I take Plaquenil for my non-specific inflammatory arthritis and I never really thought of this drug as an immunosupresent drug. Over the past two months I have been hospitalized twice for MRSA skin infections. Last month it was on my abdomen and last week it was on my lip. Oh my god - they were both so painful and required lancing. The lip was the worst. It swelled up to 6 times its normal size. With my obvious tendencies towards MRSA is continuing to take an immune suprescent drug a good idea? I am going to talk to my Rheumy doc as well.
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I can't find anything about Plaquenil causing (or making one more prone to) infections of any sort; perhaps someone else will find a connection. Remember that MRSA is only special because antibiotics are ineffective against it; it otherwise behaves exactly like other *untreated* staph infections. No matter what medicine you are taking you can't get MRSA unless you are exposed to it somewhere in your environment.
Are there places you go that may be exposing you to MRSA (e.g. a contaminated gym or other place with plenty of bodies)? It only takes one person with careless hygiene to spread it around. Not everyone carrying MRSA will even know that they are.
The CDC has a helpful page about MRSA in the workplace:
MRSA and the Workplace
The article points out that "MRSA is transmitted most frequently by direct skin-to-skin contact or contact with shared items or surfaces that have come into contact with someone else's infection (e.g., towels, used bandages)."
Are there places you go that may be exposing you to MRSA (e.g. a contaminated gym or other place with plenty of bodies)? It only takes one person with careless hygiene to spread it around. Not everyone carrying MRSA will even know that they are.
The CDC has a helpful page about MRSA in the workplace:
MRSA and the Workplace
The article points out that "MRSA is transmitted most frequently by direct skin-to-skin contact or contact with shared items or surfaces that have come into contact with someone else's infection (e.g., towels, used bandages)."
Plaquenil is classified as a DMARD (disease modifying anti rheumatic drug), although it was first used an an anti-malarial. It has immune modulating properties, but it is not immune suppressing like steroids or biologics. It is used to reduce pain and swelling, but also helps slow or stall the progress of rheumatic disease (disease modifying). It is in the same category as sulfasalazine.
I've done some searching, but have not seen anything indicating immune suppression in pathways preventing infection. Rare instances of retinal damage is the primary risk. But, this is one of those drugs that is not fully understood. What is known is that it works and can be combined with other DMARDs.
http://www.hopkinsarthritis.or...hritis/ra-treatment/
I might suggest that it possibly is your inflammatory arthritis that is increasing your infection risk, and not the treatment you are currently on. It is also possible that you need more/better treatment, not less. Perhaps switching to a different DMARD or adding another is what you need?
http://www.arthritistoday.org/...ction-risk-in-ra.php
Another thing to keep in mind, is that once you are infected by MRSA, you are more likely to relapse, particularly if the first infection was only suppressed, not eradicated. A longer course of antibiotics and at higher doses may be necessary.
Jan
I've done some searching, but have not seen anything indicating immune suppression in pathways preventing infection. Rare instances of retinal damage is the primary risk. But, this is one of those drugs that is not fully understood. What is known is that it works and can be combined with other DMARDs.
http://www.hopkinsarthritis.or...hritis/ra-treatment/
I might suggest that it possibly is your inflammatory arthritis that is increasing your infection risk, and not the treatment you are currently on. It is also possible that you need more/better treatment, not less. Perhaps switching to a different DMARD or adding another is what you need?
http://www.arthritistoday.org/...ction-risk-in-ra.php
Another thing to keep in mind, is that once you are infected by MRSA, you are more likely to relapse, particularly if the first infection was only suppressed, not eradicated. A longer course of antibiotics and at higher doses may be necessary.
Jan
Thanks for the info guys! Jan - I definitely got a much better course of the IV antibiotics this time. 4 full bags vs barely 1.5. The nurse that did my IV worked a miracle and using an ultrasound found a good vein and then strapped my arm to a soft board which kept me from moving the arm and causing the IV to infiltrate. This equaled an IV that lasted the full 3 days (a previously unheard of occurrence for me)! I have another 6 days on Bactrim and I am going to talk to my GP about how to manage this going forward. I will also talk to my rheumy at my next appointment. Fingers crossed that I have this thing beat!