Probably, the reader more than once had to meet people on the street with inflamed swollen purple spots on the skin of the face, hands or feet. This disease is called erysipelas because of the skin's intense pink color. The appearance of a bright spot indicates that the affected tissues are highly inflamed, and the cause of this condition is the infection that has penetrated the tissue through a small wound. And since any bacterial infection is treated only with the help of antimicrobial agents, antibiotics for erysipelas are the basis of therapy.
What is erysipelas?
Erysipelas is a disease of soft tissues caused by ingestion of a bacterial pathogen through the damaged skin. The causative agent of this pathology is considered to be group A streptococci , which secretes enzymes and toxins that promote the development of a strong inflammatory process on the skin and mucous membranes.
The inflammatory process begins at the site of entry of pathogenic microorganisms and spreads to nearby areas. Foci of inflammation in most cases can be seen on the hands and feet of patients, as well as in the face where the inflammation gradually passes to the mucous membranes and skin around the neck. Stop the further spread of the process with erysipelas and prevent recurrences of the disease, which are quite possible in case of its chronic course (there are cases when relapses occurred up to 6 times a year), antibiotics of various groups help.
Despite the fact that the disease is caused by a bacterial infection, it does not have an epidemic nature. Infection is not transmitted from person to person. So, the maintenance of patients in quarantine conditions is not required.
This pathology is more common in the female environment. Men are less likely to get sick. Most patients are over 40-50 years old and overweight, many have diabetes mellitus or pre-diabetic condition, when any wound heals very hard, keeping the risk of infection for a long time.
By the way, with long-term non-healing wounds, as in the case of diabetes mellitus, not one, but several types of pathogenic microorganisms can be found in the wound, which complicates the course of the disease and requires the use of antimicrobial agents of a wide spectrum of action.
The erysipelas is such a pathology that not only negatively affects the appearance of a person, causing a certain psychological discomfort, but is also dangerous with its complications. In the erysipelas, pus and tissue necrosis can be formed, which is dangerous for the development of sepsis (blood poisoning). In the field of inflammation there is a strong edema, the tissues are tightly compressed, lymph flow and limb mobility (elephantia) are disturbed. Chronic forms of pathology in some cases became even the cause of a serious decline in performance, and a person became disabled.
Treatment of erysipelas with antibiotics
Humanity has not yet come up with a more effective way to combat bacterial infection than the use of antimicrobial agents. Let's just say, antibiotics were developed for this purpose in due time, and their active use in erysipelas, which is an infectious pathology, is quite logical.
Yes, non-steroidal anti-inflammatory drugs (NSAIDs) or corticosteroids (SCS) can also cope with inflammation, but they can not prevent recurrence of the disease, since they do not have sufficient antibacterial activity.
The fact that the erysipelas is caused by such a common bacterium as streptococcus greatly facilitates the task of treating this pathology, because in fact all antibiotics are active against this pathogen: from old kind penicillins and ending with the latest achievements of the pharmacological industry in the field of antibacterial agents.
The problem, as in many other cases, is the development of antibiotic resistance of pathogenic microorganisms due to uncontrolled intake of antibiotics according to the doctor's prescription and without it, and the emergence of mutant new resistant strains of long-known bacteria. This situation leads to the fact that among the many antibiotics it is not always possible to find the one whose action will be disastrous in relation to the causative agent of the disease.
Earlier erysipelas can be effectively treated with natural and semisynthetic penicillins or cephalosporins, which perfectly cope with streptococcal infection. However, beta-lactam antibiotics do not cope with the new strains that produce a special enzyme beta-lactamase, which destroys the antimicrobial drug.
A modern approach to the treatment of erysipelas involves the use of protected penicillins and combined cephalosporins, in which the integrity of the beta-lactam antibiotic is protected by a special component (most often clavuonic acid).
The fact that erysipelas develops under the influence of bacteria of the streptococcal group does not cause doctors doubts. However, quite often other pathogens join this pathogen, so physicians prefer antibiotics of a wide spectrum of action. Especially when it comes to the erysipelas, developing against a background of diabetes mellitus or bullous form of inflammation with the formation of multiple vesicles. The presence of pus in the wound can also indicate a rich bacterial composition of the lesion.
To date, despite the development of new effective groups of antibiotics, many doctors still consider antimicrobial preparations of the penicillin line to be the best antibiotic for erysipelas. Among penicillin antibiotics penicillin, amoxicillin, ampicillin in combination with clavuonic acid and oxacillin are popular.
The cephalosporin series of antibiotics used for erysipelas is represented by cephalexin, cephradin and antibiotics of later generations, at the choice of the treating physician. The resistance of the antibiotic to the causative agent of the disease can be established with the help of bacterial analysis, which will make the treatment more effective.
True, antibiotics such as penicillins and cephalosporins (including beta-lactamase-resistant drugs) are effective in treating streptococci, they often cause severe reactions of intolerance, which means that they are not suitable for everyone. In this case, doctors need to look for effective drugs among other groups of antibiotics: macrolides (azithromycin, oletetrine, oleandomycin, etc.), sulfonamides (synthomycin), carbapenems (imipenem), nitrofurans, tetracyclines, etc. Additionally, the therapeutic regimen may include lincosamides, for example, clindomycin, which reduces the toxic effect of bacteria in the streptococcal group.
Sometimes doctors resort to the help of combined ani- biotics (for example, oletetrin, a combination of tetracyclines and macrolides) and antibiotics of new previously unknown groups (daptomycin, oxazolidones: linezolid, amisolide, zenix, zyvox, raulin routec). To help fluoroquinolones in the case of erysipelas do not resort, because this group of antibiotics is used mainly in severe cases of purulent infections.
Antibiotics for erysipelas can be used for systemic (pills and injections) and for local (mainly creams and ointments) applications, but it is still a case of skin disease and underlying soft tissues. Among the effective local antimicrobial agents are tetracycline, erythromycin and sintomycin ointment.
It should immediately be said that the choice of an effective drug is performed by a physician, regardless of the localization of the pathological process, i.e. With erysipelas, hands, feet, only the lower leg or face, including mucous membranes, the same antibiotics can be used. It is important that the antibiotic chosen by the doctor can cope with streptococcal infection that caused inflammation of soft tissues, and other pathogenic microorganisms that could enter the body through the wound on the body.
When asked whether antibiotics can be changed with erysipelas, the answer will be yes. Replacement of antimicrobials is carried out if the antibiotic used does not give a positive result, or bacterial analysis indicates the presence of resistance of the pathogen to the previously prescribed drug.