Antibiotic-resistant skin infections spreading among gay men, also in prisons

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: