What is the role of antimicrobial therapy in the treatment of omphalitis?

Updated: May 20, 2019
  • Author: Patrick G Gallagher, MD; Chief Editor: Santina A Zanelli, MD  more...
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Answer

Note the following:

  • Include parenteral antimicrobial coverage for gram-positive and gram-negative organisms. A combination of an antistaphylococcal penicillin vancomycin and an aminoglycoside antibiotic is recommended.

  • Some believe that anaerobic coverage is important in all patients. Omphalitis complicated by necrotizing fasciitis or myonecrosis requires a more aggressive approach, with antimicrobial therapy directed at anaerobic organisms as well as gram-positive and gram-negative organisms. Metronidazole or clindamycin may provide anaerobic coverage.

  • Pseudomonas species have been implicated in particularly rapid or invasive disease.

  • As with antimicrobial therapy for other infections, consider local antibiotic susceptibility patterns, particularly patterns of S aureus and enterococcal susceptibility.

  • Additional topical therapy with triple dye, bacitracin, and other antimicrobials has been suggested in addition to parenteral antibiotic therapy, but such treatment is unproven.


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