The course, costs and complications of oral versus intravenous penicillin therapy of erysipelas

Abstract

Oral versus intravenous antibiotic therapy of severe erysipelas was compared in a controlled trial of 60 patients. No clinical benefit of intravenous therapy was found, as evaluated by fever duration, hospital stay and sick leave. Untoward reactions were comparable between the groups. No difference in recurrence was found. The difference in administration time and drug cost was considerable. It is therefore suggested that erysipelas without complications should be treated orally.

Practice Guidelines for the Diagnosis and Management of Skin and Soft-Tissue Infections

“…Many clinicians choose an agent that is also effective against S. aureus, although this organism rarely causes cellulitis unless associated with an underlying abscess or penetrating trauma. A large percentage of patients can receive oral medications from the start [73]. Suitable agents include dicloxacillin, cephalexin, clindamycin, or erythromycin, unless streptococci or staphylococci resistant to these agents are common in the community (A-I).…”

Invasive Group B Streptococcal Disease in Non-pregnant Adults

“…Thereafter, systemic inflammatory response signs often resolve within 1-2 days, and treatment can be promptly switched to oral antibiotics. However, in a Swedish study including 60 episodes of erysipelas without previous treatment [120], oral therapy (with penicillin or clindamycin) had no inferiority in clinical course and outcome compared to intravenous treatment. Furthermore, penicillin V concentrations measured in punch biopsies from 45 orally treated patients with erysipelas exceeded the MIC of isolated streptococci [121].…”

Cellulitis of Lower Limb- A Clinical and Microbiological Profile

“…With respect to the antibiotic sensitivity, most of the beta haemolytic streptococci were sensitive to pencillins and erythromycin and most of staphylococci species were sensitive to pencillin and pipperacillin tazobactam combination. (18) Regarding gram negative organisms pseudomonas and klebsiella species were sensitive to Imipenam, aminoglycosides, and pipperacillin tazobactam (19) . In concordance with our study the results obtained by Siggurdsson et al showed that all staphylococcus aureus and beta haemolytic streptococci were sensitive to pencillins.…”