From the Guidelines
Facial Erysipelas treatment is primarily managed with antibiotics against Gram-positive bacteria, particularly streptococci.
Key Points
- The recommended treatment for facial erysipelas is antibiotics effective against streptococci, such as penicillin 1.
- For patients with severe infections or those who do not respond to first-line therapy, parenteral antibiotics such as penicillinase-resistant penicillins or first-generation cephalosporins may be necessary 1.
- In cases where MRSA is suspected, antibiotics such as vancomycin, linezolid, or daptomycin should be used 1.
- Elevation of the affected area and treating underlying conditions can also aid in the treatment of facial erysipelas 2.
- The use of systemic corticosteroids as an adjunct to antibiotic therapy may be considered in selected adult patients to hasten resolution and reduce inflammation 2.
- Treatment duration is typically 5-10 days, with a 5-day course being as effective as a 10-day course in uncomplicated cases 2.
Antibiotic Options
- Oral antibiotics: dicloxacillin, cephalexin, clindamycin, or erythromycin 2
- Parenteral antibiotics: nafcillin, cefazolin, or vancomycin 2
From the Research
Treatment of Facial Erysipelas
The treatment of facial erysipelas typically involves the use of antibiotics, with the goal of eliminating the underlying bacterial infection.
- The first line treatment is usually group G penicillin, with other options including amino-penicillins, cephalosporins, and anti-staphylococcal penicillins 3.
- Alternative antibiotics such as macrolides, clindamycin, and fluoroquinolones may be used as second line treatments 3.
- Amoxicillin is also effective in treating erysipelas, particularly in uncomplicated cases 4, 5.
- Penicillin remains the gold standard treatment for erysipelas, although other antibiotics may be used in certain cases 6, 7.
Adjuvant Measures
In addition to antibiotic therapy, several adjuvant measures may be used to support treatment and prevent complications.
- Anticoagulation may be indicated in patients at risk of venous thromboembolism 4.
- Non-steroidal anti-inflammatory agents, dressings, and immobilization may also be used to manage symptoms and support recovery 3.
- Treatment of local predisposing factors, such as interdigital tinea, is also important to prevent recurrence 3.
Duration of Treatment
The duration of treatment for facial erysipelas typically ranges from 10 days, although this may vary depending on the severity of the infection and the response to treatment.
- The median treatment duration is 10 days, although some studies suggest that longer treatment durations may be necessary in certain cases 3.