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No evidence found comparing intravenous with oral antibiotics in otherwise well children with staphylococcal scalded skin syndrome

Three Part Question

In [systemically well children with staphylococcal scalded skin syndrome ] are [ oral antistaphylococcals as effective as intravenous] in [ improving outcome]

Clinical Scenario

2 yr old girl attends your department with a history of impetigo. In addition she has developed an erythematous rash with some bullous formation. She has a minimal pyrexia and seems otherwise quite well. You diagnose staphylococcal scalded skin syndrome. You wonder, as she is clinically well, whether you can treat her with oral rather than intravenous antibiotics.

Search Strategy

Medline 1966 to November 2002 using OVID interface
{[exp staphylococcal scalded skin syndrome OR exp toxic epidermal necrolysis OR exp staphylococcal skin infection ] AND [exp injections OR intravenous OR infusions OR parenteral OR i.v. mp ] AND [ exp oral administration OR oral mp] AND [exp flucloxacillin OR flucloxacillin mp OR exp penicillins OR penicillin mp ]} LIMIT to human AND English language.

Search Outcome

4 papers found none of which were relevant.

Comment(s)

There was no literature comparing the relative efficacy of administration of the antibiotics.

Clinical Bottom Line

There is no evidence to suggest intravenous is better than oral antibiotics. Local guidelines should be followed.