Therapeutic targets
- Elimination of the pathogens
- Pain relief
Therapy recommendations
- Immediate antibiosis (antibiotic therapy: penicillin, first-line agent); duration of therapy: oral for ten days (-14 days); even milder cases should be treated for at least 7 daysOther antibiotics depending on: e.g., penicillin allergy, V. a. S. aureus(-participation), V. a. Gram-negative pathogens (-participation)
- Antiseptic therapy (germ-reducing and -fighting) of the entry site, e.g., Braunovidon ointment, povidone (PVP) iodine, polyhexanide; moist envelopes with potassium permanganate solution.
- Symptomatic therapy: antipyretics (antipyretic drugs/analgesics (painkillers: eg, acetaminophen; if necessary, also antipruriginosa (antipruritic drugs).
- Supportive therapy (supportive therapy): elevation, immobilize and cool and, if necessary, compression therapy of the affected limb.
- Recurrent prophylaxis of erysipelas: penicillin V, benzathine penicillin G, erythromycin; also clarithromycin if necessary Note: Recurrent erysipelas is said to occur when ≥ 2 episodes occur in three years.
Hospitalization:
- Severe courses (blistering (erysipelas vesiculosum et bullosum) and bullous-hemorrhagic (blistering-bleeding) erysipelas, phlegmonous (“spreading diffusely”) or necrotizing (“accompanied by local tissue death (necrosis)”)).
- Localization in the face (cave cerebral venous thrombosis!) → Anticoagulation (inhibition of blood clotting) required!
- Pronounced systemic inflammatory reaction (see below “Symptoms – Complaints”).
- Concomitant thrombophlebitis (acute thrombosis and inflammation of superficial veins).
- Necrosis (due tosurgical necrosis removal).
- Septic shock
- Patients with immunodeficiency
