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March 7, 1986

Staphylococcus aureus Infection of the Nose

Author Affiliations

Good Samaritan Clinic at St Johns Portland, Ore

JAMA. 1986;255(9):1137-1138. doi:10.1001/jama.1986.03370090059015

To the Editor.—  I would like to propose an alternative antibiotic therapy for Dr Martin's patient with recurrent Staphylococcus aureus infection of the nose.1 Your consultant appropriately emphasized the difficulty of eradicating the nasal carrier state. Because of rifampin's unique ability to achieve high concentrations in body secretions, it is very useful for this purpose.2 However, because many microorganisms can develop one-step resistance through an alteration in the drug target, DNA-dependent RNA polymerase, it is important to combine rifampin with an antistaphylococcal antibiotic. If the patient wears contact lenses, he must be cautioned to remove them during therapy, as similarly high concentrations achieved in lacrimal secretions will permanently stain contact lenses yellow. Finally, if relapse occurs, Dr Martin should consider the possibility that other household members are colonized with the same strain and may be reinfecting the patient. In that case, the risks and benefits of treating the