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Cartilage Piercing Riskier Than Earlobes

Infection From Stubborn Bacteria More Likely When Upper Ear Is Pierced

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For this bacterium in ear cartilage, his study suggests, stronger antibiotics such as Cipro may be more effective than more commonly prescribed drugs like amoxicillin.

"But Cipro is not specifically approved for use in children, which makes primary care doctors reluctant to use it," says Keene. "When these patients saw their family doctors, they were initially prescribed antibiotics used for other skin infections that proved to be ineffective. In fact, one patient was hospitalized not because she was sick but because she needed intravenous medication." In his study, all of those infected from cartilage piercing were between ages 10 and 19.

His study also reinforces the importance of having any body piercing done under sterile conditions. But he stresses the added necessity when it comes to cartilage piercings, which may better be done at a surgical center than at the local mall. He calls for better infection-control training at these piercing kiosks and elsewhere. He notes that at the business where the infections occurred, the same "single-use" disinfectant bottle was repeatedly used, and was often used improperly. That business has since closed.

'Cosmetically Devastating'

Pseudomonas infection typically occurs weeks or months after the initial piercing. "Realize this is not a trivial thing and requires medical attention," he tells WebMD. "While Pseudomonas infection is not life-threatening, it can be cosmetically devastating. Untreated, the cartilage dies and needs to be surgically removed. And without cartilage to maintain the ear's shape, you get these deformities."

His advice for avoiding problems: "It's one thing to say, 'Don't go to a dirty place,' but even if it looks clean, you cannot tell if the gun has been sterilized properly. But people getting their ears pierced should be aware of the potential for problems, especially if they're having cartilage pierced. And they certainly can see the device being used. If it's not a sterilized needle or encapsulated gun, go somewhere else."

SOURCES: Keene, W, The Journal of the American Medical Association, Feb. 25, 2004; vol 291; pp 981-985. William E. Keene, PhD, MPH, epidemiologist, Oregon Department of Human Services, Portland.

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