Which medications are used 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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A combination of parenterally administered antistaphylococcal penicillin and an aminoglycoside antibiotic is recommended for uncomplicated omphalitis. Intravenous antimicrobial therapy with clindamycin or metronidazole may be indicated in some cases. Some believe that anaerobic coverage also should be considered in all infants with omphalitis. Omphalitis complicated by necrotizing fasciitis or myonecrosis requires a more aggressive approach, and antimicrobial therapy directed at anaerobic organisms, as well as gram-positive and gram-negative organisms, is suggested. Metronidazole may be added to the combination of antistaphylococcal penicillin and aminoglycoside to provide anaerobic coverage, or clindamycin may be substituted for antistaphylococcal penicillin. As with antimicrobial therapy for other infections, consider local antibiotic susceptibility patterns and results of blood and biopsy specimen culturing.

Application of antimicrobial agents to the cord is appropriate in resource poor settings where the risk of omphalitis and its complications are high. In these cases, antimicrobial agents applied to the umbilicus have been shown to decrease bacterial colonization and to prevent omphalitis and associated complications.

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