[Should NSAID/corticoids be considered when treating erysipelas?]. / Existe-t-il une place pour les AINS/corticoïdes dans la prise en charge de l'érysipèle?

ABSTRACT

Using non-steroidal anti-inflammatory drugs (NSAID) in association with a suitable antibiotherapy in the treatment of erysipelas, is still being largely discussed in medical publications. When compared to other fields of medicine, here their use might be justified by their ability to reduce local inflammation processes, to relieve patients more quickly, and to prevent potential sequels due to an inflammatory process. Numerous reports have suggested an association between the use of NSAID and the progression of an invasive streptococcal infection, particularly necrotizing fasciitis. The exact mechanism is still unclear. No controlled survey (NSAID versus placebo) checking the efficiency and the safety of these treatments is currently available. Only one comparative study showed a gain of one single day for prednisolone The prednisolone-treated patients had a shorter median length of hospital stay (5 days vs. 6) than the placebo-treated ones. The median treatment time with intravenous antibiotics, in the placebo group, was 1 day longer than in the prednisolone group. The occurrence of side effects was not higher in the prednisolone group. If this currently available data is not sufficient to establish a relationship between severe infectious complications and the use of NSAID, one should be cautious when using them to treat erysipelas, since their efficiency has not been positively proved.