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Old 09-28-2014
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Warning! Microbiology question !

What is the treatment of Staph Toxic shock Syndrome ? I got confused as i read " Antibiotics may worsen the case and not curative at all " at MMRS although Treatment of toxic shock like Syndrome ( Streptococcal ) is Penicillin G + Clindamycin , knowing that also it is the pyrogenic toxin the causes this ... ( in both cases a toxin is the caustive agent ) , can someone get me this ?

Last edited by lastwizard; 09-28-2014 at 07:28 AM.
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Old 09-28-2014
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upppppppppp .
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Old 09-28-2014
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Recommended antibiotic therapy
For patients with GAS infection, the administration of clindamycin (600 mg -900 mg IV q8h) is recommended. Other clinicians recommend combined therapy, in which penicillin G (4 million U IV q4h) is combined with clindamycin.

Because differentiating between STSS and streptococcal TSS on clinical grounds alone is difficult, intravenous penicillin also should be administered in addition to a beta-lactamase resistant antibiotic until a bacteriologic diagnosis is confirmed by culture. Alternatively, a first-generation cephalosporin or vancomycin can be used.

Staphylococcal toxic shock syndrome

Large doses of a beta-lactamase–resistant, antistaphylococcal, antimicrobial agent should be administered intravenously to patients with staphylococcal infections. The usually prescribed antibiotics are nafcillin, oxacillin, and first generation cephalosporin. Nafcillin or oxacillin (2 g q4h) is generally recommended. Vancomycin can be used in penicillin-allergic patients.

These agents have been known to increase TSST-1 in culture possibly by cell lysis. Therefore, clindamycin may be used in combination for the first few days to reduce synthesis of TSST-1.


The antibiotic treatment is continued for 10 to 14 days in absence of a complication.

Source : Medscape

The underlined lines is probably the rationale behind the statement that you read. Since, the effect is only seen in culture, I doubt any clinician would withhold antibiotics in a Toxic Shock Syndrome patient. Especially since the article states that it is difficult to differentiate between Staph. and Strep.
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