Definition
Omphalitis is a chronic inflammatory disease of infectious origin that affects the navel.
Omphalitis mainly affects infants and children, but it can sometimes affect adults as well.
Patients most at risk for developing omphalitis are mainly those hospitalized and undergoing invasive procedures and / or those with impaired immune system.
Causes
In most cases, omphalitis is caused by a polymicrobial infection sustained by both Gram-positive and Gram-negative bacteria. More rarely, omphalitis is caused by a single type of microorganism.
The bacteria most involved in the development of the infection are: it Staphylococcus aureus, lo Streptococcus pyogenes, L"Escherichia coli, the Klebsiella pneumoniae and the Proteus mirabilis.
Symptoms
The typical symptoms caused by omphalitis consist of: formation of a purulent and foul-smelling discharge in the navel, edema, periumbilical erythema, pain and burning.
Additionally, premature babies with omphalitis can also experience jaundice, tachycardia, and hypotension.
If not adequately treated, omphalitis can become complicated and give rise to other serious pathologies - such as necrotizing fasciitis, sepsis, myonecrosis and septic embolization - which, in the most tragic cases, can then lead to the patient's death.
The information on Omphalitis - Medicines for the Treatment of Omphalitis is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Omphalitis - Medicines for the Treatment of Omphalitis.
Medicines
Since omphalitis is an infectious disease, its treatment involves the topical and / or systemic administration of antibiotic drugs. It is therefore clear how important it is to identify which microorganisms have triggered the inflammation, in a way that such as to be able to establish a suitable and specific antibiotic therapy.
Penicillins are particularly effective against mild omphalitis incurred by Staphylococcus aureus and from Streptococcus pyogenes.
Aminoglycoside antibiotics are indicated to counteract the Gram-negative bacteria that may be involved in the development of the infection.
On the other hand, for invasive omphalitis - in particular, those triggered by anaerobic bacteria - combinations of antibiotics are used, within which metronidazole is also present.
Generally, treatment with antibiotic drugs should continue for about 10-15 days. In any case, the doctor will determine the optimal duration of treatment for each patient.
The following are the classes of antibiotic drugs most used in the therapy against omphalitis and some examples of pharmacological specialties; it is up to the doctor to choose the most suitable active ingredient and dosage for the patient, based on the severity of the disease, the state of health of the patient and his response to treatment.
Penicillins
As mentioned, penicillins are particularly effective in killing Gram-positive bacteria - such as lo Streptococcus pyogenes and it Staphylococcus aureus - often involved in the "onset of" omphalitis. Although, in truth, some broad-spectrum penicillins may also be useful in fighting the Gram-negative bacteria involved in the infection.
Among the various active ingredients that can be used, we remember:
- Oxacillin (Penstapho ®): Oxacillin belongs to the class of β-lactamase resistant penicillins and is indicated for the treatment of infections caused by Gram-positive bacteria.
It is a drug available for intravenous administration. The exact amount of medicine to be administered should be determined by the physician on an individual basis for each patient. - Ampicillin (Amplital ®): Ampicillin is a broad spectrum antibiotic, useful in treating infections caused by both Gram-positive and Gram-negative.
Usually, in children, Ampicillin is administered in the form of an oral suspension. The dose usually used is 250-500 mg, to be taken every six hours. It being understood that the exact dose of antibiotic to be used must be determined by the doctor on a individual, depending on the severity of the infection and the patient's condition. - Amoxicillin (Augmentin ®, Zimox ®, Amox ®, Clavulin ®, Velamox ®): amoxicillin is also a penicillin with a broad spectrum of action. The dose of drug usually used in children is 20-30 mg / kg of body weight per day, to be taken orally. Also in this case, the exact dosage of the drug must be established by the physician on an individual basis for each individual, according to the severity of the infection and the patient's condition.
Aminoglycosides
Aminoglycoside antibiotics are particularly useful in fighting Gram-negative bacteria that can contribute to the development of omphalitis.
Indeed, aminoglycosides are antibiotics with a broad spectrum of action, but their high toxicity limits their use to the treatment of severe infections caused by Gram-negative bacteria.
Most of these drugs can only be administered parenterally, however, some of them can also be administered topically. Among these, we remember:
- Gentamicin (Gentalyn ®, Gentamicina Hexal ®, Eutopic ®): gentamicin is an aminoglycoside with a broad spectrum of action and is found in pharmaceutical formulations suitable for both parenteral and topical administration. For administration through the latter. away, gentamicin is available as a cream for skin use.
Generally, it is recommended to apply the gentamicin-based cream directly to the affected area 1-4 times a day. However, the doctor will determine the exact amount of medicine to be used and how often to administer it.
Metronidazole
In cases of invasive omphalitis caused by anaerobic bacteria, the doctor may decide to undertake metronidazole therapy in combination with other antibiotics.
Metronidazole (Deflamon ®) is available for parenteral administration. In children less than 12 years of age, the drug dose usually used is 7.5 mg / kg of body weight, to be administered every eight hours. In any case, the doctor will decide, on a case-by-case basis, if and how much metronidazole to use, the frequency of administration and the duration of treatment.
