Toxic Shock Syndrome: Treatment Overview

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Treatment Overview

By the time a person with toxic shock syndrome (TSS) sees a health professional, immediate medical treatment is usually necessary. Because TSS can progress rapidly and cause life-threatening complications, treatment almost always takes place in a hospital where a person's condition can be closely monitored. Treatment for shock or organ failure is usually necessary before any test results are available. Admission to the intensive care unit (ICU) is usually needed when a person shows signs of shock or has problems breathing (respiratory failure).

Treatment for strep or staph toxic shock syndrome includes:

• Removal of the source of the infection. If a woman is using a tampon, diaphragm, or contraceptive sponge, it is removed immediately. Infected wounds are usually drained and cleaned to rid the area of bacteria. Your doctor may give you a shot to numb the area in order to use a scalpel or scissors to remove dead or severely infected tissue. This is called surgical debridement. As soon as the source of the infection is removed, a person's condition often improves rapidly.
• Treatment of complications of the illness, including low blood pressure, shock, and organ failure. The specific treatment depends on what problems have developed. Large amounts of intravenous (IV) fluids are typically used to replace fluids lost from vomiting, diarrhea, and fever and to avoid complications of low blood pressure and shock.
• Antibioticsto kill the bacteria that are producing the toxins causing TSS. Clindamycin stops toxin production and is started immediately to treat symptoms.¹ Other medicines, such as cloxacillin or cefazolin, may be added when the specific strep or staph bacteria is identified by lab tests. Strains of Staphylococcus aureus that are resistant to medicines such as cloxacillin or cefazolin have spread throughout the United States. These staph strains are called methicillin-resistant Staphylococcus aureus (MRSA). Other antibiotics may be needed to kill these bacteria. These antibiotics include vancomycin, daptomycin, linezolid, or tigecycline.

When there are no major complications, most people recover completely in 1 to 2 weeks with antibiotic treatment.

Strep TSS has about a 50% death rate.⁵ This may be because strep TSS can be more difficult to identify early before serious complications develop, such as blood infection (sepsis) or a rare bacterial infection that can destroy skin (necrotizing fasciitis).

Staph TSS is serious but leads to death in only about 5% of people when identified and treated properly.⁵

Last updated:	March 03, 2008
Author:	Maria G. Essig, MS, ELS
Reviewed By:	Anne C. Poinier, MD - Internal Medicine, Dennis L. Stevens, MD, PhD - Internal Medicine, Infectious Diseases
Editors:	Susan Van Houten, RN, BSN, MBA, Tracy Landauer