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Treatment of erysipelas, rose: Medications, antibiotics and topical ointments
Treatment of erysipelas must be comprehensive. The basis is antibiotic therapy.
In general, the following principles are observed in the treatment of erysipelas:
- antibiotic treatment
- hydration of the patient
- pain control
- prevention of recurrences
- prevention of thromboembolic disease
In case of uncomplicated erysipelas, penicillin G is the first choice drug.
In case of allergy to penicillin, the following preparations are used in the treatment of erysipelas:
- macrolides (azithromycin)
- quinolones (ciprofloxacin, levofloxacin)
- lincosamides (clindamycin)
In the case of a history of a non-serious allergic reaction to penicillin or allergy to other antibiotics as well, we may consider the administration of cephalosporins (cephalexin, cefadroxil, cefuroxime).
In practice, the physician chooses oral or parenteral administration of the drug according to the severity and site of involvement. For example, in milder cases, antibiotics are given orally. In more extensive erysipelas, antibiotics are given intramuscularly or intravenously.
Parenteral therapy is appropriate in patients with erysipelas in specific sites (face). Parenteral therapy is indicated in all immunosuppressed patients (post-transplant, neutropenia, haematological disease, HIV positivity).
Patients improve in 24 to 48 hours after starting treatment with antibiotics with bactericidal effect. If antibiotics with bacteriostatic effect are chosen, improvement occurs in 3 to 4 days.
Patients should not be alarmed if they notice significant redness of the affected area. Such a condition is caused by the destruction of the pathogen and the release of enzymes that promote the development of inflammation.
Antibiotics with bacteriostatic effect stop the growth and multiplication of microbial cells (chloramphenicol, tetracyclines, macrolides, lincosamides and others).
Antibiotics with bactericidal effect kill microorganisms (beta-lactam antibiotics, aminoglycosides and others).
Antibiotic treatment should last at least 10 days until the redness and inflammation disappear. With more extensive findings and slower resolution of symptoms, treatment can be extended to 15-17 days.
After completion of antibiotic treatment, a follow-up examination (in 1-2 weeks) is advisable.
Local treatment
Bed rest, immobilizing the patient and keeping the affected body part in an elevated position are integral to successful treatment. Sleeping on the opposite side (when localized in the face) reduces swelling and relieves pain.
Local treatment is supportive.
In particular, cold compresses and anti-inflammatory ointments are applied. These relieve burning sensations and tension. Local application of antiseptics prevents secondary (usually staphylococcal) infection.
In practice, moist compresses with a disinfectant solution are used. In gangrene, necrolytic treatment and surgical treatment are often necessary.
