From the Guidelines
If Keflex (cephalexin) is not effectively treating your earlobe cellulitis, you should contact your healthcare provider immediately for alternative antibiotics, such as clindamycin, trimethoprim-sulfamethoxazole, or doxycycline, for 5-7 days, as recommended by the most recent guidelines 1. When considering alternative treatments, it's essential to note that the choice of antibiotic should be guided by the severity of the infection and the potential causative pathogens.
- For nonpurulent cellulitis, a 5- to 6-day course of antibiotics active against streptococci is recommended 1.
- For patients with systemic signs of infection or those who do not respond to initial treatment, broader-spectrum antibiotics, including coverage for MRSA, may be necessary 1. Some key points to consider when managing earlobe cellulitis include:
- Applying warm compresses to the affected area to improve circulation and reduce inflammation
- Keeping the area clean and avoiding touching or manipulating the earlobe
- Monitoring for signs of worsening infection, such as increased redness, swelling, or fever, and seeking prompt medical attention if symptoms do not improve within 48-72 hours of antibiotic therapy It's also important to note that treatment failure with Keflex could indicate bacterial resistance, inadequate dosing, poor medication adherence, or infection caused by organisms not susceptible to cephalexin 1. In such cases, switching to a different antibiotic, as mentioned earlier, may be necessary to effectively treat the infection and prevent potential complications.
From the Research
Earlobe Cellulitis Treatment
If Keflex (cephalexin) is not working for earlobe cellulitis, there are alternative treatment options to consider.
- The majority of non-purulent, uncomplicated cases of cellulitis are caused by β-hemolytic streptococci or methicillin-sensitive Staphylococcus aureus, and appropriate targeted coverage of this pathogen with oral antibiotics such as penicillin, amoxicillin, and cephalexin is sufficient 2.
- However, in areas with a high prevalence of community-acquired methicillin-resistant Staphylococcus aureus (MRSA) infections, antibiotics with activity against community-associated MRSA, such as trimethoprim-sulfamethoxazole and clindamycin, may be preferred empiric therapy for outpatients with cellulitis 3.
- Studies have shown that the addition of trimethoprim-sulfamethoxazole to cephalexin did not improve outcomes overall or by subgroup in patients diagnosed with cellulitis without abscess 4, 5.
- Trimethoprim-sulfamethoxazole has been used successfully in combination with topical antibiotics to treat acute otitis media with otorrhea caused by community-acquired methicillin-resistant Staphylococcus aureus in children 6.
Alternative Treatment Options
- Trimethoprim-sulfamethoxazole may be considered as an alternative treatment option for earlobe cellulitis, especially in areas with a high prevalence of community-acquired MRSA infections.
- Clindamycin may also be considered as an alternative treatment option, especially in patients who have failed cephalexin therapy or have moderately severe cellulitis.
- It is essential to note that the treatment of cellulitis should be guided by the severity of the infection, the presence of purulent drainage or abscess, and the patient's underlying medical conditions.