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	<title>Comments on: Where&#8217;s the combo drugs for MRSA?</title>
	<atom:link href="http://gruntdoc.com/2005/06/wheres-the-combo-drugs-for-mrsa.html/feed" rel="self" type="application/rss+xml" />
	<link>http://gruntdoc.com/2005/06/wheres-the-combo-drugs-for-mrsa.html</link>
	<description>Ramblings of an Emergency Physician in Texas</description>
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		<title>By: GruntDoc</title>
		<link>http://gruntdoc.com/2005/06/wheres-the-combo-drugs-for-mrsa.html/comment-page-1#comment-2303</link>
		<dc:creator>GruntDoc</dc:creator>
		<pubDate>Fri, 12 Aug 2005 07:25:27 +0000</pubDate>
		<guid isPermaLink="false">http://gruntdoc.com/2005/06/wheres-the-combo-drugs-for-mrsa.html#comment-2303</guid>
		<description>Well, it&#039;s not a combo drug, it&#039;s a very new and therefore expensive, IV only, drug.</description>
		<content:encoded><![CDATA[<p>Well, it&#8217;s not a combo drug, it&#8217;s a very new and therefore expensive, IV only, drug.</p>
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		<title>By: gerrie kim</title>
		<link>http://gruntdoc.com/2005/06/wheres-the-combo-drugs-for-mrsa.html/comment-page-1#comment-2302</link>
		<dc:creator>gerrie kim</dc:creator>
		<pubDate>Fri, 12 Aug 2005 02:03:11 +0000</pubDate>
		<guid isPermaLink="false">http://gruntdoc.com/2005/06/wheres-the-combo-drugs-for-mrsa.html#comment-2302</guid>
		<description>well what about tygacil?</description>
		<content:encoded><![CDATA[<p>well what about tygacil?</p>
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		<title>By: Susan Pesek</title>
		<link>http://gruntdoc.com/2005/06/wheres-the-combo-drugs-for-mrsa.html/comment-page-1#comment-2301</link>
		<dc:creator>Susan Pesek</dc:creator>
		<pubDate>Thu, 14 Jul 2005 01:46:00 +0000</pubDate>
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		<description>I use IV Zyvox and IV Riphampin. After IV, PO of Bactrim.</description>
		<content:encoded><![CDATA[<p>I use IV Zyvox and IV Riphampin. After IV, PO of Bactrim.</p>
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		<title>By: daen</title>
		<link>http://gruntdoc.com/2005/06/wheres-the-combo-drugs-for-mrsa.html/comment-page-1#comment-2300</link>
		<dc:creator>daen</dc:creator>
		<pubDate>Fri, 01 Jul 2005 11:48:16 +0000</pubDate>
		<guid isPermaLink="false">http://gruntdoc.com/2005/06/wheres-the-combo-drugs-for-mrsa.html#comment-2300</guid>
		<description>With a prepackaged combination you create a nice constant selection pressure in the same way that led to MRSA in the first place.  By keeping the drugs separate, you have the chance of varying the regimen from time to time, and possibly also from place to place.  That should stop any one mechanism of resistance from becoming dominant thus keeping the bugs on the defensive.  Regarding the regulatory issues, I would imagine it&#039;s not just a reformulation, so no doubt the FDA would demand trial data.</description>
		<content:encoded><![CDATA[<p>With a prepackaged combination you create a nice constant selection pressure in the same way that led to MRSA in the first place.  By keeping the drugs separate, you have the chance of varying the regimen from time to time, and possibly also from place to place.  That should stop any one mechanism of resistance from becoming dominant thus keeping the bugs on the defensive.  Regarding the regulatory issues, I would imagine it&#8217;s not just a reformulation, so no doubt the FDA would demand trial data.</p>
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		<title>By: In the Pipeline</title>
		<link>http://gruntdoc.com/2005/06/wheres-the-combo-drugs-for-mrsa.html/comment-page-1#comment-2304</link>
		<dc:creator>In the Pipeline</dc:creator>
		<pubDate>Fri, 01 Jul 2005 01:58:41 +0000</pubDate>
		<guid isPermaLink="false">http://gruntdoc.com/2005/06/wheres-the-combo-drugs-for-mrsa.html#comment-2304</guid>
		<description>&lt;strong&gt;Where&#039;s the Combo?&lt;/strong&gt;

Gruntdoc wonders about why a particular combination therapy isn&#039;t available yet. Skin infections with methacillin-resistant staphylococcus aureus (MRSA), which I hope I never come any closer to experiencing, are treated with one of several antibiotic c...
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		<content:encoded><![CDATA[<p><strong>Where&#8217;s the Combo?</strong></p>
<p>Gruntdoc wonders about why a particular combination therapy isn&#8217;t available yet. Skin infections with methacillin-resistant staphylococcus aureus (MRSA), which I hope I never come any closer to experiencing, are treated with one of several antibiotic c&#8230;</p>
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		<title>By: cardioNP</title>
		<link>http://gruntdoc.com/2005/06/wheres-the-combo-drugs-for-mrsa.html/comment-page-1#comment-2299</link>
		<dc:creator>cardioNP</dc:creator>
		<pubDate>Mon, 27 Jun 2005 17:43:56 +0000</pubDate>
		<guid isPermaLink="false">http://gruntdoc.com/2005/06/wheres-the-combo-drugs-for-mrsa.html#comment-2299</guid>
		<description>When I managed a subacute ward in a VA Hospital, ID always recommended 2 drug tx - either Rif and doxy or Rif and TMP/SMX as Grunt Doc has suggested.  But ID did call the lab to confirm that the bug was bactrim and/or tetracycline susceptible.  
Since both drugs are generic, I doubt that any company would spend the money to get FDA approval for a combo drug - most healthcare agencies would probably not approve the expensive combo.  Though compliance probably would be better.</description>
		<content:encoded><![CDATA[<p>When I managed a subacute ward in a VA Hospital, ID always recommended 2 drug tx &#8211; either Rif and doxy or Rif and TMP/SMX as Grunt Doc has suggested.  But ID did call the lab to confirm that the bug was bactrim and/or tetracycline susceptible.<br />
Since both drugs are generic, I doubt that any company would spend the money to get FDA approval for a combo drug &#8211; most healthcare agencies would probably not approve the expensive combo.  Though compliance probably would be better.</p>
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		<title>By: Bad Shift</title>
		<link>http://gruntdoc.com/2005/06/wheres-the-combo-drugs-for-mrsa.html/comment-page-1#comment-2298</link>
		<dc:creator>Bad Shift</dc:creator>
		<pubDate>Mon, 27 Jun 2005 02:11:26 +0000</pubDate>
		<guid isPermaLink="false">http://gruntdoc.com/2005/06/wheres-the-combo-drugs-for-mrsa.html#comment-2298</guid>
		<description>I have been using Bactrim and Rifampin, but just learned at dept. meeting that most others are going with Bactrim single coverage?  Any data?</description>
		<content:encoded><![CDATA[<p>I have been using Bactrim and Rifampin, but just learned at dept. meeting that most others are going with Bactrim single coverage?  Any data?</p>
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		<title>By: Doc Shazam</title>
		<link>http://gruntdoc.com/2005/06/wheres-the-combo-drugs-for-mrsa.html/comment-page-1#comment-2297</link>
		<dc:creator>Doc Shazam</dc:creator>
		<pubDate>Sun, 26 Jun 2005 05:29:01 +0000</pubDate>
		<guid isPermaLink="false">http://gruntdoc.com/2005/06/wheres-the-combo-drugs-for-mrsa.html#comment-2297</guid>
		<description>I just use Bactrim.  BTW, Community aquired MRSA is not the same strain that has simply escaped from the health care industry, it is it&#039;s own monster, born of and modified by the (non-healthcare) community in general.  Showing that multiple strains will eventually respond in a similar way to similar pressures.</description>
		<content:encoded><![CDATA[<p>I just use Bactrim.  BTW, Community aquired MRSA is not the same strain that has simply escaped from the health care industry, it is it&#8217;s own monster, born of and modified by the (non-healthcare) community in general.  Showing that multiple strains will eventually respond in a similar way to similar pressures.</p>
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		<title>By: Ryan Maves</title>
		<link>http://gruntdoc.com/2005/06/wheres-the-combo-drugs-for-mrsa.html/comment-page-1#comment-2296</link>
		<dc:creator>Ryan Maves</dc:creator>
		<pubDate>Sat, 25 Jun 2005 17:03:29 +0000</pubDate>
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		<description>HM2 - If it was responding to Ancef and Keflex, then it almost definitely wasn&#039;t MRSA. The Marines are definitely crawling with the stuff, though...MCRD San Diego is a one of early hotspots.

Bactrim and rifampin is a great combo. Wouldn&#039;t want to use rifampin alone (resistance emerges rapidly). I lean towards Bacrim and minocycline around here, since rifampin tends to stain orange the contact lenses of patients on it, but of course your choices need to be dictated by local susceptibility patterns. Plus that minocycline vertigo thing pops up every now and then.</description>
		<content:encoded><![CDATA[<p>HM2 &#8211; If it was responding to Ancef and Keflex, then it almost definitely wasn&#8217;t MRSA. The Marines are definitely crawling with the stuff, though&#8230;MCRD San Diego is a one of early hotspots.</p>
<p>Bactrim and rifampin is a great combo. Wouldn&#8217;t want to use rifampin alone (resistance emerges rapidly). I lean towards Bacrim and minocycline around here, since rifampin tends to stain orange the contact lenses of patients on it, but of course your choices need to be dictated by local susceptibility patterns. Plus that minocycline vertigo thing pops up every now and then.</p>
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	<item>
		<title>By: GruntDoc</title>
		<link>http://gruntdoc.com/2005/06/wheres-the-combo-drugs-for-mrsa.html/comment-page-1#comment-2295</link>
		<dc:creator>GruntDoc</dc:creator>
		<pubDate>Sat, 25 Jun 2005 04:50:16 +0000</pubDate>
		<guid isPermaLink="false">http://gruntdoc.com/2005/06/wheres-the-combo-drugs-for-mrsa.html#comment-2295</guid>
		<description>My personal preference is BactrimDS and Rifampin.  Cheap and effective.</description>
		<content:encoded><![CDATA[<p>My personal preference is BactrimDS and Rifampin.  Cheap and effective.</p>
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