Treatments for Staph Infections

Antistaphylococcal antibiotics are the usual treatments for staph infections. This may include a topical antibiotic cream (Bactroban, Altabax, etc.) for simple impetigo, warm compresses and drainage for abscesses, an oral antibiotic, or an intravenous antibiotic for more serious or persistent infections. Commonly used oral antistaphylococcal antibiotics include the first-generation cephalosporins like Keflex (cephalexin) and Duricef (cefadroxil). As resistance to antibiotics is now common among staph bacteria, including MRSA, or methicillin resistent staph aureus, the first antibiotic your child is prescribed may not work. Many of these community acquired MRSA infections can still be treated with oral antibiotics though, such as clindamycin and trimethoprim-sulfamethoxazole (TMP-SMX or Bactrim). More serious and multi-drug resistent MRSA can usually be treated in the hospital with the antibiotic vancomycin and/or surgical drainage. Unfortunately, some staph infections, especially invasive MRSA infections, can be deadly.

Abscess
Abscess anesthesia of abscesses and tropical myositis Anesthesia of an abscess with lidocaine is not very effective. It is not possible to anesthetise the whole cavity and furthermore, the needle may spread the infection. General anesthesia is preferable: ketamine IM, at the rate of 5mg/kg for exemple. For superficial abscesses, use ethylene chloride: anesthetise the area and incise immediately (the anesthetic freezes the skin by evaporation). abscess A collection of pus in the soft tissues. An abscess cavity is not accessible to antibiotics. Treatment is thus surgical only. Indications Incision and drainage (I & D) should be performed once the abscess is "ripe" i.e. fluctuant upon gentle palpation. Material Sterile scalpel blade and handle Surgical gloves Plain curved forceps (Kelly forceps) Sterile corrugated drain Antiseptic s, e.g. chlorhexidine (+ cetrimide) solution (see table page 7). Technique Figures 17,18 and 19 Scalpel: the correct way to hold a scalpel is between the thumb and forefinger with the handle resting against the palm. Il should not be held as one holds a pen. The plane of the scalpel blade should be perpendicular to the plane of the skin.

 Incision: the free hand immobilizes the wall of the abscess between thumb and forefinger. Incise in the long axis of the abscess with a single stroke to breach the skin. The incision should be long enough to allow insertion of an exploring finger. Take care not to incise too deeply if the abscess overlies major blood vessels (the carotid, axillary, humeral, femoral and popliteal regions). After breaching the skin, blunt dissect down to the cavity using Kelly's forceps. Explore the cavity with the forefinger, breaking any loculating adhesions and evacuating the pus. Abundant lavage of the cavity using a syringe filled with chlorhexidine (+ cetrimide) (see table page 7). Insert a drain, if possible fixing it with a single suture at the edge of the incision. The drain is withdrawn progressively then removed altogether after 3 to 5 days.

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Vol. 212, Suppl. 1, 2006

Article (Fulltext)

Article (PDF 78 KB)

Asian Pacific Congress on Antisepsis. Editor(s): Kobayashi, H. (Tokyo), Ermini, M. (Basel)

Oro-Buccal Antisepsis Clinical Application of Povidone-Iodine Oral Antiseptic 1% (Betadine Mouthwash) and Povidone-Iodine Skin Antiseptic 10% (Betadine Solution) for the Management of Odontogenic and Deep Fascial Space Infection Lucia Sarmiento Valderrama Manila, Philippines