Dr. Hive? Do I wait it out?

[sbgrace]

Warning--kind of gross..

I went to urgent care 4 days ago for an infected cyst (we have a high deductible insurance/our urgent care is my cheapest option). The NP told me it was likely staph, asked if I had any family members with MRSA (no), and prescribed 5 days of Bactrim with Bactroban ointment as well and instructions to apply heat. Tomorrow is my last day of antibiotics. I still have the infection. It's not worse, it might be a little bit smaller, at least in the area that is red if not in the swelling itself. I think it hurts a tiny bit less today, maybe. But it still hurts and is swollen and red. It has never come to a head or drained.

I called urgent care tonight, and the nurse told me I was welcome to come in tomorrow if I wanted, but she would probably wait a few days after stopping the antibiotic to see if it got worse. I'm uncomfortable with the idea of stopping the antibiotic while I still have infection?? Wouldn't that increase resistance or something? Maybe it's expected that the Bactrim will keep working?  I think this would heal better if it was drained. I'm not sure it's going to do that on its own.

So, question is, do I return to Urgent Care on the last day of my antibiotic, just to see if they might refill and possibly open it? Or, do I do as the nurse suggested, and wait for a few days and see? 

[Jean in Newcastle]

I would not wait. I would push for a different antibiotic. And I would push for a skin culture. 

[gardenmom5]

there are many different classes of antibiotics.   UC's especially, tend to prescribe less . ..hostile antibiotics.  

I would go back and get something stronger.  and if the dr is "guessing" - there needs to be a culture.

[mom2hunangirls]

Having just dealt with an urgent care for stitches on my daughter’s thumb, I would go to your regular doctor next. 

I’m in a similar Insurance situation as you so I get what you are saying. But at this point, it’s going to cost you more if they don’t take care of it right. 

My GYN has a nurse practitioner in her office that I can see for much less. Could you try that?

My daughter had staph on her hand and it escalated so quickly. By the time she stopped her antibiotic there was noticeable improvement. And we did do the ointment longer (it had to be put in her nose too though.)

after this last episode I’m not sure what would warrant me going back to an urgent care. Go with your gut. 

[Carol in Cal.]

I got a frozen shoulder for several years from an undertreated cellulitis infection in that arm.  Don't wait, you want to actually get better, not just stable.  This is nothing to fool with.

[Tap]

Do you need a referral to go to a dermatologist? If not, then I would get an appointment with a dermatologist instead of the UC.  If you do need a referal, call and ask the urgent care if they will do the referal for you. 

[Acadie]

I'd go wherever you think you can get the best care, whether that's Urgent, primary or a dermatologist, regardless of cost. 

Are you using Hibiclens (or a store brand equivalent--CVS has a good one)? It's a soap that kills MRSA and I'd use it for several weeks in a broad area surrounding the cyst and also any areas that are below the site where water might run off when you shower.

Also if it's an area covered by clothing, wash those clothes on hot with ammonia. We've had experience with a boil that kept recurring until I treated the laundry. 

 

[ktgrok]

I've successfully treated staph with just the ointment, no oral antibiotic, so it may still clear up. That said, it should be looking better by now and it isn't. A dermatologist is probably the best option now, or a different doctor. Sorry. 

Are ou soaking it a few times a day in hot salt water?

[mmasc]

I agree with seeing a dermatologist if it’s at all possible. But I would see *someone* again, even if it had to be UC. I had a couple of these in my 20s...one treated by a general dr, one by a derm. I had better results with the derm. It was drained properly, cultured, antibiotics, bacitracin in the nose. I don’t think I had another one after seeing the derm. 

Good luck and I’m sorry you’re dealing with this. I know how painful they can be. 

[mmasc]

How are you today sbgrace?

[sbgrace]

I appreciate the replies here--they helped me think through, and I went back to UC yesterday. I would have tried for a dermatology, but  I was really uncomfortable with going off the antibiotic after the 5 days when I still clearly had an infection. The NP yesterday drained it and prescribed 10 more days of Bactrim along with the antibiotic ointment.

It hurts far less today. I feel encouraged.

I think I'm going to see dermatology anyway--I want to see if they can just remove the cyst perhaps. I'm ok with a scar. I don't want a repeat of this ever again.