From the Research
For a laceration that occurred in seawater, the recommended antibiotic is flucloxacillin (or clindamycin) and doxycycline (or ciprofloxacin) as empirical oral therapy in adults, as suggested by the most recent study 1. This recommendation is based on the findings of the Australian Mid-West Coastal Marine Wound Infections Study, which identified Staphylococcus aureus and Vibrio species as the most common organisms in marine wounds, and often polymicrobial infections 1. The study suggests that flucloxacillin (or clindamycin) and doxycycline (or ciprofloxacin) would be a reasonable combination for empirical oral therapy in adults, which is effective against both Staphylococcus aureus and Vibrio species. Before starting antibiotics, it is essential to thoroughly clean the wound with soap and water, remove any foreign material, and consider tetanus prophylaxis if needed. Patients should monitor for signs of infection such as increasing redness, warmth, swelling, pain, or discharge. Those with liver disease, diabetes, or immunocompromised conditions are at higher risk for severe Vibrio infections and may require more aggressive treatment or hospitalization. Prompt treatment is essential as marine organism infections can progress rapidly, potentially leading to necrotizing fasciitis in severe cases. Other studies, such as 2 and 3, also support the use of antibiotics effective against Vibrio species, but the most recent study 1 provides the most up-to-date guidance on empirical oral therapy for marine wound infections.