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Recurrent erysipelas despite antibiotic prophylaxis: an analysis from case studies
J B Koster1, B J Kullberg, J W M van der Meer
1Department of General Internal Medicine, Radboud University Nijmegen Medical Centre, and Nijmegen University Centre for Infectious Diseases, PO Box 9101, 6500 HB Nijmegen, the Netherlands.
The Netherlands Journal of Medicine
|March 28, 2007
Summary
Erysipelas can recur despite antibiotic prophylaxis due to noncompliance, incorrect antibiotic choice, or other pathogens. Clinicians should confirm diagnosis and tailor treatment for recurrent skin infections.
Area of Science:
- Dermatology
- Infectious Diseases
- Pharmacology
Background:
- Erysipelas, a superficial cellulitis often caused by group A streptococci, frequently recurs.
- Prophylactic antibiotic treatment is common for recurrent erysipelas.
- Despite prophylaxis, some patients experience further erysipelas recurrences.
Observation:
- This study reviewed 117 adult patients with erysipelas between 1990 and 2004.
- Eight patients experienced recurrent erysipelas episodes despite prophylactic antibiotic treatment.
Findings:
- Recurrences were linked to noncompliance, incorrect antibiotic selection, insufficient dosing, or non-streptococcal pathogens.
- In three cases, the reason for treatment failure remained unidentified.
Implications:
- Confirming erysipelas diagnosis and identifying causative microorganisms are crucial.
- Appropriate antibiotic selection, dosing, and timing are essential for effective prophylaxis.
- Clinicians must address patient compliance and acknowledge prophylaxis limitations in preventing all erysipelas cases.
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