Pyodermas: an analysis of 127 cases.

In an analysis of 127 patients with pyodermas, 38 (30%) had primary pyodermas and 89 (70%) had secondary pyodermas. Seventy-one percent (71%) of the primary pyodermas were due to Staphylococcus aureus (S. aureus). Five (5%) of the primary pyodermas were due to multiple organisms. Among the patients with secondary pyodermas, 45% were due to S. aureus, 21% Streptococci, 9% Pseudomonas and 9% Proteus species. Forty-four percent (44%) of the secondary pyodermas were due to multiple organisms. S. aureus is highly sensitive to cephalothin, cloxacillin, erythromycin, methicillin and co-trimoxazole. Streptococci are highly sensitive to cephalothin, erythromycin, ampicillin and penicillin. The gram-negative organisms are sensitive to amikacin, gentamicin, kanamycin and co-trimoxazole. Cloxacillin, or erythromycin (for patients with penicillin allergy) is the antibiotic of choice in patients with primary pyodermas. In patients with infected eczemas, first-generation cephalosporin or cloxacillin is the preferred antibiotic. In patients with infected ulcers, a combination of cloxacillin and gentamicin or a cephalosporin effective against the causative agent is most suitable.