From the Guidelines
For ear piercing infections, the antibiotic of choice is typically a fluoroquinolone, such as ciprofloxacin or levofloxacin, due to their effectiveness against common pathogens like Pseudomonas aeruginosa, S aureus, and S pyogenes 1. When managing ear piercing infections, it's essential to consider the potential complications, such as auricular perichondritis and perichondrial abscess, which can occur in the first month after piercing 1.
- The most common pathogens involved in these infections are Pseudomonas aeruginosa, S aureus, and S pyogenes, which are often responsive to fluoroquinolone antibiotic treatment 1.
- Alternative options, such as clindamycin, ceftazidime, and cefepime, may be considered for hospitalization, depending on the pathogen and severity of the infection 1.
- In cases where an abscess is present, surgical incision and drainage are often necessary to prevent further complications and promote healing 1.
- It's crucial to note that earrings can become embedded in the earlobe, and gentle probing or a small incision under local anesthesia may be necessary to locate and remove the earring or backing 1.
- Any suspected infection should be treated promptly, and the earring can be replaced or the ear repierced 6 to 8 weeks after resolution of local swelling and tenderness 1.
From the FDA Drug Label
Clindamycin is indicated in the treatment of serious infections due to susceptible strains of streptococci, pneumococci, and staphylocci Serious skin and soft tissue infections Bacteriologic studies should be performed to determine the causative organisms and their susceptibility to clindamycin
The antibiotic of choice for an ear piercing infection is not directly stated in the label. However, considering the types of infections clindamycin is indicated for, it may be considered for serious skin and soft tissue infections.
- Staphylococci and streptococci are common causes of skin and soft tissue infections, including those related to ear piercings.
- Bacteriologic studies should be performed to determine the causative organisms and their susceptibility to clindamycin. 2
From the Research
Ear Piercing Infection Antibiotic Treatment
- The choice of antibiotic for ear piercing infections depends on the causative bacteria, with Pseudomonas aeruginosa and Staphylococcus aureus being the most common pathogens 3, 4.
- Early administration of an antibiotic therapy active against P. aeruginosa and S. aureus is recommended in case of chondritis 3.
- Dual intravenous antibiotic therapy may be administered for a median duration of six days, replaced by an oral antibiotic therapy for a median duration of 15 days 3.
- Oral antibiotic monotherapy may be used for 10 days, with a median duration of antibiotic therapy of 16 days 3.
Common Bacterial Pathogens
- Pseudomonas aeruginosa accounts for 87.2% of infections, with 92.3% of patients hospitalized 4.
- Staphylococcus aureus is also a common pathogen, with 75% of patients hospitalized 4.
Antibiotic Options
- Erythromycin is effective against M. pneumoniae, Legionella species, group A beta-hemolytic streptococci, and Streptococcus pneumoniae 5.
- Clindamycin is bactericidal to most nonenterococcal gram-positive aerobic bacteria and many anaerobic microorganisms, and is an excellent alternative to beta-lactam antibiotics for treatment of many staphylococcal infections 5.
- Metronidazole is efficacious for treating nonpulmonary anaerobic infections, various parasitic infections, and Clostridium difficile-mediated colitis 5.