Erysipelas antibiotics

Trade names Abbocillin Apo-Pen Diistaquaine V-K Novapen-VK Ospen Penbeta Phenoxymethylpenicillin Indications Cellulitis, endocarditis, erysipelas, oral infections, otitis media, rheumatic fever, scarlet fever, tonsillitis Category Antibiotic, penicillin Half-life 4 hours... 

Erysipelas is a superficial skin infection with extensive lymphatic involvement that is caused by Streptococcus pyogenes and is treated with penicillin. Serious infections should be treated with intravenous antibiotics. 

The goal of treatment of erysipelas is rapid eradication of the infection. Mild to moderate cases of erysipelas are treated with procaine penicillin G 600,000 units intramuscularly twice daily or penicillin VK 250-500 mg orally four times daily (in children 1-18 years of age, 25,000-90,000 units/kg per day divided into four doses) for 7 to 10 days. " Penicillin-allergic patients can be treated with clindamycin 150-300 mg orally every 6 to 8 hours (in children, 10-30 mg/ kg per day in three to four divided doses). For more serious infections, the patient should be hospitalized, and aqueous penicillin G 2-8 million units daily should be administered intravenously. Marked improvement usually is seen within 48 hours, and the patient often may be switched to oral penicillin to complete the course of therapy. One randomized, double-blind, placebo-controlled study showed that the median time for cure, intravenous antibiotics, and hospital stay was reduced in patients receiving prednisolone in addition to antibiotics. Further studies are needed, however, before corticosteroids can be recommended for routine use/- ... 

Bergkvist P, SjobeckK. Antibiotic and prednisolone therapy of erysipelas ... 

For skin and soft tissue infections, roxithromycin is an effective and well-tolerated therapy for erysipelas and acne [162, 163]. As with other macrolide antibiotics, its immunomodulatory effects make it useful as an adjunctive therapy of psoriasis vulgaris [164]. Despite its in vitro activity against Borrelia burgdorferi, monotherapy with this macrolide was not effective for the treatment of Lyme borrelio-sis [165]. However, a small, nonrandomized, open prospective clinical study of 17 patients with confirmed late Lyme disease (stage n/III) showed a 76% complete recovery rate from a therapeutic combination of roxithromycin 300 mg... 

Deeper bacterial infections of the skin include folliculitis, erysipelas, cellulitis, and necrotizing fasciitis. Since streptococcal and staphylococcal species also are the most common causes of deep cutaneous infections, penicilUns (especially ji-lactarruise-resistant ji-lactams), and cephalosporins are the systemic antibiotics used most frequently in their treatment (see Chapter 44). A growing concern is the increased incidence of skin and soft tissue infections with hospital- and community-acquired methicillin-resistant S. aureus (MRSA) and drug-resistant pneumococci. Infection with community-acquired MRSA often is susceptible to trimethoprim—sulfamethoxazole. 

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