From the Guidelines
Ear piercing cellulitis should be treated with fluoroquinolone antibiotic treatment, such as ciprofloxacin or levofloxacin, as it is effective against the most common pathogens, including Pseudomonas aeruginosa, S aureus, and S pyogenes. When managing ear piercing cellulitis, it is essential to consider the potential complications, such as auricular perichondritis and perichondrial abscess, which can occur in the first month after piercing, especially during warm-weather months 1. Key considerations for treatment include:
- Identifying the causative pathogen to guide antibiotic selection
- Monitoring for signs of complications, such as abscess formation or necrosis
- Avoiding removal of the jewelry unless instructed by a healthcare provider to prevent trapping the infection
- Applying warm compresses and keeping the area clean with mild soap and water
- Seeking immediate medical attention if symptoms worsen or if there are signs of spreading infection. In cases where an abscess is present, surgical incision and drainage are often necessary to prevent further complications and promote healing 1. It is also crucial to educate patients on proper aftercare, including avoiding touching the area with unclean hands and keeping the area clean to prevent the introduction of bacteria and reduce the risk of infection 1.
From the Research
Ear Piercing Cellulitis
- Ear piercing can lead to infectious complications, including cellulitis, with a study finding that transcartilaginous ear piercing is associated with a higher risk of infection and ear deformity 2.
- The most common bacteria causing cellulitis are Staphylococcus aureus, Streptococcus pyogenes, and other β-hemolytic streptococci, with methicillin-resistant S. aureus being more common in abscesses 3.
- In the context of ear piercing, Pseudomonas aeruginosa is the most common bacterial infection, accounting for 87.2% of infections, and is more likely to result in hospitalization 2.
- The treatment of cellulitis typically involves oral antibiotics, such as penicillin or cephalosporin, with the choice of antibiotic depending on the suspected causative organism 4, 3.
- A systematic review and meta-analysis found that there is no evidence to support the superiority of any one antibiotic over another, and that antibiotics with activity against methicillin-resistant Staphylococcus aureus do not add an advantage 5.
- Delay in seeking medical attention and scapha piercing are associated with poorer outcomes, highlighting the importance of prompt treatment and proper aftercare for ear piercings 2.