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Ender
06-16-2006, 03:26 AM
Well i was at my docs the other month and i asked them why they don't treat staph like they treat pseudo. She told me of the two bugs, staph was better to culture than pseudo, and that when they do actually take steps to irradicate the staph, they find that the patient usually cultures peudo after anways. So they think that maybe the staph creates a balance in the lungs and keeps the pseudo at bay. At least i got an answer that made sort of sense <img src="i/expressions/face-icon-small-tongue.gif" border="0">

NoExcuses
06-16-2006, 11:29 AM
Your nurse is right on the cutting edge of microbiological thinking.

The latest thinking is that Staph prevents PA from growing out of control. Perhaps they use the same resources for survival or for growth... they're not sure yet.

So if you're having a Staph over-growth, but you're colonized with PA, it's a good idea to treat with an antibiotic that treats not only Staph but PA as well.

Why? Because if you treat just Staph, this will give PA an opportunity to grow. And PA is a much more nasty, difficult bug to treat.

This is why Augmentin is always strongly discouraged by people who understand this theory. Augmentin treats Staph, but not PA. Therefore taking Augmentin for a person who has both Staph and PA may encourage PA growth.

Great thread. This is a very interesting topic.

2005CFmom
06-16-2006, 11:39 AM
Hmmm...I've been wondering the same thing....

My daughter cultures Staph and not PA. I have been wondering why they don't have some kind of proactive antibiotic for staph like they have Tobi for the PA.

Thanks!

anonymous
06-16-2006, 11:50 AM
I think this has been discussed before in a different conversation (not specific to staph/PA). The principle is pretty simple, from what I read in the past. Like what Amy said, there is limited real estate and resources within your system (lungs in this case). Just like a big reef, there is only so much resources and real estate to go around. You can only have so much of particular life forms that are dependent on this real estate and resources, because they will compete for it. There are tons of helpful/normal/non harmful bacteria in the human body/lungs. If you can increase this population, or increase a population of bacteria that is much less harmful than the other bacteria types that are harmful (staph, PA, etc), and they operate in the same ways (need for similar resources/real estate, you will be better off.


It makes perfectly sound sense to me.

anonymous
06-16-2006, 12:10 PM
<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>amy</b></i>


So if you're having a Staph over-growth, but you're colonized with PA, it's a good idea to treat with an antibiotic that treats not only Staph but PA as well.



Why? Because if you treat just Staph, this will give PA an opportunity to grow. And PA is a much more nasty, difficult bug to treat.
</end quote></div>


Is Bactrim one of these drugs that would treat both & if not, do you happen to know of a drug that would combat both?

anonymous
06-16-2006, 12:16 PM
<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>anonymous</b></i>

<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>amy</b></i>





So if you're having a Staph over-growth, but you're colonized with PA, it's a good idea to treat with an antibiotic that treats not only Staph but PA as well.







Why? Because if you treat just Staph, this will give PA an opportunity to grow. And PA is a much more nasty, difficult bug to treat.

</end quote></div>





Is Bactrim one of these drugs that would treat both & if not, do you happen to know of a drug that would combat both?</end quote></div>

Fortaz should if you are going the IV route.

anonymous
06-16-2006, 12:17 PM
Levaquin

anonymous
06-16-2006, 12:20 PM
<div class="FTQUOTE"><begin quote>Is Bactrim one of these drugs that would treat both & if not, do you happen to know of a drug that would combat both? </end quote></div>

It depends on your cultures. What drugss work for me may not work for you. You would have to talk to your doc and maybe even ask for a copy of your culture/sensitivity results (they are really easy to read).

As for Psuedo and Staph I culture both, well the staph was MRSA until recently. So for me the bugs were equally difficult to treat. Psuedo is more harmful, it is a more destructive bug that reproduces/spreads much quicker than Staph by what my doc has told me. In the long run though Staph can do just as much damage - also by what my doc has said.

I normally get treated for both with a cocktail of meds, Cipro oral for psuedo and now dicloxicillin oral for staph. As for IV meds I have been given Tobramyxin and fortaz (ceftazidime) for Psuedo and up until recently either Vanco or Zyvox for MRSA/Staph. For me there is not one single drug I can take to treat both the bugs I grow.

Lindsey

angelsmom
06-16-2006, 12:45 PM
I find this very interesting as my 2 year old wcf has cultured pseudo once (last two cultures have been negative) but seems to always show staph, which we don't treat.

Does anyone have any sources for the information you have provided regarding this subject or does most of your information come right from your doc? I'd like to read more about staph v. pseudo . . . are there any research papers I can find online?

Thanks

Sandra

anonymous
06-16-2006, 01:41 PM
So should I be wishing I had staph?

John

NoExcuses
06-16-2006, 08:48 PM
<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>anonymous</b></i>

<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>amy</b></i>





So if you're having a Staph over-growth, but you're colonized with PA, it's a good idea to treat with an antibiotic that treats not only Staph but PA as well.







Why? Because if you treat just Staph, this will give PA an opportunity to grow. And PA is a much more nasty, difficult bug to treat.

</end quote></div>





Is Bactrim one of these drugs that would treat both & if not, do you happen to know of a drug that would combat both?</end quote></div>


As a rule of thumb, the antibiotics that treat PA treat Staph. but those that treat Staph don't necessarily treat PA.

Drugs that treat PA are usually very powerful drugs.... and they destroy almost all bacteria. Drugs like Quinolones (Cipro, Avelox, Levaquin), Tobramycin, etc. They all treat PA and treat the less virulent bacteria, Staph Aureus.

anonymous
06-17-2006, 04:06 PM
Amy,

Does that mean if you are on nebulised coliston, then that is killing of staph too??

fugikitten2087
06-17-2006, 05:52 PM
I have 4 staph, and 5 pseudo and a couple other bacterias, and the staph and other bacterias do keep the pseudo at bay. My "adult" dr. explained that to me. That some bacteria can also hide pseudo and others..so what you culture may not be correct based on what you grow.

NoExcuses
06-17-2006, 08:29 PM
<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>anonymous</b></i>

Amy,



Does that mean if you are on nebulised coliston, then that is killing of staph too??</end quote></div>

Collistin definitely treats Staph

anonymous
06-18-2006, 05:19 AM
I wouldn't wish for staph if i were you......staph is the one that makes me feel really crappy - no appetite, nauseus, dizzy...bla bla. I culture pseudo and cepacia and used to culture staph too, but for some reason i haven't lately and i feel a box of birds most of the time, no time off work for 3 months and my energy levels are great, as is my appetite. I know it isn't theoretically as harmful but it sure feels worse!! My CF nurse told me when i was feeling at my worst 'oh, that'll be the staph'
Kat (37 with CF, NZ)

anonymous
06-18-2006, 01:04 PM
<div class="FTQUOTE"><begin quote>Originally posted by: anonymous
Amy,



Does that mean if you are on nebulised coliston, then that is killing of staph too??

Collistin definitely treats Staph
</end quote></div>

It doesn't necessarily treat Staph. I am sure it has the ability too if the Staph the patient is culturing is sensitive to that med, but that is not always the case.

To find out what meds you can take to treat the bugs you grow you should really talk to your doc about your sensitivities.

Lindsey

NoExcuses
06-18-2006, 03:56 PM
Alomst every antibiotic on the market treats Staph Aureus. Macrolides, Penicillins, Beta-lactams, Cephelasporins, Tetracyclins, Ketolides, Quinolones, etc.

Of course every antibiotic with relation to a certain bacteria has a break point.

But, for example, Augmentin has no effect on gram negatives such as PA, because of PA's mechanism of action. But Flouroquinolones do treat gram negatives, such as PA and E. Coli. Of course a bacteria can become resistant.......

So the question of does Coliston treat Staph, yes. Can Staph become resistant to Colistin? Of course..... there's that potential of any bacteria becomming resistant. But Collistin does treat bugs such as Staph as long as they're not resistant to Collistin. This is in contrast to an Augmentin, for example, that is inheritantly resistant to PA. There is no strain of PA that is susept to Augmentin because of PA's mechanism of action.