Lymphangitis Medication

  • Author: Raymond D Pitetti, MD, MPH; Chief Editor: Russell W Steele, MD   more...
 
Updated: Aug 19, 2011
 

Medication Summary

Treat children with lymphangitis with an appropriate antimicrobial agent. Analgesics can help control pain, and anti-inflammatory medications can help reduce inflammation and swelling.

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Antibiotics

Class Summary

Provide empiric coverage for group A streptococcal species and S aureus. Acceptable outpatient regimens include penicillinase-resistant synthetic penicillin or a first-generation cephalosporin. Acceptable inpatient regimens include a second- or third-generation cephalosporin (eg, cefuroxime, ceftriaxone) or a penicillinase-resistant synthetic penicillin. In certain geographical areas of the country with high rates of methicillin-resistant S aureus (MRSA), alternative antimicrobial agents such as clindamycin or trimethoprim-sulfamethoxazole (TMP-SMZ) should be considered.

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Dicloxacillin

 

Binds to 1 or more penicillin-binding proteins, which in turn inhibits synthesis of bacterial cell walls.

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Cephalexin (Keflex)

 

First-generation cephalosporin. Arrests bacterial growth by inhibiting bacterial cell-wall synthesis; provides bactericidal activity against rapidly growing organisms.

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Nafcillin

 

Binds to 1 or more penicillin-binding proteins, which in turn inhibits synthesis of bacterial cell walls. Because of thrombophlebitis, administer parenterally for only 1-2 d; change to PO as clinically indicated.

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Cefazolin

 

First generation semi-synthetic cephalosporin that arrests bacterial cell-wall synthesis, inhibiting bacterial growth.

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Cefuroxime (Zinacef)

 

Second-generation cephalosporin that arrests bacterial cell-wall synthesis, inhibiting bacterial growth.

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Ceftriaxone (Rocephin)

 

Third-generation cephalosporin arrests bacterial growth by binding to 1 or more penicillin-binding proteins.

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Clindamycin (Cleocin)

 

Semisynthetic antibiotic produced by 7(S)-chloro-substitution of 7(R)-hydroxyl group of parent compound lincomycin. Inhibits bacterial growth, possibly by blocking dissociation of peptidyl transfer RNA (tRNA) from ribosomes, causing RNA-dependent protein synthesis to arrest. Widely distributes in the body without penetration of CNS. Protein bound and excreted by the liver and kidneys.

Used to treat serious skin and soft-tissue staphylococcal infections. Also effective against aerobic and anaerobic streptococci (except enterococci).

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Trimethoprim and sulfamethoxazole (TMP/SMZ, Bactrim, Septra)

 

Inhibits bacterial growth by inhibiting synthesis of dihydrofolic acid. Antibacterial activity includes common urinary-tract pathogens except Pseudomonas aeruginosa.

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Contributor Information and Disclosures
Author

Raymond D Pitetti, MD, MPH  Associate Professor, Department of Pediatrics, Division of Pediatric Emergency Medicine, University of Pittsburgh School of Medicine; Associate Division Chief, Division of Pediatric Emergency Medicine; Associate Medical Director, Emergency Department; Medical Director, Sedation Services; Medical Director, Express Care; Medical Director, Patient Safety; Consulting Staff, University of Pittsburgh Physicians

Raymond D Pitetti, MD, MPH is a member of the following medical societies: Allegheny County Medical Society, American Academy of Pediatrics, Pennsylvania Medical Society, and Society for Pediatric Research

Disclosure: Nothing to disclose.

Specialty Editor Board

Gary J Noel, MD  Professor, Department of Pediatrics, Weill Cornell Medical College; Attending Pediatrician, New York-Presbyterian Hospital

Gary J Noel, MD is a member of the following medical societies: Pediatric Infectious Diseases Society

Disclosure: Nothing to disclose.

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Larry I Lutwick, MD  Professor of Medicine, State University of New York Downstate Medical School; Director, Infectious Diseases, Veterans Affairs New York Harbor Health Care System, Brooklyn Campus

Larry I Lutwick, MD is a member of the following medical societies: American College of Physicians and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Robert W Tolan Jr, MD  Chief, Division of Allergy, Immunology and Infectious Diseases, The Children's Hospital at Saint Peter's University Hospital; Clinical Associate Professor of Pediatrics, Drexel University College of Medicine

Robert W Tolan Jr, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Association, American Society for Microbiology, American Society of Tropical Medicine and Hygiene, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, Phi Beta Kappa, and Physicians for Social Responsibility

Disclosure: GlaxoSmithKline Honoraria Speaking and teaching; MedImmune Honoraria Speaking and teaching; Merck Honoraria Speaking and teaching; Sanofi Pasteur Honoraria Speaking and teaching; Baxter Healthcare Honoraria Speaking and teaching; Novartis Honoraria Speaking and teaching

Chief Editor

Russell W Steele, MD  Head, Division of Pediatric Infectious Diseases, Ochsner Children's Health Center; Clinical Professor, Department of Pediatrics, Tulane University School of Medicine

Russell W Steele, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Immunologists, American Pediatric Society, American Society for Microbiology, Infectious Diseases Society of America, Louisiana State Medical Society, Pediatric Infectious Diseases Society, Society for Pediatric Research, and Southern Medical Association

Disclosure: Nothing to disclose.

References

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