From the Research
For sea water exposed wounds, the recommended antibiotic treatment is a combination of doxycycline and a third-generation cephalosporin, such as ceftazidime, or a fluoroquinolone, such as ciprofloxacin or levofloxacin, as stated in the study by 1. This recommendation is based on the need to cover common gram-positive and gram-negative aquatic bacteria, including Vibrio species, Aeromonas hydrophila, Pseudomonas, and Plesiomonas species. The study by 1 provides guidance on the initial antibiotic therapy for wounds sustained in oceans, lakes, and streams, emphasizing the importance of recognizing and treating less common pathogens in a timely manner to prevent significant morbidity or death. Key points to consider when treating sea water exposed wounds include:
- Thoroughly cleaning the wound with soap and water
- Irrigating the wound with sterile saline
- Removing any foreign material or necrotic tissue
- Updating tetanus prophylaxis if needed
- Providing broad-spectrum antibiotic coverage targeting marine pathogens, rather than standard skin flora coverage. More recent studies, such as 2, have evaluated prophylactic antimicrobial therapy practices for patients with marine-associated injuries, but the recommendations from 1 remain the most relevant for guiding antibiotic treatment. It's worth noting that other studies, such as 3 and 4, have investigated the efficacy of different antibiotic regimens for Vibrio vulnificus infections, but the study by 1 provides the most comprehensive guidance for treating sea water exposed wounds. In terms of specific antibiotic regimens, the study by 5 recommends a combination of penicillin or ampicillin with levofloxacin for empiric antibiotic coverage, but this is not the most recent or highest-quality study on the topic. Overall, the recommendation from 1 to use a combination of doxycycline and a third-generation cephalosporin or fluoroquinolone remains the most appropriate choice for treating sea water exposed wounds.