Erysipelas treatment

I Penicillin is the treatment of choice for erysipelas. In uncomplicated cases, a 5-day course is as effective as a 10-day course.3 Other agents that are acceptable for treatment include clindamycin, erythromycin, cephalexin, and dicloxacillin. 

Coley WB. The treatment of malignant tumors by repeated inoculations of erysipelas. With a report of ten original cases. Am J Med Sci 1983 105 487-511. 

Hypersensitivity to any component monotherapy in primary bacterial infections such as impetigo, paronychia, erysipelas, cellulitis, angular cheilitis, erythrasma (clobetasol), treatment of rosacea, perioral dermatitis, or acne use on the face, groin, or axilla (very high or high potency agents) ophthalmic use. 

Therapy should always be streamlined if and when a microbiological report becomes available. Erysipelas caused by streptococci can be treated by penicillin. In arthritis and osteomyelitis, culture of the joint fluid or of deep tissue is recommended before the start of treatment. 

Unlabeled Uses Treatment of actinomycosis, babesiosis, erysipelas, malaria, otitis media, Pneumocystis carinii pneumonia, sinusitis, toxoplasmosis... 

Coley, W.B. (1894) Treatment of inoperable malignant tumors with the toxins of Erysipelas and the bacillus. Prodigious. Am. J. Med. Sci., 108,183-121. 

The levels of Elephantopus spicatus [syw. Pseudelephantopus spicatus C.F. Baker, Vernon-ieae] are used for the treatment of cough and headache. Applied topically, they are employed as an antipyretic, for the treatment of erysipelas, skin infections, and measles. A preparation made from the roots is taken as a remedy for colic the whole plant helps against diarrhea. It is one of the most popular cough remedies of middle America. 

In a multicenter, open, randomized trial in 204 patients with erysipelas treated with either oral pristinamycin 1 g tds or intravenous then oral penicillin, adverse events related to treatment were significantly more common with pristinamycin they were mostly mild or moderate and mainly involved the gastrointestinal tract (33). Pristinamycin can cause pseudomembranous colitis. 

Tamarind leaves and flowers, dried or boiled, are used as poultices for swollen joints, sprains and boils. The latter are usually applied after grinding leaves and flowers into powder whereby they are used in lotions or infusions. Lotions and extracts made from them are used in treating conjunctivitis, as antiseptics, as vermifuges, treatments for dysentery, jaundice, erysipelas and haemorrhoids, and various other ailments. Frait shells are burned and reduced to an alkaline ash which enters into medicinal formulas (S). The leaves, mixed with salt and water, are used to treat throat infections, coughs, fever, intestinal worms, urinary troubles and liver ailments. Leaves and pulp act as a cholagogue, laxative and are often used in treating liver congestion , constipation and haemorrhoids (3). 

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/- ... 

Martin also describes treatment with cesium as producing remission in late-stage cancer patients. Another possibility described is a killed vaccine from the dead bacteria of the streptococcus of erysipelas. This vaccine is better known as Coley s Toxins. The genus is Streptococcus and the disease is known as erysipelas, an acute feverish condition with intense local inflammation of the skin and subcutaneous tissue. The treatment can be described as a form of immunotherapy. 

Pharyngitis, scarlet fever, erysipelas, and cellulitis caused by S. pyogenes and pneumonia caused by S. pneumoniae respond to macrolides. They are valuable alternatives for treatment of patients who have a serious allergy to penicillin. Unfortunately, macrolide-resistant strains are increasingly encountered. Penicillin-resistant strains of S. pneumoniae also are very likely to be resistant to macrolides. 

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... 

A. acutifdia Jiquiro, Jarrinha whole plant treatment of erysipelas 47... 

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. 

The effectiveness of plasma NO therapy is most apparent with the treatment of the pyoneerotie form of erysipelatous inflammation - patients who are considered the most severe cases of purulent surgery departments (Lipatov et al., 2002). The combination of surgical preparation of extensive pyoneerotie centers and local NO therapy allowed the majority of the patients with phlegmonous-necrotic erysipelas during 12-14 days of treatment to liquidate heavy pyoneerotie process and to create conditions for completion of reparative procedures. 

Macrolides are used in a variety of dosage forms, including medicated feed, a water-soluble powder for the addition to drinking water, tablets, and injections for the treatment of systemic and local infections in animals. Erythromycin and/or tylosin are indicated for the prophylaxis of hepatic abscesses and the treatment of diphtheria, metritis, bacterial pneumonia, pododermatitis, and bovine respiratory disease in cattle. These drugs are also used in pigs for the prophylaxis and treatment of atrophic rhinitis, infectious arthritis, enteritis, erysipelas, respiratory syndrome, and bacterial respiratory infections, and in farrowing sows for leptospirosis. Erythromycin is indicated for the prophylaxis of enterotoxemia in lambs, while erythromycin and tylosin are used in the treatment... 

A 47-year-old man with a history of rash to cephalexin was treated for erysipelas with clindamycin. His condition did not improve on clindamycin, so it was discontinued and he was initiated on ertapenem. After 2 days of ertapenem treatment, he developed fever, a generalised rash and neufrophilia of 28 x fi cells/L (7.1 x 10 cells/L the day before). All other laboratory values, cultures and chest X-rays were normal. He was diagnosed with acute generalised exanthematous pustulosis (AGEP). Patch tests were posihve for penicillin, cephalothin, meropenem and ertapenem at 48 h. Per the autiiors, this was the first reported cause of carbapenem-induced AGEP confirmed by patch testing [79 ]. 

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