Earlier today I had mentioned that the culture taken from Namine’s chest incision indicated that she has MRSA. Before the culture results had come back, the doctors had put Namine on clindamycin as a precautionary measure, as they suspected infection (pus oozing out of a wound, with barely a touch to provoke it, will do that). It is ironic, then, to find that the particular strain that Namine is incubating is resistant to clindamycin.
There are two things that Namine could be put on to combat this strain of MRSA: vancomycin or bactrim. Bactrim is an oral antibiotic, and she’s been on it before. Vancomycin, on the other hand, can only be given intravenously. And while this strain could be fought with bactrim, it is especially susceptible to vancomycin. The antibiotic regimen, no matter what Namine is given, will likely continue from ten days to two weeks. The doctors settled on the vancomycin, since it is more likely to eliminate the infection.
In my job, I deal with infection all the time. It always comes down to risk versus benefit.
The physician’s assistant who paid us a visit today said it best. The risk, in this case, is what it takes for Namine to receive the vancomycin for the next two weeks, which in all likelihood will be at home: a PICC line. The benefit, of course, is receiving the vanco.
We know the PICC line comes with its own risks of infection; even a simple IV comes with a risk of infection. (When Namine was younger, an IV site became painful, infected, and inflamed. All she has to show for that episode is a scar, not even a stupid t-shirt.) She can’t go home with an IV in her hand, at any rate. PICC lines are placed and left in for even as long as a year, and Namine certainly won’t need it for that long. We trust that the cardiology doctors are making the right call. They have her heart’s best interest in mind, after all; and the faster the infection is dealt with and eliminated, the better.