Staphylococcus aureus

[Tazman007]

About 1 month ago i went and saw my doctor as i had been consistently getting small spots (often puss filled) around my nose and mouth area. The spots would not last very long and would go after about 3-4 days but would be replaced by new ones in different locations. I managed to convince him that i had 2 seperate issues, one being acne on the right cheek and secondly some sort of skin infection based on Staphylococcus aureus. He prescribed some Flucloxacillin, 250mg tablets 4 times a day for 7 days. I have to say i was amazed at the results. All my small spots cleared up after 2-3 days and for the remainder of the course i had no new spots. The acne on my right cheek also improved. But after my flucloxacillin tablets finished about 3 days later the small spots started to return and my acne on the right cheek went back to normal. So i went back to the doctors and saw another person. This doctor now prescribed Erythromycin, 500mg tablets twice a day. I have been on them for 1 week and it has has no impact on the small spots. However it has improved my acne on the right cheek significantly. I think i am suffering from 2 skin infections, one being a type of Staphylococcus aureus and the other being acne.

1)Why did the small spots return, was the dosage of flucloxacillin to low. 2)Can i take Flucloxacillin or any other narrow spectrum beta-lactam antibiotic aswell as Erythromycin as this is showing good results against the acne on my right cheek?

[Alan Rockoff, MD]

If the first doctor did not perform a bacterial culture, then my best guess is that you've had acne all along, not staph, and that the apparent sudden improvement was part of acne's natural fluctuation and not because of the antibiotic.  (Antibiotics don't usually work that fast even when there is an infection.)  So I would proceed on the assumption that you have acne--for which erythromycin is a good choice--and that the time frame for improvement is on the order of 2-3 months, not 2-3 days.  Your doctor can perform a skin culture, if you need more certainty (in acne it would show no growth.)

Take care.

Dr. Rockoff

[Martin2007]

Not to add anything to the expertise of Dr. Rockoff, I can tell you about my experience with Staph Aureus.

I actually went on Fucidin (20 days, 1 g/day) and then did a full course of  Erythromycin (30 days, 1 g per day). Had same symptoms, works while on antibios ( Erythromycin takes time to act) and once antibios are over it is back. The only antibiotic with significant effect was the third one: Pristinamycin as it is targeted towards methycilin resistant staph aureus (MRSA).

A bacterial culture is the only way to reveal what your staph is sensitive to. Mine was not sensitive to Erythromycin but got hit by Pristinamycin. With staph, you will never get rid of them completely, it is a suppressive treatment. As Dr. Rockoff replied to me once, antibacterial topical for regular cleansing is probably the only way to keep them down.

[Tazman007]

Thanks for the replies. I'm 99% sure it is not acne as it is concentrated around the nose and mouth area, small spots that come and go quickly. My doctor classified them as septic spot. Can you recommend a good anti bacterial topical cream/wash designed to target Staphylococcus aureus to help keep these small spots at bay. I will keep going with the Erthromycin for the full 30 days and then see how it is doing.

[Martin2007]

I actually use a cleansing lotion that contains chlorhexidine. Chlorhexidine is practically one of the best cleansing agent that kills staph aureus (among many other bacteria). Now the trick is that I do not use it on the face (on the thighs). It dries the skin after a while, so I really don't know if it should be used on the face. Ask in the pharmacy if they have a soap for face that contains chlorhexidine. (the brand Cyteal has a lot of products...)

[Allie M]

I have had a serious staph break out at least one time every year for the past three years, now. WHat does this mean? I know we all carry staph on our skin, but how is it that I KEEP getting infected. So does my boyfriend. I appreciate your help.

[Jenna24]

you prob have MRSA if you keep getting you never got rid of it go ahve you self and you boyfriend checked ASAP for MRSA it almost killed my mom