Infected Seroma on the 2nd course of Levaquin. What antibiotic is best for someone with a PCN allergy to clear this infection?

Question

I had a TT with back/thigh lipo a month ago. Seroma one week post op but no infection. Took Levaquin 750mg fo 10 days due to Penicilin allergy. Drain placed after that and five days later drainage showed signs of infection. Now i've been restarted on Levaquin. Today is day five with no apparent signs of improvement, except for a slight decrease in the amount of drainage. Is there a better antibiotic to try for someone with a PCN allergy to use to clear this infection? The incision looks good.

Millicent Odunze Geers, MD, MPH · Answer

The best antibiotic to treat your particular infection would be directed by the culture and sensitivity of the seroma fluid. Additionally evacuation of the seroma is necessary. Finally, fluoroquinolones such as Levaquin should not be used indiscriminately as they can be associated with tendinitis and tendon rupture.

Samir Shureih, MD · Answer

Infected seroma should be treated like an abscess by incision and drainage. the antibiotics are chosen based on the results of cultures and sensitivity and some times a tissue culture and tissue pathology considering very rare bacteria seen frequently these days from over seas cosmetic surgery.Infectious disease consult is needed.

Robert H. Hunsaker, MD · Answer

At this point, hopefully your surgeon has sent a fluid specimen for culture and antibiotic sensitivities. Only this can guide for the "best" antibiotic choice in your case. It depends on the exact bacteria.Good luck!

Francis (Frank) William Rieger, MD (retired) · Answer

Good question, but I don't have the correct answer for you!  In my practice I would use the expertise of our local Infectious Disease specialist to assist you in treating this condition.  I would advise you to ask your Plastic Surgeon to consider  referring you to this type of specialist as well.Good luck to you.Frank Rieger M.D.  Tampa Plastic Surgeon

Infected Seroma on the 2nd course of Levaquin. What antibiotic is best for someone with a PCN allergy to clear this infection?

Answers (4)