Integrated Maternal and Newborn Care Basic Skills Course ...

Skin Infection
The severity of skin infection is classified by the number and size of the lesions, and signs of
sepsis as follows :
• Fewer than ten pustules/blisters, with no signs of sepsis:
o Wash the affected areas with an antiseptic.
o Swab the pustules/blisters with gentian violet 4 times a day until they are healed.
o Ask the mother to bring the baby for follow-up after 2 days.
o If the lesions don’t clear but there are no danger signs, give erythromycin or
cloxacillin by mouth for 5 days (50 mg/kg every 12 hours the first week of life; every 8
hours the 2 nd week of life; and subsequently every 6 hours). If not available, try oral
amoxicillin (every 12 hours the first week of life, older than 1 week, every 8 hours).
• Ten or more pustules/blisters with no danger signs of sepsis:
o Continue local treatment as noted above.
o Give cloxacillin orally.
o Ask the mother to come back for follow-up, ideally the next day or at least after 2
days.
o Assess the baby for signs of improvement (not spreading and drying):
̌ If there is improvement, continue treatment to complete 5-7 days.
̌ If there is no improvement, add gentamicin (Day 1-7): 4 mg/kg IM once daily for
babies < 2 kg, 5 mg/kg once daily for babies ≥ 2 kg; day 8 and over: 7.5 mg/kg
once daily for all weights and treat for 7-10 days.
• For cellulitis/abscess:
o If there is fluctuant swelling, incise and drain the abscess. If this is not feasible in the
peripheral center, refer to the referral center after giving the first dose of the
antibiotic. If cloxacillin cannot be given IV, give oral cloxacillin with IM injection of
gentamycin
o If admitted locally, assess the baby daily:
If the baby improves, continue to complete 10 days of treatment.
If there is no improvement, refer to the appropriate center.
156
Integrated maternal and newborn care
Basic skills course