Which medications in the drug class Antibiotics are used in the treatment of Superficial Thrombophlebitis?

Updated: Apr 17, 2019
  • Author: Khanjan H Nagarsheth, MD, MBA; Chief Editor: Vincent Lopez Rowe, MD  more...
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Answer

Antibiotics

These agents are not routinely useful in nonseptic superficial phlebitis. Antibiotics are indicated whenever infection is suspected to play a role and whenever phlebitis of the great saphenous vein above the knee threatens to approach the saphenofemoral junction. The choice of antibiotics should be guided by blood culture results whenever possible, but empiric therapy should at a minimum provide coverage for group A streptococci and for Staphylococcus aureus.

Superficial phlebitis must not be confused with septic phlebitis, which can be life threatening. If septic phlebitis is suspected, the selection of antibiotics is critically important and depends upon the clinical setting.

Ceftriaxone (Rocephin)

Ceftriaxone is a third-generation cephalosporin with broad-spectrum, gram-negative activity. It has lower efficacy against gram-positive organisms and higher efficacy against resistant organisms. This agent arrests bacterial growth by binding to 1 or more penicillin-binding proteins. When used for the treatment of phlebitis, ceftriaxone should be administered intravenously rather than intramuscularly.

Ceftriaxone is effective in the treatment of superficial phlebitis and bacterial septicemia caused by Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pyogenes, viridans group streptococci, Escherichia coli, Enterobacter cloacae, Streptococcus pneumoniae, Haemophilus influenzae, Klebsiella oxytoca, Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa, Morganella morganii, Serratia marcescens, Acinetobacter calcoaceticus, Bacteroides fragilis, and various Peptostreptococcus species.

Cephalexin (Keflex)

Cephalexin is a first-generation cephalosporin that may be used as adjunctive therapy in superficial phlebitis if infection is possible but unlikely, and if the only likely organisms would be skin flora, including staphylococci and streptococci.


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