Erysipelas secondary prevention: Difference between revisions
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==Overview== | ==Overview== | ||
Secondary prevention for erysipelas is [[antibiotic]] prophylaxis for severe cases with high likelihood of recurrence. [[Phenoxymethylpenicillin]], [[erythromycin]], and [[benzathine]] [[penicillin]] have all displayed varying levels of efficacy in preventing erysipelas recurrence. More research is needed to determine standardized [[antibiotic]] selection, dosing, and interval of administration for universal application. | |||
==Secondary Prevention== | ==Secondary Prevention== | ||
The mainstay of | The mainstay of erysipelas secondary prevention is [[antibiotic]] prophylaxis for severe cases with high frequency of recurrence. | ||
*[[Phenoxymethylpenicillin]] or [[erythromycin]] are indicated for prophylaxis for those with severe cases.<ref name="pmid3110071">{{cite journal |vauthors=Jorup-Rönström C, Britton S |title=Recurrent erysipelas: predisposing factors and costs of prophylaxis |journal=Infection |volume=15 |issue=2 |pages=105–6 |year=1987 |pmid=3110071 |doi= |url=}}</ref> | *[[Phenoxymethylpenicillin]] or [[erythromycin]] are indicated for prophylaxis for those with severe cases and predisposition to the disease, such as [[venous insufficiency]].<ref name="pmid3110071">{{cite journal |vauthors=Jorup-Rönström C, Britton S |title=Recurrent erysipelas: predisposing factors and costs of prophylaxis |journal=Infection |volume=15 |issue=2 |pages=105–6 |year=1987 |pmid=3110071 |doi= |url=}}</ref> | ||
*Research on the efficacy of [[antibiotic]] prophylaxis of | *Research on the efficacy of [[antibiotic]] prophylaxis of erysipelas is not conclusive for complete prevention of recurrence.<ref name="pmid17387234">{{cite journal |vauthors=Koster JB, Kullberg BJ, van der Meer JW |title=Recurrent erysipelas despite antibiotic prophylaxis: an analysis from case studies |journal=Neth J Med |volume=65 |issue=3 |pages=89–94 |year=2007 |pmid=17387234 |doi= |url=}}</ref> | ||
**[[Benzathine]] [[penicillin]], administered intravenously every 3 weeks for 6 months at 2.4 MU, prevented recurrence during treatment, but cessation of therapy | **[[Benzathine]] [[penicillin]], administered intravenously every 3 weeks for 6 months at 2.4 MU, prevented recurrence during treatment, but cessation of therapy prompted the recurrence of erysipelas for 25% of patients.<ref name="pmid2861358">{{cite journal |vauthors=Duvanel T, Mérot Y, Harms M, Saurat JH |title=Prophylactic antibiotics in erysipelas |journal=Lancet |volume=1 |issue=8442 |pages=1401 |year=1985 |pmid=2861358 |doi= |url=}}</ref> | ||
**[[Erythromycin]] was shown to be effective prophylaxis throughout administration.<ref name="pmid3110071">{{cite journal |vauthors=Jorup-Rönström C, Britton S |title=Recurrent erysipelas: predisposing factors and costs of prophylaxis |journal=Infection |volume=15 |issue=2 |pages=105–6 |year=1987 |pmid=3110071 |doi= |url=}}</ref><ref name="pmid2002231">{{cite journal |vauthors=Kremer M, Zuckerman R, Avraham Z, Raz R |title=Long-term antimicrobial therapy in the prevention of recurrent soft-tissue infections |journal=J. Infect. |volume=22 |issue=1 |pages=37–40 |year=1991 |pmid=2002231 |doi= |url=}}</ref> | **[[Erythromycin]] was shown to be effective prophylaxis throughout administration.<ref name="pmid3110071">{{cite journal |vauthors=Jorup-Rönström C, Britton S |title=Recurrent erysipelas: predisposing factors and costs of prophylaxis |journal=Infection |volume=15 |issue=2 |pages=105–6 |year=1987 |pmid=3110071 |doi= |url=}}</ref><ref name="pmid2002231">{{cite journal |vauthors=Kremer M, Zuckerman R, Avraham Z, Raz R |title=Long-term antimicrobial therapy in the prevention of recurrent soft-tissue infections |journal=J. Infect. |volume=22 |issue=1 |pages=37–40 |year=1991 |pmid=2002231 |doi= |url=}}</ref> | ||
**A randomized controlled trial of [[phenoxymethylpenicillin]] and [[erythromycin]] were shown to reduce | **A randomized controlled trial of [[phenoxymethylpenicillin]] and [[erythromycin]] were shown to reduce erysipelas recurrence in patients with [[venous insufficiency]] or lymphatic congestion, but relapse still occurred in 10% of the patients in the the treatment arm.<ref name="pmid8132369">{{cite journal |vauthors=Sjöblom AC, Eriksson B, Jorup-Rönström C, Karkkonen K, Lindqvist M |title=Antibiotic prophylaxis in recurrent erysipelas |journal=Infection |volume=21 |issue=6 |pages=390–3 |year=1993 |pmid=8132369 |doi= |url=}}</ref> | ||
*Efficacy of prophylaxis is dependent on dose volume, time interval of administration, and accurate identification and specification of the pathogen.<ref name="pmid8132369">{{cite journal |vauthors=Sjöblom AC, Eriksson B, Jorup-Rönström C, Karkkonen K, Lindqvist M |title=Antibiotic prophylaxis in recurrent erysipelas |journal=Infection |volume=21 |issue=6 |pages=390–3 |year=1993 |pmid=8132369 |doi= |url=}}</ref><ref name="pmid17387234">{{cite journal |vauthors=Koster JB, Kullberg BJ, van der Meer JW |title=Recurrent erysipelas despite antibiotic prophylaxis: an analysis from case studies |journal=Neth J Med |volume=65 |issue=3 |pages=89–94 |year=2007 |pmid=17387234 |doi= |url=}}</ref> | *Efficacy of prophylaxis is dependent on dose volume, time interval of administration, and accurate identification and specification of the pathogen.<ref name="pmid8132369">{{cite journal |vauthors=Sjöblom AC, Eriksson B, Jorup-Rönström C, Karkkonen K, Lindqvist M |title=Antibiotic prophylaxis in recurrent erysipelas |journal=Infection |volume=21 |issue=6 |pages=390–3 |year=1993 |pmid=8132369 |doi= |url=}}</ref><ref name="pmid17387234">{{cite journal |vauthors=Koster JB, Kullberg BJ, van der Meer JW |title=Recurrent erysipelas despite antibiotic prophylaxis: an analysis from case studies |journal=Neth J Med |volume=65 |issue=3 |pages=89–94 |year=2007 |pmid=17387234 |doi= |url=}}</ref> | ||
**Consensus for [[penicillin]] concentrations and frequency sufficient for prophylaxis is not yet established.<ref name="pmid17387234">{{cite journal |vauthors=Koster JB, Kullberg BJ, van der Meer JW |title=Recurrent erysipelas despite antibiotic prophylaxis: an analysis from case studies |journal=Neth J Med |volume=65 |issue=3 |pages=89–94 |year=2007 |pmid=17387234 |doi= |url=}}</ref> | **Consensus for [[penicillin]] concentrations and frequency sufficient for prophylaxis is not yet established.<ref name="pmid17387234">{{cite journal |vauthors=Koster JB, Kullberg BJ, van der Meer JW |title=Recurrent erysipelas despite antibiotic prophylaxis: an analysis from case studies |journal=Neth J Med |volume=65 |issue=3 |pages=89–94 |year=2007 |pmid=17387234 |doi= |url=}}</ref> | ||
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==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
{{WH}} | {{WH}} | ||
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[[Category:Dermatology]] | |||
[[Category:FinalQCRequired]] | |||
[[Category:Emergency medicine]] | |||
[[Category:Disease]] | |||
[[Category:Up-To-Date]] | |||
[[Category:Infectious disease]] | |||
Latest revision as of 21:39, 29 July 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Luke Rusowicz-Orazem, B.S.
Overview
Secondary prevention for erysipelas is antibiotic prophylaxis for severe cases with high likelihood of recurrence. Phenoxymethylpenicillin, erythromycin, and benzathine penicillin have all displayed varying levels of efficacy in preventing erysipelas recurrence. More research is needed to determine standardized antibiotic selection, dosing, and interval of administration for universal application.
Secondary Prevention
The mainstay of erysipelas secondary prevention is antibiotic prophylaxis for severe cases with high frequency of recurrence.
- Phenoxymethylpenicillin or erythromycin are indicated for prophylaxis for those with severe cases and predisposition to the disease, such as venous insufficiency.[1]
- Research on the efficacy of antibiotic prophylaxis of erysipelas is not conclusive for complete prevention of recurrence.[2]
- Benzathine penicillin, administered intravenously every 3 weeks for 6 months at 2.4 MU, prevented recurrence during treatment, but cessation of therapy prompted the recurrence of erysipelas for 25% of patients.[3]
- Erythromycin was shown to be effective prophylaxis throughout administration.[1][4]
- A randomized controlled trial of phenoxymethylpenicillin and erythromycin were shown to reduce erysipelas recurrence in patients with venous insufficiency or lymphatic congestion, but relapse still occurred in 10% of the patients in the the treatment arm.[5]
- Efficacy of prophylaxis is dependent on dose volume, time interval of administration, and accurate identification and specification of the pathogen.[5][2]
- Consensus for penicillin concentrations and frequency sufficient for prophylaxis is not yet established.[2]
- More research is needed to determine the efficacy of administration every second week and every third week.
- Doubling the dosage of Benzathine penicillin administered (usually 1.2 MU) may provide longer and more effective prophylaxis.
- Consensus for penicillin concentrations and frequency sufficient for prophylaxis is not yet established.[2]
References
- ↑ 1.0 1.1 Jorup-Rönström C, Britton S (1987). "Recurrent erysipelas: predisposing factors and costs of prophylaxis". Infection. 15 (2): 105–6. PMID 3110071.
- ↑ 2.0 2.1 2.2 Koster JB, Kullberg BJ, van der Meer JW (2007). "Recurrent erysipelas despite antibiotic prophylaxis: an analysis from case studies". Neth J Med. 65 (3): 89–94. PMID 17387234.
- ↑ Duvanel T, Mérot Y, Harms M, Saurat JH (1985). "Prophylactic antibiotics in erysipelas". Lancet. 1 (8442): 1401. PMID 2861358.
- ↑ Kremer M, Zuckerman R, Avraham Z, Raz R (1991). "Long-term antimicrobial therapy in the prevention of recurrent soft-tissue infections". J. Infect. 22 (1): 37–40. PMID 2002231.
- ↑ 5.0 5.1 Sjöblom AC, Eriksson B, Jorup-Rönström C, Karkkonen K, Lindqvist M (1993). "Antibiotic prophylaxis in recurrent erysipelas". Infection. 21 (6): 390–3. PMID 8132369.