From the Guidelines
For infected ear piercings with perichondritis, fluoroquinolones are the best oral antibiotic choice due to their effective coverage against Pseudomonas and Staphylococcus species. When considering treatment options, it's crucial to prioritize the most recent and highest quality evidence to minimize morbidity, mortality, and improve quality of life. According to the study published in Pediatrics in 2017 1, antibiotic agents with good coverage against Pseudomonas and Staphylococcus species, such as fluoroquinolones, are advised for treating piercing-associated infections of the auricular cartilage.
Some key points to consider when treating infected ear piercings include:
- The importance of proper wound care, including rinsing with nonprescription oral cleansers or the topical application of cleansers to prevent infection after oral piercing 1
- The role of pediatricians in promoting injury prevention and advising adolescents on the potential risks associated with piercings, such as tooth chipping with tongue piercings 1
- The need for clean piercing establishments to follow proper hygiene protocols, including the use of new, disposable gloves and sterile equipment 1
In terms of specific treatment, fluoroquinolones are a suitable option due to their broad-spectrum coverage. However, it's essential to consider individual patient factors, such as allergy history and potential side effects, when selecting an antibiotic. If fluoroquinolones are not suitable, alternative options may be considered, but fluoroquinolones remain the preferred choice based on the most recent evidence. Patients should be advised to continue cleaning the piercing twice daily with saline solution and avoid removing the jewelry unless advised by a healthcare provider. If symptoms worsen or do not improve after 48 hours of antibiotic treatment, patients should seek immediate medical attention.
From the Research
Oral Antibiotics for Infected Ear Piercings with Perichondritis
- The best oral antibiotic for infected ear piercings with perichondritis is not explicitly stated in the provided studies, but based on the information available, antibiotics that cover Gram-positive organisms such as Staphylococcus aureus and Streptococcus pyogenes may be effective 2.
- A study on bacterial chondritis complications following ear piercing found that Pseudomonas aeruginosa and Staphylococcus aureus were common causative organisms, and early administration of an antibiotic therapy active against these organisms is recommended 3.
- Another study on impetigo, a bacterial skin infection, lists several oral antibiotic options including amoxicillin/clavulanate, dicloxacillin, cephalexin, clindamycin, doxycycline, minocycline, trimethoprim/sulfamethoxazole, and macrolides, which may also be effective against infected ear piercings with perichondritis 4.
- Cefdinir, an advanced-generation, broad-spectrum oral cephalosporin, has been shown to have a broad spectrum of activity against many gram-negative and gram-positive aerobic organisms, including Staphylococcus aureus and Streptococcus pyogenes, and may be an alternative option for treating infected ear piercings with perichondritis 5.
Considerations for Treatment
- The choice of antibiotic should be based on the suspected causative organism and the patient's medical history and allergies.
- It is essential to note that antibiotic resistance is a growing concern, and the use of broad-spectrum antibiotics should be reserved for cases where they are truly necessary 4.
- In addition to antibiotic therapy, earring removal may be necessary to prevent further complications 3.
- Proper precautions and aftercare can help prevent many common complications associated with ear piercing 6.