From the Guidelines
Perichondritis is typically treated with fluoroquinolone antibiotics, such as ciprofloxacin or levofloxacin, which are effective against the most common pathogens, including Pseudomonas aeruginosa, S aureus, and S pyogenes. The choice of antibiotic is crucial in managing perichondritis, as it can help prevent complications such as abscess formation and cartilage destruction. According to the study published in Pediatrics 1, fluoroquinolone antibiotic treatment is often effective in treating auricular perichondritis.
Key Considerations
- The most common pathogens responsible for perichondritis are Pseudomonas aeruginosa, S aureus, and S pyogenes 1.
- Fluoroquinolone antibiotics, such as ciprofloxacin or levofloxacin, are effective against these pathogens and are often used as first-line treatment.
- Alternative options for hospitalization may include clindamycin, ceftazidime, and cefepime, depending on the pathogen and severity of the infection 1.
- Surgical incision and drainage may be necessary if an abscess is present, and warm compresses can help improve circulation and antibiotic delivery to the affected area.
Treatment Approach
- Fluoroquinolone antibiotics, such as ciprofloxacin or levofloxacin, should be considered as first-line treatment for perichondritis.
- The duration of treatment typically ranges from 10-14 days but may extend to 2-4 weeks for severe cases.
- Patients should be monitored closely for clinical improvement within 48-72 hours, and antibiotic adjustments should be made based on culture results when available.
From the Research
Antibiotics Used for Perichondritis
The following antibiotics are used to treat perichondritis:
- Ciprofloxacin 2, 3, 4, 5, 6
- Ceftazidime 2, 3, 5, 6
- Piperacillin-tazobactam 2, 3, 5, 6
- Gentamicin 3, 5
- Levofloxacin 3, 5
- Imipenem 3
- Sulfamethoxazole 4
- Tetracycline 4
- Trimethoprim 4
- Polymyxin B 4
- Berberine 4 (phytochemical)
- Myricetin 4 (phytochemical)
- Ellagic acid 4 (phytochemical)
- Gallic acid 4 (phytochemical)
- Protocatechuic acid 4 (phytochemical)
- Rutin 4 (phytochemical)
Specific Combinations
Some studies suggest that combining antibiotics can be effective against Pseudomonas aeruginosa:
- Cefepime and gentamicin 5
- Cefepime and ciprofloxacin 5
- Cefepime and levofloxacin 5
- Piperacillin/tazobactam and gentamicin 5
- Piperacillin/tazobactam and ciprofloxacin 5
- Piperacillin/tazobactam and levofloxacin 5
- Ceftazidime and ciprofloxacin 6
- Ceftazidime and ofloxacin 6
- Piperacillin and ciprofloxacin 6
- Piperacillin and ofloxacin 6
Bacterial Findings
Pseudomonas aeruginosa is commonly found in suppurative perichondritis, while Staphylococcus aureus is predominant in non-abscess infections 2.