From the Guidelines
Treatment for periauricular infection in a pediatric patient following ear piercing typically involves antibiotic therapy. For minor infections, fluoroquinolone antibiotics such as ciprofloxacin or levofloxacin are often effective 1. In cases of more severe infection, alternative options like clindamycin, ceftazidime, and cefepime may be considered, depending on the pathogen 1.
- Key considerations in treatment include:
- Antibiotic selection: Fluoroquinolones are commonly used due to their effectiveness against common pathogens like Pseudomonas aeruginosa, S aureus, and S pyogenes 1.
- Surgical intervention: If an abscess is present, surgical incision and drainage may be necessary to prevent further complications and promote healing 1.
- Jewelry removal: Removing the piercing jewelry, if possible, can help prevent further infection and promote healing 1.
- Follow-up care: The patient should be monitored for signs of improvement or worsening infection, and adjustments to treatment should be made as necessary 1. It is essential to address the infection promptly to prevent complications such as abscess formation, necrosis, or systemic symptoms 1.
From the FDA Drug Label
CLINICAL STUDIES The efficacy of topical mupirocin ointment in impetigo was tested in two studies. Pediatrics There were 91 pediatric patients aged 2 months to 15 years in the first study described above Clinical efficacy rates at end of therapy in the evaluable populations were 78% for mupirocin ointment (n=42) and 36% for vehicle placebo (n=49).
The treatment for a periauricular infection (infection near the ear) following a recent ear piercing in a pediatric patient is not directly addressed in the provided drug label. The label discusses the efficacy of mupirocin ointment in treating impetigo, but does not specifically mention periauricular infections or ear piercings 2.
From the Research
Treatment for Periauricular Infection
The treatment for a periauricular infection (infection near the ear) following a recent ear piercing in a pediatric patient (child) can be managed with antibiotics.
- The choice of antibiotic depends on the severity of the infection and the health of the child 3.
- For oral antibacterials, penicillinase-resistant penicillins such as flucloxacillin are the treatment of choice 3.
- Cefalexin and erythromycin are suitable cost-effective alternatives with broader cover, although care must be taken with the use of macrolides due to the development of resistance 3.
- Other cephalosporins such as cefadroxil and cefprozil are also effective and can be given once daily 3.
- Azithromycin has the advantage of a 3-day course and is effective against a range of pathogens, including those that cause skin and soft tissue infections 4.
Management of Infection
- Supportive management, including removal of any infected foreign bodies, surgical drainage of walled-off lesions, and regular wound cleaning, plays a vital role in ensuring cure 3.
- The duration of antibiotic treatment is typically 7-10 days, although there is no evidence that a 10-day course is more effective than a 7-day course 3.
Considerations for Pediatric Patients
- In children, azithromycin is usually given as either a 3-day course of 10 mg/kg/day or a 5-day course with 10 mg/kg on the first day, followed by 5 mg/kg/day for a further 4 days 4.
- The choice of antibiotic and duration of treatment should be guided by the severity of the infection and the health of the child, as well as consideration of potential adverse effects and resistance patterns 3, 4.