infectious diseases
Erysipeloid
Treatment of Erysipeloid
Penicillin, cephalosporins, fluoroquinolones, orclindamycin Forlocalized cutaneous disease,usual treatment is one of the following, given for 7 days: Penicillin Vorampicillin(500 mg orally every 6 hours) Ciprofloxacin(250 mg orally every 12 hours) Clindamycin(300 mg orally every 8 hours) Cephalosporins are also effective.Daptomycinandlinezolidare active in vitro and may be considered if patients are very allergic to beta-lactams. Tetracyclines and macrolides may no longer be dependable. E. rhusiopathiaeare resistant to sulfonamides, aminoglycosides, andvancomycin. Severe diffuse cutaneous or systemic infectionis best treated with one of the following: Penicillin G(2 to 3 million units IV every 4 hours) Ceftriaxone(2 g IV once a day) A fluoroquinolone (eg,ciprofloxacin400 mg IV every 12 hours,levofloxacin500 mg IV once a day) Endocarditisis treated withpenicillin Gfor 4 to 6 weeks. Cephalosporins and fluoroquinolones are alternatives.Vancomycinis often used empirically for the treatment of gram-positive bacillary endocarditis; however,E. rhusiopathiaeis resistant tovancomycin. Thus, rapid differentiation ofE. rhusiopathiaefrom other gram-positive organisms is critical. The same antibiotics and doses are appropriate for arthritis (given for at least 1 week after defervescence or cessation of effusion), but repeated needle aspiration drainage of the infected joint is also necessary. 