From the Guidelines
Cefdinir is not the preferred antibiotic for treating ear piercing infections, and first-line treatment typically involves cleaning, antibiotic ointment, and oral antibiotics like cephalexin or dicloxacillin if necessary. The management of ear piercing infections should prioritize the prevention of complications such as auricular perichondritis and perichondrial abscess, which can occur in the first month after piercing 1. According to the evidence, auricular perichondritis and perichondrial abscess are typically caused by pathogens such as Pseudomonas aeruginosa, S aureus, and S pyogenes, which often respond well to fluoroquinolone antibiotic treatment, such as ciprofloxacin or levofloxacin 1.
For minor infections, cleaning the area with saline solution and applying an over-the-counter antibiotic ointment like bacitracin or Polysporin is usually sufficient. If an oral antibiotic is needed, cephalexin 500mg four times daily or dicloxacillin 500mg four times daily for 7-10 days are commonly recommended as they effectively target the common bacteria in these infections, such as Staphylococcus aureus and Streptococcus species. Cefdinir, while effective against many bacteria, is broader spectrum than typically needed for uncomplicated piercing infections and is generally reserved for other types of infections or when first-line treatments fail.
Key considerations in the management of ear piercing infections include:
- Monitoring for signs of infection such as increasing redness, warmth, swelling, pus, fever, or red streaks extending from the piercing site
- Avoiding touching or rotating the jewelry to prevent introducing bacteria into the piercing
- Considering the use of earrings with a locking back or screw back to prevent aspiration and ingestion of earring parts, especially in infants or young children
- Being aware of the potential for contact dermatitis resulting from nickel exposure and taking steps to avoid the metals that trigger a reaction.
Proper treatment is crucial as untreated infections can lead to more serious complications, including cartilage damage if the infection involves ear cartilage 1.
From the FDA Drug Label
To reduce the development of drug-resistant bacteria and maintain the effectiveness of cefdinir and other antibacterial drugs, cefdinir should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria Uncomplicated Skin and Skin Structure Infections caused by Staphylococcus aureus (including β-lactamase producing strains) and Streptococcus pyogenes.
Cefdinir can be used for uncomplicated skin and skin structure infections, which may include infections from ear piercings, as long as they are caused by susceptible bacteria such as Staphylococcus aureus or Streptococcus pyogenes 2.
From the Research
Cefdinir for Ear Piercing Infection
- Cefdinir is an oral third-generation cephalosporin with good in vitro activity against many pathogens commonly causative in community-acquired infections, including those that may cause ear piercing infections 3.
- The drug provides good coverage against Haemophilus influenzae, Moraxella catarrhalis, and penicillin-susceptible Streptococcus pneumoniae, which may be involved in ear infections 3.
- However, ear piercing infections are often caused by Pseudomonas aeruginosa, which is not typically covered by cefdinir 4.
- Cefdinir has been shown to be effective in treating mild-to-moderate bacterial infections, including skin and skin structure infections, but its effectiveness in treating ear piercing infections specifically is not well established 3, 5.
- A study on transcartilaginous ear piercing and infectious complications found that Pseudomonas aeruginosa accounted for 87.2% of infections, and initial oral antibiotics prescribed did not target the cultured bacterium in 53.3% of cases 4.
- Another study found that cefdinir was effective in treating uncomplicated skin and skin structure infections, including those caused by methicillin-susceptible Staphylococcus aureus, but its effectiveness against Pseudomonas aeruginosa is not well established 5.