Oral piercings tend to have a lower infection rate but when present are treatable with amoxicillin/clavulanate. Removal of the piercing jewelry is requisite, and the placement of a loose loop suture through the piercing can be used to maintain the piercing patency throughout the duration of infection treatment. Infected piercings of the high ear involving the cartilaginous structures are likely to be caused by Pseudomonas and are treatable with a fluoroquinolone like ciprofloxacin. If concerns for methicillin-resistant Staphylococcus aureus exist, then oral trimethoprim/sulfamethoxazole confers adequate coverage. Oral antibiotics such as cephalexin or clindamycin provide coverage for streptococcus and staphylococcus. Conservative treatment of minor local infections includes warm compress and over-the-counter or prescription topical antibiotics such as bacitracin or mupirocin.
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