Water related skin infections

Summary of changes

Medicines 

  • For moderate infection (fresh water): ceftriaxone changed to trimethoprim-sulfamethoxazole
  • For if soil or sewerage contaminated: added metronidazole
  • For moderate infection (salt water):
    • low MRSA risk: ciprofloxacin and ceftriaxone (changing from ceft to cefalexin if improvement after 24 hrs)
    • High MRSA risk: ciprofloxacin and trimethoprim-sulfamethoxazole

Other

  • Moderate infections (salt water) divided into high or low MRSA risk

Primary references

  1. Diaz JH and Lopez FA (2015) 'Skin, soft tissue and systemic bacterial infections following aquatic injuries and exposures', American Journal of Medical Sciences, 349(3):269-75, doi:10.1097/MAJ.0000000000000366

  2. Expert Groups for Antibiotic, version 16 (2021) Water-immersed wound infections, Therapeutic Guidelines, accessed 11 January 2022.

  3. McAuliffe GN, Hennessy J and Baird RW (2015) 'Relative frequency, characteristics, and antimicrobial susceptibility patterns of Vibrio spp., Aeromonas spp., Chromobacterium violaceum, and Shewanella spp. in the northern territory of Australia, 2000-2013', American Journal of Tropical Medicine and Hygiene, 92(3):605-10, doi:10.4269/ajtmh.14-0715

  4. Morris JG (2021) Vibrio vulnificus infections, UpToDate, accessed 11 January 2022.

  5. Wong KC, Brown AM, Luscombe GM, Wong SJ and Mendis K (2015) 'Antibiotic use for Vibrio infections: important insights from surveillance data', BMC Infectious Diseases, 15:226, doi:10.1186/s12879-015-0959-z