From the FDA Drug Label
- 3 Skin and Skin Structure Infections Cephalexin capsules are indicated for the treatment of skin and skin structure infections caused by susceptible isolates of the following Gram-positive bacteria: Staphylococcus aureus and Streptococcus pyogenes.
The treatment for mild skin ulceration caused by coagulase-negative (CoNS) Staphylococcus is not directly addressed in the provided drug label, as it only mentions Staphylococcus aureus as a susceptible isolate for skin and skin structure infections.
- Key points:
- The drug label does not explicitly mention coagulase-negative Staphylococcus.
- Cephalexin is indicated for skin and skin structure infections caused by Staphylococcus aureus and Streptococcus pyogenes. 1
From the Research
The treatment for mild skin ulceration caused by coagulase-negative Staphylococcus (CoNS) typically involves topical antibiotics as first-line therapy, with mupirocin 2% ointment applied three times daily for 7-10 days being a recommended option 2. For most cases, this approach is sufficient, but it's essential to monitor the clinical response closely due to the potential for antibiotic resistance, particularly to methicillin. The affected area should be kept clean by gentle washing with mild soap and water, followed by covering with a sterile, non-adherent dressing that should be changed daily. Some key points to consider in the treatment of CoNS infections include:
- The use of topical antibiotics like mupirocin, fusidic acid, or retapamulin as first-line therapy 3, 2.
- The potential for resistance to certain antibiotics, such as methicillin, and the need for vigilant surveillance of nosocomial isolates of CoNS 4.
- The importance of keeping the affected area clean and covered to promote healing and prevent further infection.
- The possibility of needing oral antibiotics if the infection does not improve with topical treatment, with options including cephalexin, dicloxacillin, or clindamycin 5, 2. It's also crucial for patients to seek further medical attention if the ulceration worsens, or if there are signs of increasing infection or systemic symptoms like fever. Given the most recent and highest quality evidence, the recommendation for treating mild skin ulceration caused by CoNS is to start with topical antibiotics and monitor closely for signs of resistance or worsening infection 2.