyvox). The article is at:

http://bmj.com:80/cgi/content/full/326/7383/235?maxtoshow=?eaf

A fact sheet by the US CDC, revised February 7, 2003, is at:

http://www.cdc.gov/ncidod/hip/aresist/mrsafaq.htm

Source: AIDS Treatment News

Copyright 2003 by John S. James. AIDS Treatment News, 1233 Locust St., 5th floor Philadelphia, PA 19107 USA. Phone 800/TREAT-1-2 toll-free, or 215-546-3776. aidsnews@aidsnews.org