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Since MRSA is no longer just found in the hospital settings it is becoming harder to track, but if you are having several patients that have MRSA coming out of the hospital, please make sure that the Infection Control Nurse is aware. Also I know you probably are already doing this, but be careful not to assign a nurse to a patient with suppressed immune system that needs care after seeing a patient with MRSA.
As far as help from antibiotics, they only seem to beat down the MRSA for a while and then it returns. I have had some success with adding a nutritional program to their antibiotics but few in home health have funds for good supplementation. The biggest bang for the buck that I have seen work is a good Olive Leaf Extract added to the antibiotic regimine and then continued as a lifetime supplement. There is some research out there about nutrition in addition to antibiotic therapy that you may want to find.
Depends if they have a wound colonized with MRSA or a systemic infection? If they have a systemic infection, you need systemic antibiotic treatment (often for at least 6 weeks). If it's local, I've had good success resolving colonization with Medihoney - but I'm not sure if it's FDA approved.
Don't be positive the MRSA came from the hospital either - there is a large rise in community-acquired MRSA.
Here in Belgium we only use Bactroban if a patient has MRSA in the nose and sometimes skin but never in the wound because we just have a patient now with MRSA in his wounds and we are not using Bactroban but a special product made by the Pharmacist. I don't think Bactroban works to get rid of MRSA in wounds it works hardly for the skin.
Research has shown that silver dressings are effective against MRSA. There is no need to treat systemically when the infection is in the wound. Systemic treatment with antibiotics takes its toll on the body in so many facets.Read the literature regarding silver dressings and you will find the documentation to support their use. Also, be sure to leave the dressing on the recommended period of time to obtain the full effect of the silver. Change the packing and secondary dressing as needed but maintain the silver on the wound bed. As for honey...no idea!
In my LTC we tend to use silvadine for wounds, get a sensitivity on the wound culture and treat appropriately with PO antibiotics at the same time.
At the same time we start what we call MRSA protocol. It's really new and I was VERY skeptical when it was introduced.
As soon as you know someone is positive for MRSA, we start with all daily bathing and weekly baths are done with tea tree oil body wash for 30 days, at the same time we start bactroban ointment in both nares bid for 14 days. 48 hours after the 30 days of tea tree bathing is complete we do swabs of nares, axilla and groin for C&S one week apart for a total of 3 wks. If all 3 of the weekly tests are negative. That's the end of it. If any of the 3 wks comes back positive, we repeat the whole process again and retest. If any of them come back positive after the second treatment, we stop there and consider the person colonized.
We do this for anyone who tests positive for MRSA from any source and have seen positive results. (anyone else ever heard or done this treatment? Just curious)
bebop1
76 Posts
Hey...if anyone can help....I have multiple patients with wounds that have MRSA. I am a home health nurse, and of course they send them home....and about a week or two later after we have them...fianlly they are Dx with MRSA.
what is the best sort of wound product to use on MRSA. is any kind of a silver dressing going to do any good on the wound if not on antibiotics? or do the two have anything to do with one another?
any help would be great!