Hello, I have an issue with recurrent infection of an umbilical piercing that has subsequently been removed (due to infection during pregnancy ). The remaining scar has a region that failed to seal, on the umbilical end rather than outside the umbilicus. This area retains dead skin and periodically I attempt to remove the dead sking by expressing it while cleaning the region. Unfortunately, the area became infected this last time I was cleaning it. I had used a topical dual antibiotic ointment, and thouogh there was an initial response, it seems to have resurged a bit. There is local pain, which I would suggest is at least moderate, but very little erythema and no appreciable fluid collection. I do not have any systemic symptoms e.g. fever , or other discomforts, no gi distubance etc. As the area is colonized by anaerobes, and possiby MRSA , do you think it wise to continue topical treatment, or is it time to use a systemic antibiotic. If you believe systemic antibiotics are in order, which drug would you select as a first line agent and how long would you wait to see a clinical resonse before moving to a second line antibiotic?
Asked On : Tue, 8 Feb 2011