Modified Dakin's solution for cutaneous vibrio infections.
Vibrio species, specifically Vibrio vulnificus, are known to be endemic to warm saltwater environments. As a human pathogen they are capable of causing severe, progressive, necrotizing infections. The lesions are bullous in nature and often require wide surgical debridement due to the aggressiveness of this organism. The literature supports prophylactic antibiotic therapy for those with preexisting hepatic dysfunction or immunocompromise. The authors routinely implement prophylactic antibiotic coverage with doxycycline 100 mg every 12 hours for vibrio in patients with wounds exposed to or acquired in saltwater. In addition, they institute topical therapy with 0.025% sodium hypochlorite solution (modified Dakin's), based on their in vitro study of vibrio sensitivity to antimicrobials. Over the past 2 years, the authors have treated 10 patients with this protocol for cutaneous vibrio infections confirmed by quantitative cultures. None of these patients experienced progression of infection requiring operative debridement-contrary to the aggressive nature of this organism documented in other reports.
Wilhelmi
B J
BJ
Division of Plastic Surgery, The University of Texas Medical Branch, Galveston 77555-0724, USA.
Calianos
T A
TA
Appelt
E A
EA
Ortiz
M E
ME
Heggers
J P
JP
Phillips
L G
LG
D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004202:Disinfectants / Q000627:therapeutic use*; D004318:Doxycycline / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017192:Skin Diseases, Bacterial / Q000188:drug therapy*; D012973:Sodium Hypochlorite / Q000627:therapeutic use*; D014735:Vibrio Infections / Q000188:drug therapy*
D000900:Anti-Bacterial Agents; D004202:Disinfectants; D012973:Sodium Hypochlorite; D004318:Doxycycline