What's the best antibiotic for cellulitis caused by fish spines?

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Last updated: June 7, 2025View editorial policy

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From the Research

The best antibiotic for cellulitis caused by fish spine injuries is typically amoxicillin and clavulanic acid, as most bacteria introduced by fish spine injuries are from the patient's own skin flora, according to a study published in 2018 1. When considering the treatment of cellulitis caused by fish spine injuries, it's essential to note that the majority of infections are caused by bacteria that are normally found on the patient's skin, rather than marine-specific pathogens.

  • The study published in 2018 1 found that only 12% of patients with fish spine injuries grew clinically relevant bacteria resistant to amoxicillin and clavulanic acid, and only one patient grew a true marine-specific bacteria, which was susceptible to amoxicillin and clavulanic acid.
  • Another study published in 2022 2 notes that the majority of non-purulent, uncomplicated cases of cellulitis are caused by β-hemolytic streptococci or methicillin-sensitive Staphylococcus aureus, and appropriate targeted coverage of this pathogen with oral antibiotics such as penicillin, amoxicillin, and cephalexin is sufficient.
  • A study published in 2020 3 found that there was no association between the route of antibiotic administration (oral vs. intravenous) and clinical outcome, and that the duration of antibiotic therapy did not affect the outcome as measured at day 10 and day 30. In addition to antibiotics, proper wound care is essential, including thoroughly cleaning the wound with soap and water, removing any visible foreign material, and considering tetanus prophylaxis if the patient's vaccination is not current.
  • It's also crucial to seek immediate medical attention if the patient develops increasing pain, redness, swelling, fever, or if red streaks appear extending from the wound, as these infections can progress rapidly, especially in people with compromised immune systems or liver disease 4.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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