What is the management for Pseudomonas aeruginosa (P. aeruginosa) folliculitis?

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From the FDA Drug Label

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From the Research

Management of pseudomonal folliculitis primarily involves supportive care, and the condition typically resolves spontaneously within 7-10 days. For symptomatic relief, patients should discontinue use of the contaminated water source (hot tub, whirlpool, swimming pool) and gently cleanse the affected areas with antibacterial soap.

Treatment Options

  • Topical treatments include 5% acetic acid compresses applied 2-4 times daily for 20 minutes, which creates an acidic environment inhibiting Pseudomonas growth, as suggested by a review of acetic acid treatment for pseudomonal wound infections 1.
  • For more severe cases, topical antibiotics such as polymyxin B or gentamicin can be applied 2-3 times daily until resolution.
  • In extensive or persistent infections, oral antibiotics effective against Pseudomonas aeruginosa may be necessary, including ciprofloxacin (500 mg twice daily for 7-10 days) or levofloxacin (500 mg once daily for 7-10 days), as discussed in a review of current choices of antibiotic treatment for Pseudomonas aeruginosa infections 2.

Prevention

  • Prevention involves proper maintenance of recreational water facilities with adequate chlorination and pH control, as highlighted in a study on methods for preventing pseudomonas folliculitis 3.
  • Showering with soap immediately after exposure to potentially contaminated water, and washing swimwear after each use can also help prevent the spread of infection.

Additional Considerations

  • A review of interventions for bacterial folliculitis and boils found that comparative trials have not identified important differences in efficacy or safety outcomes between different oral antibiotics for treating bacterial folliculitis or boils 4.
  • Anti-inflammatory medications like ibuprofen (400-600 mg three times daily) can help manage pain and inflammation, and a multifaceted approach including behavioral changes in shaving habits and the use of topical therapies may be effective in treating pseudofolliculitis barbae, as discussed in a review of current treatment options for the condition 5.

References

Research

Acetic acid treatment of pseudomonal wound infections--a review.

Journal of infection and public health, 2013

Research

Interventions for bacterial folliculitis and boils (furuncles and carbuncles).

The Cochrane database of systematic reviews, 2021

Research

Pseudofolliculitis Barbae: A Review of Current Treatment Options.

Journal of drugs in dermatology : JDD, 2019

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