What is the treatment for a mild skin infection of the umbilicus (navel) in an adult?

From the Guidelines

For a mild skin infection of the umbilicus in an adult, I recommend cleaning the area twice daily with warm water and mild soap, followed by application of an over-the-counter antibiotic ointment such as mupirocin (Bactroban) or triple antibiotic ointment (containing bacitracin, neomycin, and polymyxin B) for 7-10 days. After cleaning and before applying the ointment, the area should be thoroughly dried. Keep the umbilicus area clean and dry between treatments, and avoid tight clothing that may irritate the area. If the infection shows signs of worsening (increasing redness, warmth, pain, swelling, pus formation, or if you develop fever), seek medical attention promptly as oral antibiotics may be necessary. Mild umbilical infections in adults are often caused by bacteria that normally live on the skin, which can multiply in the warm, moist environment of the umbilicus, especially if there is poor hygiene or trapped moisture. The treatment aims to reduce the bacterial load while keeping the area clean and dry to create conditions unfavorable for bacterial growth, as suggested by the guidelines for the management of skin and soft-tissue infections 1.

Some key points to consider in the management of skin and soft-tissue infections include:

• The majority of superficial skin and soft-tissue infections are caused by Gram-positive bacteria, particularly streptococci and S. aureus 1.
• Incision and drainage is the primary treatment for simple abscesses or boils, and antibiotics are not needed for simple abscesses 1.
• Empiric therapy for community-acquired MRSA should be recommended for patients at risk for CA-MRSA or who do not respond to first-line therapy 1.
• Oral antibiotics that may be used as empirical therapy for CA-MRSA include TMP-SMX, doxycycline, clindamycin, and linezolid 1.

It is essential to note that the treatment should be based on the severity of the infection and the presence of any underlying conditions, as well as the potential for antibiotic resistance, as highlighted in the guidelines for the diagnosis and management of skin and soft-tissue infections 1. In cases where the infection is severe or worsening, oral antibiotics may be necessary, and the choice of antibiotic should be guided by the results of culture and susceptibility testing, if available 1.

Overall, the goal of treatment is to reduce morbidity, mortality, and improve quality of life by effectively managing the infection and preventing complications, as emphasized in the guidelines for the management of skin and soft-tissue infections 1.

From the FDA Drug Label

Directions adults and children 2 years of age and older: clean the affected area apply a small amount of this product (an amount equal to the surface area of the tip of a finger) on the area 1 to 3 times daily may be covered with a sterile bandage For the treatment of a mild skin infection to the umbilicus of an adult,

• Clean the affected area
• Apply a small amount of bacitracin (TOP) (an amount equal to the surface area of the tip of a finger) on the area
• Apply 1 to 3 times daily
• May be covered with a sterile bandage 2

From the Research

Treatment Options for Mild Skin Infection to the Umbilicus of an Adult

• The treatment for mild skin infections, including those around the umbilicus, often involves the use of topical antimicrobials 3.
• Topical antimicrobials such as mafenide acetate, silver sulfadiazine, and bacitracin have been shown to be effective against a variety of bacteria, including some that are resistant to systemic antibiotics 3.
• However, the effectiveness of these topical agents can vary depending on the specific type of bacteria and the level of resistance 3.
• In some cases, a combination of topical antimicrobials may be more effective than a single agent 4.
• For example, a study found that a combination of polymyxin B, bacitracin, and neomycin (Polybactrin spray) was effective in reducing postoperative wound infections in abdominal surgery patients 4.

Considerations for Umbilical Infections

• The umbilicus can be a unique challenge for treatment due to its anatomy and microflora 5, 6.
• The umbilical region can harbor a variety of bacteria, including staphylococci and corynebacteria, which can be difficult to eradicate with antiseptic skin preparation alone 5.
• In some cases, umbilical infections may be caused by intra-abdominal contamination rather than skin microflora 5.
• A thorough evaluation of the infection and the surrounding tissue is necessary to determine the best course of treatment 6.