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Logo of mjafiGuide for AuthorsAbout this journalExplore this journalMedical Journal, Armed Forces India
 
Med J Armed Forces India. 1998 July; 54(3): 288–289.
Published online 2017 June 26. doi:  10.1016/S0377-1237(17)30574-9
PMCID: PMC5531656

USE OF AMOXICILLIN AND CLAVULANIC ACID (AUGMENTIN) IN THE TREATMENT OF SKIN AND SOFT TISSUE INFECTIONS IN CHILDREN: REPLY FROM THE AUTHOR

Although many skin infections in children are still best treated with older agents, several newer antibiotics offer advantages in certain situations. In addition, changes in microbial antibiotic resistance patterns have altered the drug of choice for certain childhood skin and soft tissue infections [1].

Systemic antibiotics to eradicate Staphylococci and Streptococci are the treatment of choice in skin and soft tissue infections in children [1]. It is now recognised that penicillinase producing staphylococci are more likely to be responsible for impetigo than streptococci and account for 70% to 80% of childhood impetigo [2]. For impetigo secondary to an underlying skin disease, such as dermatitis, scabies, psoriasis or varicella, staphylococci are virtually always responsible [2]. Post-streptococcal glomerulonephritis may follow such infections of the skin if nephritogenic strains of streptococci are involved [3].

Beta-lactamase production is one of the most common forms of resistance to beta- lactam antibiotics. The most recent advances has been the introduction of beta- lactamase inhibitors, which, when combined with existing beta-lactam antibiotics, act synergestically by inhibiting plasmid mediated beta-lactamases of Staphylococcus aureus [4].

The antimicrobial spectrum of amoxycillin/clavulanic acid combination make them ideally suited for the treatment of serious infections of the skin and soft tissue when polymicrobial organisms are suspected [4].

Most topical antibiotics including mupirocin ointment may result in clinical improvement but may prolong the carriage stage of pathogen on the skin [2]. Topical mupirocin ointment should not be used alone but reserved for cutaneous staphylococcal infections such as encountered in immunosuppressed children [5].

It is concluded that amoxicillin-clavulanic acid combination, with good coverage of Staph aureus and Streptococci is useful in mild skin and soft tissue infections in children or for oral treatment after an impatient course of intravenous antibiotics in moderate to severe skin and soft tissue infections in children [1].

REFERENCES

1. Chapel KL, Rasmussen JE. Pediatric dermatology: Advances in therapy. J Amer Acad Dermatol. 1997;36:513–526. [PubMed]
2. Dagen R. Impetigo in children, changing epidemiology and new treatment. Pediatr Ann. 1993;22:235–239. [PubMed]
3. Markowitz M. Changing epidemiology of group A streptococcal infection. Pediatr Infect Dis J. 1994;13:557–561. [PubMed]
4. Epstein ME, Amodio-Groton M, Sadick NS. Antimicrobial agents for the dermatologist. B- Lactam antibiotics and related compounds. J Amer Acad Dermatol. 1997;37:149–165. [PubMed]
5. Leyden JJ. Review of mupirocin ointment in the treatment of impetigo. Clin Pediatr. 1992;31:549–552. [PubMed]

Articles from Medical Journal, Armed Forces India are provided here courtesy of Elsevier