antibiotics

[Druggie]

Does the FAA have any issues with sulfamethoxazole and trimethoprim??

My doc prescribed it for some infected bug bites. I'll be off it in a week.

 

[dell30rb]

You can start here

http://www.aopa.org/members/databases/medical/druglist.cfm

 

[Gary F]

I didn't see either component of this combination antibiotic listed but doubt that it would be a problem. I did not know that this antibiotic was commonly used for skin infections.

 

[One Short]

I didn't see either component of this combination antibiotic listed but doubt that it would be a problem. I did not know that this antibiotic was commonly used for skin infections.

If they are concerned about the possibility of MRSA, Bactrim is a commonly used antibiotic.

Barb

 

[Druggie]

You can start here

http://www.aopa.org/members/databases/medical/druglist.cfm

Actually, that was my first stop. Didn't see anything, but I did notice that antibiotics didn't have a blanket "it's okay" stamp. Hopefully Dr. B will be on his lunch break soon and will check in here. If I had to guess, he probably has the answer off the top of his head.

If they are concerned about the possibility of MRSA, Bactrim is a commonly used antibiotic.

Barb

WAY over my head!

In a nutshell, got bit by something in the middle of the night about 5-6 times woke up scratching them. Next morning the spots were swollen to about the size of an acorn with the shell. Next morning after that, they were swollen 2-3 times that (some merged), red in the whole area, and warm to the touch. Figured it was a good time to call the doc. After answering her questions, she prescribed the antibiotics.

 

[Gary F]

If they are concerned about the possibility of MRSA, Bactrim is a commonly used antibiotic.

Barb

Only a limited number of MRSA strains are susceptible to Bactrim. I guess they might have cultures that show this unless it is very prevalent in that geographic area. If it is then we really have a problem with antibiotic resistance.

 

[One Short]

Does the FAA have any issues with sulfamethoxazole and trimethoprim??

My doc prescribed it for some infected bug bites. I'll be off it in a week.

You just have to report the office visit on the next physical in box 19: seen for infected bug bite, resolved with treatment.

That should be good enough. While taking the drug, decide if you feel well enough to fly and self certify.

 

[One Short]

Only a limited number of MRSA strains are susceptible to Bactrim. I guess they might have cultures that show this unless it is very prevalent in that geographic area. If it is then we really have a problem with antibiotic resistance.

I think there is a lot of regional variation. Here in Maine, most of the community MRSA is sensitive to Bactrim (>90%) and less than half are sensitive to Cipro. Where I was in Wyoming and Lower Michigan it was sensitive to both most times. Although in Gladwin MI, I had one staph that was sensitive to Penicillin. I think it must have been living in the middle of the woods and never been exposed to humans before. I double checked to make sure they hadn't mixed up the report somehow! I'm still not sure it wasn't some kind of error in reporting, but it makes for a good story.

 

[Doggtyred]

I think there is a lot of regional variation. Here in Maine, most of the community MRSA is sensitive to Bactrim (>90%) and less than half are sensitive to Cipro. Where I was in Wyoming and Lower Michigan it was sensitive to both most times. Although in Gladwin MI, I had one staph that was sensitive to Penicillin. I think it must have been living in the middle of the woods and never been exposed to humans before. I double checked to make sure they hadn't mixed up the report somehow! I'm still not sure it wasn't some kind of error in reporting, but it makes for a good story.

Must be a regional thing... About the only thing I've seen bactrim used for in my neck of the woods (Texas) is UTI's. Never for skin. But I'm also hospital based, not in an outpatient clinic.

 

[fnpdoc]

Actually Bactrim DS is a primary option for MRSA treatment. I will usually prescribe this over Clindamycin due to inducible resistance (while waiting for cultures).

Only a limited number of MRSA strains are susceptible to Bactrim. I guess they might have cultures that show this unless it is very prevalent in that geographic area. If it is then we really have a problem with antibiotic resistance.

 

[Henning]

Actually, that was my first stop. Didn't see anything, but I did notice that antibiotics didn't have a blanket "it's okay" stamp. Hopefully Dr. B will be on his lunch break soon and will check in here. If I had to guess, he probably has the answer off the top of his head.



WAY over my head!

In a nutshell, got bit by something in the middle of the night about 5-6 times woke up scratching them. Next morning the spots were swollen to about the size of an acorn with the shell. Next morning after that, they were swollen 2-3 times that (some merged), red in the whole area, and warm to the touch. Figured it was a good time to call the doc. After answering her questions, she prescribed the antibiotics.

You have Bedbugs, you need an exterminator, not doctor.

 

[Gary F]

Actually Bactrim DS is a primary option for MRSA treatment. I will usually prescribe this over Clindamycin due to inducible resistance (while waiting for cultures).

Is MRSA so prevalent that it is treated empirically for community acquired skin infections before culture?

 

[AcroBoy]

Approximately 15 percent of our patients coming in for elective surgery have MRSA colonization in their nares, and we culture everyone prior to elective joint replacement, and treat.

For a furuncle, it can take 48-72 hours for culture results- is it better to treat empirically or wait with the patient in pain? Seems like augmentin or keflex might be a good first choice, but if they have a true pen allergy then perhaps doxy or bactrim. Our ID folks seem to be favoring doxy these days for chronic suppression more than bactrim for some reason. On the other hand, we typically give clinda for surgical prophylaxis as a first choice when there is a documented true pen allergy (anaphylaxis or angioedema only, not a rash or even hives) over a first gen cephalosporin. These are the current CMS guidelines.

 

[bbchien]

Dear "druggie", no FAA problems here, at all

 

[Druggie]

You have Bedbugs, you need an exterminator, not doctor.

Gee Henning. I didn't know you were in bed with me. If you had been, I would definitely agree that I would need to exterminate.


BTW... Never heard of having bedbugs do just six bites in small space.

 

[Druggie]

Dear "druggie", no FAA problems here, at all

Thanks Doc!!

 

[fnpdoc]

Yes, it is not difficult to tell an MRSA abscess. They need to be treated while awaiting the culture. I I&D them, culture then start on antibiotics.

Keflex and augmentin are not indicated for MRSA suspected infections.
Doxy is fine.
I occasionally pick up a MRSA carrier. Bactroban nasal works great.

Is MRSA so prevalent that it is treated empirically for community acquired skin infections before culture?

 

[poadeleted21]

Gee Henning. I didn't know you were in bed with me. If you had been, I would definitely agree that I would need to exterminate.


BTW... Never heard of having bedbugs do just six bites in small space.

We were in the middle of a home remodel, including pulling the floor back to the sub floor. (i.e. digging up stuff that hadn't been seen in 40 years). I woke up one morning with the same thing, on the back of my head. 5-6 localized bites that kept swelling. I popped the bed sheet out and captured the perpetrator, a hobo spider. My guess is he snuck in through the cracks and got testy when I started rolling my head around on him in the middle of the night.

 

[dell30rb]

What is a hobo spider?

Glad we don't have these things in NC. Bout the only thing I am concerned about is a black widow, or moccasin biting my retriever...