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MRSA

Question
Hello. My daughter has the MRSA and since she has it she is not doing very well, totally phlegmy cough and permanent vomiting. Can we do anything about the vomiting? As she loses also weight by this.
Thank you.
Answer
Hello,
I assume that your daughter suffers from CF as you are asking our expert panel. You report, that your daughter is doing worse since the colonization with MRSA and that she has a phlegmy cough and vomits premanently. You ask, what can be done about the vomiting.
The finding of MRSA in the throat swab or the sputum of CF patients is often by instance, without that a worsening of the health situation can be observed. As you observe that your daughter is clearly doing worse since the colonization and she has above all clearly more phlegmy cough, one has to assume that the MRSA here plays a causing role. MRSA is a germ which is in CF patients partially very difficult to eliminate. Nevertheless one should undertake an intensive trial and initiate an antibiotic therapy according to the sensitivity testing (antibiogram). Such a therapy should be performed at least for the duration of 14 days. In some centers, a 3-week therapy is preferred. As the vomiting is a typical side effect in patients with increased sputum, one can assume that the vomiting ceases under a respective antibiotic therapy, when the amount of sputum normalizes. In case the vomiting should not cease, it should be considered together with the physicians of the CF-center, if other causes, like e.g. an inflammation of the stomach mucosa or an inflammation of the oesophagus could come causally into account. We wish you and your daughter much luck and that the MRSA can be eliminated and that your daughter will do better then.
Yours sincerely,
Dr. H.-G. Posselt
07.04.2011