Wound Infections: Which Antibiotics Should I Use?

According to the National Library of Medicine, approximately 6.5 million patients suffer from chronic wounds with more than $25 billion spent on wound care treatment in the U.S. each year.

While minor wounds may heal with over-the-counter treatments, such as ointments and creams, patients with more severe wounds will require a course of antibiotics.

In this article we'll cover wound infections, their symptoms, the antibiotics and alternative treatments that can be used to treat them, and what happens when they’re left untreated.

What is a Wound Infection?

A wound becomes infected when bacteria or fungi enter the wound and start multiplying.

The skin is a natural barrier that guards the body against pathogens, such as bacteria and viruses. Once this natural barrier is compromised by a break in the skin, microorganisms (germs) can enter the body and multiply within the wound, causing an infection.

Open wounds, such as cuts, tears, abrasions, punctures, and lacerations, are more susceptible to infection, but closed wounds may also become infected and sometimes fill with pus or cloudy fluid when they do.

How Do I Know if a Wound is Infected?

Patients who develop infected wounds after surgery will likely be closely monitored by doctors and nurses while they recover in hospital, or will receive wound care at their follow-up appointments.

If they develop a surgical site infection (SSI), a doctor will provide the required medical treatment.

However, if you’re not under the care of medical staff, here are a few signs you can look for that indicate a possible infection:

• Tenderness around the wound
• Skin around the wound that’s warm to the touch
• Cloudy, yellow, or green fluid draining from the wound
• Increased pain and swelling at the wound site
• A crust around the wound
• A wound that emits a foul smell
• A scab that increases in size
• Swollen lymph nodes
• A fever

What Happens to an Untreated Wound Infection?

Infections that are left untreated can have life-threatening consequences, some of which include:

• Cellulitis: A painful infection of the skin (upper and/or lower layers) with the potential to enter the bloodstream.
• Gangrene: Death of body tissue in the extremities, muscles, and other organs.
• Sepsis: Otherwise known as blood poisoning, this is a type of inflammation that spreads throughout the body, affecting various organs. If septic shock occurs, the patient may experience a fatal drop in blood pressure.
• Osteomyelitis: Infection of the bone tissue that results in the bone having to be removed.

What are the Treatment Options for a Wound Infection?

Some infected wounds can be treated with OTC medications at home. However, if you have serious injuries that have become infected, you’ll need professional medical care.

Below are some treatment options:

• Home Care: Superficial wound infections (infections on the surface of the skin), like those from small cuts, scrapes, and abrasions, can be treated at home with ointments, creams, topical antibiotics, and pain medications. If your wound does not heal on its own, seek medical attention.
• Medical Care: If any of the more serious symptoms mentioned earlier are present, it’s prudent to visit your healthcare provider. Only a doctor can prescribe the oral antibiotics required to treat your wound infection.
• Hospitalization: If the wound has been contaminated, the person is exhibiting signs of sepsis, or the wound requires extensive debridement, the patient will be hospitalized for treatment.

Hospitalization also occurs if the patient requires intravenous (IV) antibiotics for their infection.

In cases where a surgical wound infection cannot be treated with antibiotics alone, the patient may have to undergo surgery to heal the infection.

When Should I Get Antibiotics?

If your wound does not heal on its own or it's serious enough that you need to visit a doctor or hospital, you’ll be prescribed antibiotics that may be topical, oral, or intravenous.

Topical antibiotics are available over-the-counter and with a prescription, while oral antibiotics can only be purchased with a doctor’s prescription.

IV antibiotics are administered at healthcare facilities but can also be taken at home under the guidance of a clinician. These antibiotics are typically reserved for serious infections, such as sepsis.

What are Some Common Antibiotics for Wound Infections?

The type of antibiotic you are prescribed for a wound infection will depend on a number of factors, such as:

• The cause of your wound’s infection
• Any allergies you have
• Your overall general health
• The antibiotic’s interaction with other medication you may be taking

Here are some common antibiotics:

Topical Antibiotics

• Bacitracin
• Neomycin
• Polymyxin B
• Mupirocin
• Nitrofurazone
• Fusidic acid

Oral Antibiotics

• Amoxicillin-clavulanate
• Cephalexin
• Clindamycin
• Dicloxacillin
• Doxycycline
• Trimethoprim-sulfamethoxazole

IV Antibiotics

• Cephalosporins
• Penicillin
• Fluoroquinolones
• Nitroimidazoles
• Glycopeptides
• Oxazolidinone
• Carbapenems

The dosage of antibiotics varies depending on the patient, the severity of their infection, and the type of microorganism that has caused the infection.

It is important that patients follow doctors’ guidelines and complete the entire course of antibiotics, whether or not they feel better by day 3 or 4 of their treatment.

What are Some Alternatives to Oral Antibiotics?

If you’re allergic to oral antibiotics, have developed antibiotic resistance, or if you’re pregnant and cannot use certain antibiotics, you can explore the following options:

• Natural remedies: These should be used only on minor wounds. They include aloe vera, honey, tea tree oil, snail mucin, topical vitamin E, and more. Wounds take longer to heal with these remedies.
• Topical antibiotics: These are considered safer than oral antibiotics, but individuals — especially those who are pregnant — should consult a healthcare provider first.
• Corticosteroids: Steroids may be suitable alternatives to antibiotics, but should be taken in low doses by pregnant women.
• Hospitalization: This is the best option for severe infections that require IV antibiotics.

Where Can I Learn More About Antibiotics for Wound Infections?

If you’re concerned about a wound and think you may need antibiotics, you can speak to a board-certified doctor or nurse practitioner from the comfort of your home. Head over to LifeMD to schedule a telehealth appointment.