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MRSA treatment at 39 weeks

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  • MRSA treatment at 39 weeks

    I was diagnosed with a MRSA infection at 37 weeks pregnant and given a 1 week dose of sulfamethoxazole and trimethoprim. It seemed to do the trick and the symtoms went away. However, I've been finished with the antibiotic for 4 days not, and today I noticed the rash is coming back. Now that I am 39 weeks pregnant with a scheduled c-section exactly one week from today, I wonder what would be the best course of action--more sulfamethoxazole and trimethoprim? Clindamycin? My OBGYN and dermatologist are trying to coordinate a plan (before the relapse, they were going to treat me with Clindamycin after the c-section), but I would like to hear suggestions from the reputable admins of this forum.

    My biggest worries are having this infection spread when I have my surgery (and getting an internal MRSA infection), and then (even bigger) is the impact on my child. Breastfeeding is also very important to me and I don't want to take any actions that threaten me being able to do so. Any help as do how I should handle the next week would be greatly appreciated. Thank you in advance for any input.

  • #2
    Dear Nico,

    Bactrim (sulfamethoxazole + trimethoprim) should be used with caution in mothers who have premature infants and infants who are younger than 1 month of age as the drug may increase the risk of hyperbilirubinemia (high jaundice levels) in these breastfeeding infants. Clindamycin is secreted minimally into breastmilk and half of the drug is eliminated from the body within two hours. Waiting two hours after the dose to breastfeed would decrease the risk to your infant. Observe your infant for diarrhea, but clinical effects in a breastfeeding infant would be unlikely. Your physicians will guide you on the best treatment choices depending on the timing of treatment and location of your infection. You may call the InfantRisk Center at 806-352-2519 if you have further questions. We are open Monday through Friday, 8 to 5, CT.

    Sincerely,
    Cindy Pride, MSN, CPNP
    TTUHSC InfantRisk Center

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