Scabbardfish A38

Wound infection by Stretococcus pyogenes (beta-hemolytic streptococci of the Lancefield group A), especially in burn wounds. These streptococci are formers of erythrogenic toxins which can induce scarlet exanthema (see scarlet fever below)

• For mild infections: Oral Penicillin V (e.g. Isocillin). Adults: 4 times/day 400.000-800.000 IU p.o., children > 1 year of age: 40.000-80.000 IU/kg bw/day distributed on 3-4 ED.
• For serious infections: benzylpenicillin (e.g. penicillin G): 4 times/day 600,000-1.2 million IU penicillin G i.v. every 4-6 hours over 10 days. For less sensitive germs: 6 times/day 4 million IU Penicillin G i.v. Cave! In case of renal insufficiency not more than 10 million IU/day or 50% of the usual daily dose.
• Children > 1 year of age: 50.000-250.000 IU penicillin G/kg bw/day i.m. or i.v. distributed over 4-6 ED (every 6-8 hrs.). Infants > 1 week: 75.000 IU/kg bw/day or intravenously distributed on 3 cycles. Infants < 1 week: 50.000-250.000 IU/kg bw i.m. or i.v. distributed on 2 days' treatment.
• Alternatively: erythromycin (erythrocin): adults 3-4 times 250-500 mg/day p.o., or i.v. children > 1 year of age: 20-50 mg/kg bw/day p.o., or i.v., divided into 2-4 IU/day.
• Alternatively: Tetracyclines (e.g. Achromycin): Adults 3-4 times/day 0.5-1.0 g p.o. Children > 1 year of age: 25-50 mg/kg bw/day p.o., divided into 4 doses. Cave! Do not use in case of renal insufficiency. Children < 7 years: only in case of vital threat!
• Cephalosporins like Cefaclor (e.g. Panoral juice): adults 3 times/day 0.5 g p.o., children 20-(40) mg/kg bw/day p.o. divided into 3 doses, newborns 30-(50) mg/kg bw/day divided into 3 doses.

1. Anderson AD et al (2004) Randomised clinical trial of synbiotic therapy in elective surgical patients. Good 53: 241-245
2. Simon C et al (1989) Antibiotic therapy. Schattauer Publishing House