From the Guidelines
For an ear piercing infection involving cartilage, fluoroquinolone antibiotics like ciprofloxacin (500mg twice daily for 7-10 days) or levofloxacin (750mg once daily for 7-10 days) are typically recommended as first-line treatment. These antibiotics are preferred because they have good penetration into cartilage and are effective against Pseudomonas aeruginosa, which commonly causes these infections 1. The choice of fluoroquinolone antibiotics is supported by the fact that they often respond well to this type of treatment, as noted in a study published in Pediatrics 1.
Key Considerations
- It's crucial to seek medical attention promptly as cartilage infections (chondritis) can lead to permanent deformity if not treated properly.
- In addition to antibiotics, the infected area should be cleaned with saline solution twice daily, and the jewelry should typically be removed only if it's impeding drainage or if advised by a healthcare provider.
- Warm compresses can help reduce pain and swelling.
- If symptoms worsen despite antibiotics, or if there's increasing redness, swelling, or pus, immediate medical reevaluation is necessary as more aggressive treatment including IV antibiotics or surgical debridement may be required.
Prevention and Management
- Preventing infection is key, and rinsing with nonprescription oral cleansers or the topical application of cleansers is recommended to prevent infection after oral piercing 1.
- At clean piercing establishments, the piercer should be observed putting on new, disposable gloves and removing new equipment from a sterile container 1.
- Pediatricians play an important role in promoting injury prevention, including advising adolescents about the risks associated with piercings 1.
From the Research
Antibiotic Treatment for Ear Piercing Infection Involving Cartilage
- The most common bacteria involved in ear piercing infections are Pseudomonas aeruginosa and Staphylococcus aureus 2, 3
- Early administration of antibiotic therapy active against P. aeruginosa and S. aureus is recommended in case of chondritis 2
- Dual intravenous antibiotic therapy may be administered, followed by oral antibiotic therapy 2
- The choice of antibiotic should be guided by the epidemiology, patient's risk factors, site of infection, and available treatment options 4
Antibiotic Options for Pseudomonas aeruginosa Infections
- Amikacin, ceftazidime, and ciprofloxacin have been shown to be effective against Pseudomonas aeruginosa 5
- Novel fluoroquinolones and new combinations of β-lactams/β-lactamase inhibitors have been introduced and show promising results 4
- Cefiderocol, a new cephalosporin, has shown very promising results against P. aeruginosa 4