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1

Stages

Would Classification

Stage 1
Skin layers remail INTACT

Stage 2
blister / partial thickness

Stage 3
Full thickness skin loss
Stage 4
Further involved tissue and muscle/tendon/ bone

2

Different types of Infections

that YOU CAN TREAT

no need to refer to MD

Impetigo
direct contact, preschool, small red spots -> vessicles
Topical OTC's w/ neomycin / bacitracin / Polymixin B
Preferred = Mupirocin 2% (but RX only)

Folliculitis 
Only if SUPERFICIAL infection
HAIR follicles -> 4+ days dirty yellow/gray erythema

RX only =  Mupirocin 2%
 

 

3

What type of INFECTION?

Superficial, bacterial inflammation of HAIR FOLLICLES

Lesions last for 4+ days
dirty yellow / gray w/ erythema

Susceptable areas are usually exposed to
water / grease / oils

FOLLICULITIS

can be treated with MUPIROCIN 2% (RX Only)

Systemic Antibiotic is usually indiated
REFER TO MD

Role of OTC is very limited
limited to SUPERFICIAL infections

4

Treatment of ErythRASMA

bacterial infection of toes / groin + diabetes -> red SCALY eruptions

 

RASMA = SCALY ERUPTIONS

Minor cases may respond to
SHOWERS + POVIDONE-IODINE SOAP

 

Prefer SYSTEMIC/TOPICAL RX ANTIBIOTICS
 

REFER TO MD

5

Neosporin + PAIN RELIEF Ointment
Ingredients

Polymixn B

Neomycin

PRAMOXINE

 

no bacitracin

6

NEOSPORIN
ingredients

 

Polymixin B

Bacitracin

Neomycin

7

Treatment of Faruncles / Carbuncles

nodules

RX Systemic Antibiotics

 

REFER TO MD

 

Resolved by I & D

8

What type of Topical Antibiotic?

Polypeptide Antibiotic

Gram NEGATIVE coverage

minimally absorbed

1-3 times / day

POLYMIXIN - B SULFATE

9

Treating IMPETIGO

Topical OTC

w/ Neomycin / Bacitracin / Polymixin B

CLEANSE AREA w/ mild soap + water

 

PREFERRED TREATMENT = MUPIROCIN RX ONLY

10

Classification of

ACUTE Wounds

Result from Injury

Heal in ONE MONTH

Abrasions / punctures / lacerations / burns

 

 

chronic = Require INTENSE Medical treatment

11

What type of INFECTION?

Acute / Tender / Inflammatory NODULE

Children / Adolescents / Elderly

Located around Hair follicles

 

MAY BECOME CHRONIC --> REFER TO MD

FURUNCLES

 

Carbuncles = conglomerate of furuncles

12

What type of INFECTION?

Chronic bacterial infection of TOES & GROIN

Adults generally affected

Diabetes predisposes patients

Skin Lesions = SHARPLY marginated / Red / SCALY eruptions

May last for months to years

ErythRASMA

RASMA = SCALY ERUPTIONS

Minor cases may respond to
SHOWERS + POVIDONE-IODINE SOAP

Prefer SYSTEMIC/TOPICAL RX ANTIBIOTICS

REFER TO MD

13

OTC Treatment of INFECTION

Only the MOST SUPERFICIAL CONDITIONS should be treated OTC

Products are adjuncts to PROPER CLEANSING / Bandaging / Hygiene

Topical antimicrobials are usually used in combination
in order to cover a broad spectrum

14

What type of Topical Antibiotic?

Bactericidal

Gram POSITIVE coverage

rare resistance development

minimal absorpton

1-3 times / day

BACITRACIN

15

What type of INFECTION?​

Ulcerative Bacterial Infection

Common in children / adolescents & elderly

Erthematous pustule

Common ankles / feet / thighs / buttocks

Lesions are pruritic / tender / last for WEEKS

ECTHYMA

 

Systemic Antibiotic is usually indiated
REFER TO MD

Role of OTC is very limited
limited to SUPERFICIAL infections

16

What type of Topical Antibiotic?

AminoGlycoside + Bactericidal Activity

HYPERsensistivity is possible

Gram - NEGATIVESanaerobes, gram positive (staph)

Can result in systemic toxicity

1-3 times / day

NEOMYCIN

 

N = NEGATIVE

17

Treatment of Erysipeloid / Ecthyma / Folliculitis?

Systemic Antibiotic is usually indiated
REFER TO MD

Role of OTC is very limited
limited to SUPERFICIAL infections

Folliculitis can be treated by Mupirocin 2% tho

18

Polysporin Ointment

POLYMIXIN B

BACITRACIN

 

no neomycin

19

Questions to Ask Patient with

INFECTION

What type of wound is present?
WHERE is the wound?

Any foreign objects present

Redness / warmth / pus + swelling?

Fever / immunocompromsised

What have you tried

Allergies

20

What type of Topical Antibiotic?

Gram POSITIVE bacteria

Effective for STAPH + MRSA

IMPETIGO / FOLLICULITIS

AAA TID F7D

MUPIROCIN 2%

RX ONLY

BACTROBAN

21

Different types of Infections

that you CAN NOT TREAT YOURSELF

SEE MD!

 

Furuncles & Carbuncles
NODULES around hair follicles -> may be chronic see MD
Ecthyma
ulcerative, erythematous pustule (blister) --> pruritic / tender

ErySIPEloid
evolving cellulitis from fish/meat/poultry -> sharply marginated lesions

ErythRASMA
chronic --> toes/groin -> prediabetes --> SCALY eruptions / marginated


Folliculitis, sometimes treated w/ mupirocin 2% RX
HAIR follicles -> 4+ days dirty yellow/gray erythema

22

What type of INFECTION?

Superficial Infection

Common in preschool children

Transmitted by direct contact

Lesions are small / red spots that develop into VESSICLES

Seen on Face / Arms / Legs / Buttocks

IMPETIGO

Can be treated with TOPICAL OTC
neomycin + bacitracin + polymixin B

Cleanse area with MILD SOAP + WATER

Preferred treatment = MUPIROCIN RX ONLY

23

What type of ​WOUND?

Acute Evolving Cellulitis

Common source is FISH / MEAT / POULTRY

1-4 day inoculation period

Sharply marginated lesions

Skin ITCHES / BURNS / THROBS

resolves in 3 weeks

ErySIPELOID

 

Systemic Antibiotic is usually indiated
REFER TO MD

Role of OTC is very limited
limited to SUPERFICIAL infections