Erysipelas - Retrospective Study of the Period 1996-2000

Overview

In a cohort of 355 patients with erysipelas divided into two groups a retrospective analysis ofanamnestic data, examinations and treatmentwas made. The first group comprised 264 patients whohad erysipelas for the first time in their life, the second group of 91 (25.6 %) were patients withrelapsing erysipelas. Comparison of the two groups revealed that relapsing erysipelas affects moreadvanced age groups, appears significantly more frequently on the lower extremities and is associatedwith chronic venous insufficiency, lymphoedema, leg ulcers and mycotic infection.Evaluation of treatment of 400 cases revealed that antibiotic treatment failed in 80 (20 %).Unsuccessful treatment was recorded in all patients after cotrimoxazole and oxacillin, as well as in73.7 % patients treated with tetracyclines. Most frequently for treatment cephalosporin antibioticsof the first generation were used, i.e. in 236 (59.0 %) attacks of erysipelas which had a high therapeuticeffect (92.3 %) and least undesirable effects. The therapeutic success was less favourable afteraminopenicillins (68.7 %), basic penicillins (43.3 %) and the macrolide antibiotic roxitromycin(50.0 %).)From the results of the investigation ensues that the drugs of choice in non-complicated erysipelasremain penicillin preparations, in patients allergic to penicillin macrolide antibiotics, possiblycephalosporins of the first generation.In complicated cases with secondary bacterial flora cephalosporin antibiotics of the first generationshould be preferred or aminopenicillins combined with
-lactamase inhibitors. Treatmentshould be always adjusted according to the results of the microbiological examination. To preventrelapses of erysipel it is important to treat concurrently with antibiotic skin lesions which may allowpenetration of streptococcal infection, and to improve the function of the venous system andlymphatic drainage of the lower extremities.

Key words:
erysipelas - retrospective study - treatment