From the Guidelines
For a typical wound infection, the recommended first-line antibiotic is oral amoxicillin-clavulanate 875/125 mg twice daily for 7-10 days, as suggested by the most recent guidelines from the Infectious Diseases Society of America 1. This recommendation is based on the latest evidence from the WHO's essential medicines and aware: recommendations on first- and second-choice antibiotics for empiric treatment of clinical infections, which prioritizes amoxicillin-clavulanate as a first-choice antibiotic for mild skin and soft tissue infections. Alternatively, cephalexin 500 mg taken four times daily for 7-10 days can be used, especially if there's no concern for anaerobic bacteria involvement. For patients with penicillin allergy, clindamycin 300-450 mg three times daily for 7-10 days is an appropriate option, as it is effective against common skin bacteria like Staphylococcus aureus and Streptococcus species. Before starting antibiotics, it is essential to clean the wound thoroughly with soap and water or saline solution, apply an over-the-counter antibiotic ointment, and cover with a sterile dressing, changing daily. These antibiotics allow sufficient time to eradicate the infection while minimizing the risk of antibiotic resistance. If symptoms worsen or don't improve after 48-72 hours of treatment, it is crucial to seek medical attention as culture-guided therapy or intravenous antibiotics may be necessary, as recommended by the Infectious Diseases Society of America guidelines 1.
From the FDA Drug Label
- 7 Uncomplicated Skin and Skin Structure Infections Levofloxacin tablets are indicated for the treatment of uncomplicated skin and skin structure infections (mild to moderate) including abscesses, cellulitis, furuncles, impetigo, pyoderma, wound infections, due to methicillin-susceptible Staphylococcus aureus, or Streptococcus pyogenes.
The antibiotic used to treat wound infection is levofloxacin.
- Indications: Uncomplicated skin and skin structure infections, including wound infections.
- Target pathogens: Methicillin-susceptible Staphylococcus aureus, Streptococcus pyogenes. 2
From the Research
Antibiotics Used to Treat Wound Infections
- Cephalexin is an effective antibiotic for the treatment of streptococcal and staphylococcal skin infections, with cure rates of 90% or higher 3
- Cephalexin is comparable to erythromycin, clindamycin, dicloxacillin, cloxacillin, and other cephalosporins in the treatment of streptococcal and staphylococcal infections 3
- For mild to moderate uncomplicated skin and skin structure infections, cefdinir and cephalexin have similar clinical cure rates, with both achieving cure rates of around 89% 4
- Vancomycin powder applied to the wound before closure, in addition to intravenous antibiotics, has been shown to decrease infection rates in posterior instrumented thoracic and lumbar spine fusions 5
- The choice of antibiotic should be based on the sensitivity of the pathogen, drug distribution to the site of infection, and other factors such as cost and potential side effects 6
Specific Infections and Antibiotic Use
- For methicillin-susceptible Staphylococcus aureus (MSSA) and methicillin-resistant Staphylococcus aureus (MRSA) infections, cefdinir and cephalexin have similar clinical cure rates 4
- Vancomycin has been shown to be effective in reducing wound infection rates in posterior instrumented thoracolumbar spine fusions, with a significant reduction in deep wound infections 5
- Cephalexin remains an effective antibiotic for the treatment of streptococcal and staphylococcal skin infections, with a long history of use and a high cure rate 3, 7