Erysipelas is characterized by infection of the dermis with lymphatic involvement and raised margins; which antibiotic regimen is commonly used?

• A. Penicillin V
• B. Penicillin G
• C. Tetracycline
• D. Clindamycin

Answer: (B)

Erysipelas is a superficial skin infection of the dermis with lymphatic involvement, most often caused by group A Streptococcus. This organism is highly susceptible to penicillin, so treating with a penicillin-type antibiotic provides reliable, rapid bactericidal activity in the affected tissue.

Penicillin G is a classic choice because it delivers proven activity against Streptococcus pyogenes and can be given intravenously to achieve high tissue levels quickly in more extensive or systemic cases. This helps rapidly reduce infection and inflammation in the dermis and lymphatics with raised, well-demarcated margins.

Tetracycline is less ideal here due to variable streptococcal coverage and resistance patterns. Clindamycin can be used in penicillin-allergic patients or for mixed infections, but it’s not first-line for uncomplicated erysipelas because of potential resistance and slower bactericidal action. Penicillin V is an oral alternative for milder cases, but for infections presenting with lymphatic involvement, IV penicillin G is commonly used to ensure adequate drug levels.