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Insect bites and stings - Management
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Definition
- Secondary bacterial infection may occur as a result of scratching or may be introduced at the time of the bite or sting.
How do I know if an insect bite or sting is infected?
- A secondary infection may appear as impetigo, cellulitis, or lymphangitis.
- Signs that suggest a secondary infection include:
- The presence of pus.
- Increasing erythema, oedema, or tenderness beyond the anticipated pattern of response.
- Regional lymphadenopathy — this can also occur in the absence of infection, as a response to the inflammatory reaction produced by a bite.
- Lymphangitis, which is the most reliable sign and suggests streptococcal involvement.
How do I manage an infected insect bite or sting?
- Treat empirically with oral antibiotics for 7 days:
- Oral flucloxacillin is recommended for empirical treatment of staphylococcal and streptococcal skin infections.
- Oral erythromycin (or clarithromycin if erythromycin is not tolerated) is an alternative for people with penicillin-allergy.
In depth
What if treatment is not effective?
- Seek specialist advice regarding further management.
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