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No Mercy for MRSA. How to Treat One of the Most Common Superbugs.

MRSA may be resistant to some antibiotics, but honey can still kill it.

by James Hubbard, MD, MPH

Of all the “superbugs” that can infect you, the one you’re most likely to get outside of a hospital setting is community-acquired MRSA (pronounced mer’-suh). The official name is methicillin-resistant Staphylococcus aureus. I see it in the office fairly often, and it’s resistant to the antibiotics we commonly use for staph.

For cases where you can’t get to a doctor, everyone should know how to treat MRSA.

MRSA’s Bio

MRSA is just plain old staph that has adapted with the times. It’s a mutated strain of that same staph aureus that gave you impetigo as a child. As is often the case with superbugs, it was a matter of survival of the fittest.

Every time antibiotics are given, there’s a chance a few bacteria that have mutated a resistance to the antibiotic survive. Then, with no competition (remember, the weaker bacteria were killed), they have room to multiply. Do this a few million times and the strongest survivors develop their own strain.

Staph aureus is a bacteria famous for its adapting capabilities. Penicillin hadn’t been in use very long before staph developed resistance to the degree that we had to develop new types of penicillin (methicillin and oxacillin) to kill it. Cephalexin and erythromycin also worked. But now there’s a strain called MRSA that’s resistant to methicillin, oxacillin, and most other of the common antibiotics.

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MRSA often starts as a pimple and develops into a boil. You may think it’s a spider bite at first.

How to Treat MRSA

Well, that depends on whether it’s the hospital type or the community-acquired type.

MRSA first popped up in the hospital and it’s still a killer there. It can cause wound infections, kidney infections, and pneumonia, to name a few. Only the strongest intravenous antibiotics have any chance at all to get rid of it. Some of the so-called flesh-eating bacteria cases are caused by MRSA.

Fortunately, the one I see in the office is what we call the community-acquired type, and for now, it’s easier to treat. It’s a skin infection and often starts as a pimple that develops into a boil. Many patients come in actually thinking it’s a spider bite but don’t remember seeing a spider.

How to Treat Community-Acquired MRSA
    1. Antibiotics include the sulfa drug Septra, also known as Bactrim. Clindamycin also works, as does the prescription antibiotic cream, mupirocin (Bactroban). Sooner or later, I’m sure, community-acquired MRSA will become resistant to all of these.
    2. If it’s an abscess (boil), it needs to be drained. If the boil starts draining, either on its own or with an incision and drainage, the infection will often go away even without antibiotics. If you just can’t get to a doctor for days, read my post about how to lance a boil.
    3. Honey can kill it. Preferably the Manuka or Medihoney kind. See my post.
    4. Tea tree oil has also been shown to work.
How to Prevent Community-Acquired MRSA

MRSA is very contagious through contact. To keep from getting it:

  • Keep the area bandaged.
  • Throw away or sterilize all instruments used.
  • Wipe down any exposed areas with a ten percent bleach solution.
  • Hand washing is essential.

One more thing. MRSA is found inside the nostrils of a lot of people who don’t have symptoms, so if you’ve been around someone with the infection, consider coating your nostrils with the antibiotic cream mupirocin once a day for a few days. You’ll need to have you doctor give you a prescription for it.

Has anyone had experience with MRSA?

 

Honey photo by Hillary Stein on Flickr. MRSA photo by Jen (self-photographed) (CC-BY-SA-3.0), via Wikimedia Commons.

  • anon

    Hi, I have a serious question, I belive I have mrsa in a strange place, its actually on my left but cheek, I’m worried because I think it started as a nick, then became a pimple, I poped it and it didn’t bother me untill the next day, my entire left side of my but hurt. I had some help getting the puss out and me sterilized, but here I am day three and I had to drain it again. How do i fix this?

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      If it’s not going away, go to the doctor and have it drained. The doctor may culture the drainage to see what bacteria is causing the problem and put you on the best antibiotic to get rid of it. I do have a post on lancing a boil http://www.thesurvivaldoctor.com/2012/02/28/how-to-lance-a-boil/ but I would go to the doctor for lancing. Meanwhile try the recommended moist heat.

  • Lynnette

    In 2003 my daughter picked up MRSA, we believe from my mother who was a diabetic living in an assisted living facility and had a wound that would not heal. She kept having “bites” and was treated numerous times with Keflex. I then got a boil on my groin, and was given injectable antibiotics, oral antibiotics, and it grew so huge and so fast the Dr. had an ultrasound done. It was still undiagnosed. I flew to SD to be by my mothers side as she had chosen to go off of dialysis. When I arrived the pain and growth of the area sent me to the Drs. up north. I was taken into surgery to have it lanced, packed and I was given Clyndamycin…IV until I had an allergic reaction. I took Cipro for it, but since developed resistance. When I came home the Dr. in our small town put my daughter and I in the hospital and treated us at the same time. She had a young baby in the house and we were afraid she would become infected. My daughter never had another episode. I continued to have episodes for about another year and a half. When I couldn’t find any answers I researched and decided to use Phisohex…head to toe. I have never had another episode. My husband and granddaughter never contracted it. We were very careful when we had active MRSA by isolating ourselves to using one bathroom, spraying with Lysol after every bath. Towels washed with hot water and a drop of bleach daily. Constant handwashing. I believe that our approach to cleanliness kept us from sharing. I have had surgery twice since then, and was always a bit afraid it would reoccur, but that has never happened. I am down to being only able to use Bactrim and Vancomycin, although I have never had to use Vanc. I am glad to hear about the honey, tea tree oil and bactroban. Hopefully I will never have to try them.

    • http://www.thesurvivaldoctor.com James Hubbard, M.D., M.P.H.

      Lynnette, I’m glad you’re doing ok. Thanks for sharing. Good luck for the future.

  • Jaine

    Hi. I am very much worried. I think i am vaginal carrier of mrsa. When i was 9months pregnant i have noticed i had a big pimple on my vagina, it was painful and getting bigger, so i asked my ob gyne, she told me it was furuncolosis so she gave me cefuroxime foR 5 days. It healed. Then after 2 weeks of giving birth i had it again, i didnt pay much attention since its just localized and it burst by itself and healed without any intervention. But after 1 week my newboRn daughter had an infection in the blood, we found out that it was because of MRSA, we spent 1 mnth in the hospital and very traumatic cause her face got really swolen. After a month right now i saw again another pimple on my groin I was thinking i might be a vaginal carrier, how can i treat myself am very worried to spreading it to her Please help me asap.

    • http://www.thesurvivaldoctor.com James Hubbard, M.D., M.P.H.

      Jaine, go to your doctor or an urgent care center, and see if they can incise, drain, and culture it. That should give you an answer.

  • Minu

    I had MRSA several times within six months (I work in a hospital) and each time was worse (the last time I had an abscess and fever within hours of seeing the bump). An infectious disease doc told me to try washing with Hibiclens each day (everywhere- every inch of skin, hair, pubic hair, etc) and let it sit for a minute or two plus put Bactroban in my nostrils twice a day for a month. This seemed to do the trick- plus washing all our bedding, clothing, etc on hot. I haven’t had any problems since and I’m no longer colonized with it.

    • http://www.thesurvivaldoctor.com James Hubbard, M.D., M.P.H.

      Thanks, Minu

  • Bernadine

    On my last yearly exam my doctor says that MRSA was found in the cultures she sent to the lab. She does not seem concerned but I am very worried now. When a vaginal culture comes back with MRSA is there anything I should be doing or not doing? I take Macrobid everyday for chronic UTI’s would this be the reason there is a resistance? Thank you

    • http://www.thesurvivaldoctor.com James Hubbard, M.D., M.P.H.

      Bernadine, I couldn’t find much data on whether to treat it or not. I think many doctors don’t treat MRSA in the vagina if you’ve had no symptoms such as pimples, sores, painful bumps in the area. The reasoning, I surmise, is to leave well enough alone. Unlike in the nostrils, MRSA in the vagina is thought to not to spread to others, except in childbirth and even then, it’s rare.

  • Martha

    My husband, two children and I are all carriers of MRSA. In 2010 we all had boils. My husband had a boil in his nose. He ended up in the hospital because his face became very swollen, doctors said he was lucky it didnt get to his brain. We are lucky we have been clear of boils since then.
    In a few months I will be having a c-section. Im very afraid with all the cutting up I will be getting done that I can get a really bad MRSA Infection inside me.
    Is there anything I can do prior and during my hospital stay to reduce the infection?
    Thanks for a great and informative article.

    • http://www.thesurvivaldoctor.com James Hubbard, M.D., M.P.H.

      Martha, yes, there are things that can be done and, probably, a protocol the hospital has. Check with your doctor. They may recommend things like using a prescription antibiotic ointment in your nose, and washing all over with a specific antibiotic solution prior to surgery.

  • Marie

    When my oldest son was two he grew a boil. We had no idea what it was. It was lanced and we were told it was Staph. My husband ended up getting it sometime later. This went on and off for years. My husband is a nostril carrier. Both had been tested and neither have MRSA. My now 4 year old came along and voila, he too ended up with staph boils. We have kept it down to a dull roar for years, my husband only just recently getting one. I lance and use neosporin on them as well a bandaging clean bandages every few hours. Warm compresses for drainage. I have never had an issue. My oldest, my daughter, has MRSA. She never contracted it from them. Rather she cut her leg on something out in public and after about two months of not healing, we had a swab done. So we are extra careful around here and bleach baths and Lysol are common items here. The honey is certainly worth a try!

    • http://www.thesurvivaldoctor.com James Hubbard, M.D., M.P.H.

      Thanks, Marie.

  • Julie

    In about 2003, my 3 year old daughter started getting the (what we now know was MRSA) bumps. They showed up on her butt and midsection. We took her to a couple of doctors, both of whom told us that it was folliculitis (sp?) or spider bites. Though we hadn’t seen any spiders in the house, we bug bombed it and cleaned the whole place out. The bumps did not go away. Then my husband started to get them. We took him to the doctor and explained that our daughter had them, too. Again, the diagnosis was spider bites or folliculitis. Then our oldest daughter started to get them and so did I. Then the neighbor got one. Back to the doctors- several of them- always with the excuse that they were folliculitis and we were causing them ourselves by scratching. Our neighbor’s doctor was a lot more thorough and took care of the problem quickly. We were not so lucky. The bumps kept recurring over the years. One of us was always dealing with one here or there.

    In 2007, my husband had two bumps, one on his hand and the other on his knee. He was due to go on a TDY to Alaska, so I went with him to the Dr. on base. I took newspaper articles, pictures of past sores and told the doctor the history of these bumps with our family. He dismissed it all, saying it was folliculitis and that there was nothing to do except to lance them. My husband wanted antibiotics. He was hurting a lot. Because he was flying the next day, he didn’t want the bumps opened up and oozing on the plane. The doctor told him that antibiotics wouldn’t do anything and so he wouldn’t prescribe them.

    By the time he got to Alaska, he was so sick that he went straight to the ER on base. They lanced the bump on his leg and took a sample. Voila! MRSA…what we’d been telling the doctors for YEARS, though none would listen to us. In this particular instance, the MRSA had created a shaft from my husband’s knee down toward the middle of his shin. Needless to say, the Dr’s on Elmendorf were pretty pissed that Tinker would send someone with MRSA up there. Tinker’s doc’s excuse was that my husband “refused treatment”.

    When my husband got back from AK, we all went back to the base Dr to have swabs taken from our nostrils. Turns out that I was a carrier. I rubbed the bactrin every day inside my nose. Though we’ve had a couple more bumps here and there, it’s not even close to what it was for several years. We didn’t know about the honey or the bleach, unfortunately. We did use hibiclens and we opened and drained our own bumps with needles that we’d seared with lighters. We didn’t know what else to do. Hot, wet towels seemed to help the pus to rise and seep out easier. Also, pulling the skin away from the opening worked better and hurt less than pinching it to get the pus out.

    • http://www.thesurvivaldoctor.com James Hubbard, M.D., M.P.H.

      Julie, Thanks. Many people I’ve seen with community-acquired MRSA often thought they must have been bitten by a spider. Many times, that’s how it starts. No scratch. Just a small, painful bump. Sharing your experience of diagnosis and treatment, hopefully, should help others.

  • Bernadette

    I have been getting breakouts since May of 2012, at first I thought they were just boils….then I finally went to the doctor because they kept coming back in different spots. They tested it, and it came back as MRSA. I was on antibiotics, it went away..then a month later, they came back again…back to the dr’s, put on more antibiotics, this time for two weeks. It was gone, only to return about another month later. This time I went to a different doctor who put me on 2 weeks of antibiotics, then another week of the cream. It stayed away for a few months…but now it is back..I am ready to go to the ER, and ask to have an IV pumped through my body with antibiotics..this is crazy!!! They are painful, one drains, and another one pops up somewhere else. I’m going crazy!! I have kids and do not need this to spread to them. I was told that some people are carriers, and it stays in their nose..is this true?

    • http://www.thesurvivaldoctor.com James Hubbard, M.D., M.P.H.

      Yes, it’s true. Sometimes using the mupirocin in all family members nostrils may help. Maybe repeat it in 24 hours.

  • Krysten

    I was told by a pediatrician to put a cap full of bleach in my daughters’ bathtub water to kill the bacteria on their skin. We had an issue with staph infections with our two girls. It works! We do it a couple times a month.