From the Guidelines
Doxycycline can be used to treat perichondritis, as it is listed as an alternative option for the treatment of purulent skin and soft tissue infections, which may include perichondritis, according to the Infectious Diseases Society of America guidelines 1. The typical dosage for adults is 100 mg twice daily for 7-14 days, depending on the severity of the infection. For children over 8 years old, the dose is typically 2-4 mg/kg/day divided into two doses. Some key points to consider when treating perichondritis with doxycycline include:
- Doxycycline is particularly effective against Pseudomonas aeruginosa, which is a common cause of perichondritis, especially following ear trauma or piercings 1.
- In severe cases or when Pseudomonas is strongly suspected, doxycycline may be combined with a fluoroquinolone like ciprofloxacin or an anti-pseudomonal penicillin.
- It's essential to complete the full course of antibiotics even if symptoms improve quickly.
- Patients should keep the affected area clean and dry, avoid manipulating the infected cartilage, and use warm compresses to improve circulation and healing.
- If symptoms worsen despite antibiotic therapy, or if there is significant swelling, redness, or pain, immediate medical attention is necessary as surgical drainage or debridement may be required to prevent permanent cartilage damage. The most recent and highest quality study, which is from 2024, provides recommendations on first- and second-choice antibiotics for empiric treatment of clinical infections, including skin and soft tissue infections 1. However, the study from 2017 provides more specific information on the treatment of perichondritis, which is typically caused by Pseudomonas aeruginosa, S aureus, and S pyogenes, and can be treated with fluoroquinolone antibiotic treatment, such as ciprofloxacin or levofloxacin, or alternative options like clindamycin, ceftazidime, and cefepime 1.
From the Research
Perichondritis Treatment with Doxycycline
- Perichondritis is a serious disease that may lead to residual deformity, and its treatment often involves antibiotics 2.
- The effectiveness of doxycycline in treating perichondritis, particularly when caused by Pseudomonas aeruginosa, is not directly addressed in the provided studies.
- However, one study suggests that doxycycline can be effective against multidrug-resistant strains of Pseudomonas aeruginosa and Acinetobacter baumannii in vitro 3.
- Another study found that Pseudomonas aeruginosa is commonly found in suppurative perichondritis, but the significant pathogens in non-abscess perichondritis are unclarified 4.
- The use of doxycycline as a treatment option for perichondritis is not explicitly mentioned in the studies, but its effectiveness against certain bacterial strains suggests it could be considered in specific cases.
Antibiotic Treatment for Perichondritis
- The choice of antibiotic treatment for perichondritis depends on the causative pathogen, with Pseudomonas aeruginosa being a common cause of suppurative perichondritis 4, 2.
- Other studies suggest that anti-pseudomonal antibiotics, such as ciprofloxacin, can be effective in treating Pseudomonas aeruginosa auricular perichondritis 5.
- The use of aztreonam, a monobactam antibiotic, has also been evaluated in the treatment of serious infections due to multiresistant gram-negative organisms, including Pseudomonas aeruginosa 6.