Antibiotics vs Steroids

[Abbee]

Hello
Saturday I was stung on my foot (exactly the same spot I was stung 14 years ago!)
Anyhow as expected, big swelling but no pain. But unlike the other 2 times I've ever been stung, my palms started to itch like mad and were puffy within minutes.
Sunday the swelling on foot was worse, hard to walk but no pain or itching and the palms got better. Today, Monday, foot worse and crept up my ankle a bit. Itching set in with a vengeance, but no pain. just hard to walk.
So went to GP who said it was an infection and gave me antibiotics. But reading all the posts here on bad stings, most people were given steroids. Only a couple posts mention antibiotics.
If a foot looks like a puffed up Cornish pasty, how can you tell the difference between an infection that requires antibiotics or bee sting that requires steroids? I'm now worried that the GP gave the antibiotics because of inexperience with bee sting reactions.
What do you guys think?
I also asked if, as responsible beekeepers, would it be a good idea to keep an epipen handy in the event if ever a neighbour or guest has an anaphylactic reaction but he was having non of it.

Jen

 

[Margaret Elisabeth]

I react quite a lot to stings but have never been to the doc. I use antihistamine tablets, cold water compress, and when very severe I have used ibuprofen. It has always gone within a week. I only started to react badly after I had to start taking Omeprazol. Now I am reducing my dosage and the reaction is not quite as bad. On Saturday I was stung 5 times on my hands. I took three lots of antihistamine and this morning my hands are almost back to normal just a bit of sensitivity around the worst venom injection sites.

 

[Bosleeu]

You can buy hydrocortisone cream (steroid) without prescription it should help with the swelling and reaction.

 

[Anduril]

I was once given a tetanus injection after the swelling failed to go do down after a week. It is the decision of the the doctor how they deal with individual cases.

 

[oliver90owner]

Take the GP's advice. They are the experts, not the forum.

 

[BeeJayBee]

Sunday the swelling on foot was worse, hard to walk but no pain or itching and the palms got better. Today, Monday, foot worse and crept up my ankle a bit. Itching set in with a vengeance, but no pain. just hard to walk.
So went to GP who said it was an infection and gave me antibiotics. But reading all the posts here on bad stings, most people were given steroids

Take the GP's advice. They are the experts, not the forum.

with RAB. Trust the doctor, you went to them because you were worried, they gave you treatment. Just make sure you take the whole course of antibiotics, don't stop once you think the infection has gone.

I've been given antibiotics twice for stings that have gone bad. I've never been offered steroids. All other stings I've had have either needed no treatment at all, or have been dealt with by a single antihistamine tablet.

Think about why a sting to the foot could get infected - almost all footwear is likely to have a highish amount of bacteria inside, it'll breed merrily on a hot day and moreso if your feet are sweaty. These bacteria were probably on your skin, and will have been injected into your body along with the sting.

In future try to stop bees getting at your feet.

 

[Karol]

Abbee, please do not apply hydrocortisone to the sting. Here's a little professional advice:

Stings can broadly react in one of five ways (or in combination thereof):

1. Localised pain and swelling with no infection and no allergic reaction. Hydrocortisone can be used to treat the localised effects. Topical anaesthetics may also help. Antihistamines will provide some relief. Oral pain killers may provide relief and may help reduce swelling.

2. Localised pain and swelling with localised allergic reaction spreading beyond the immediate vicinity of the sting but not affecting other parts of the body. As above but oral antihistamines will provide a greater level of relief. Good idea to pop down to the GP and get checked over.

3. Localised pain and swelling with generalised allergic reaction spreading to other non related parts of the body. Seek urgent medical attention. If you have oral antihistamines then take them but do not delay in getting medical attention. If you have been prescribed an epipen or similar and are familiar with the symptoms of anaphylaxis then follow your prescribers' advice on how to use it and seek emergency medical attention.

4. Localised pain and swelling which persists for longer than 8 hours and which continues to feel hot and 'tight' and the area of swelling appears to be slowly increasing. This is indicative of infection especially if the sting starts to weep or the skin starts to break down. This requires medical attention and the use of antibiotics. Do not use hydrocortisone as hydrocortisone may suppress your body's natural defences and make the infection worse. Symptoms of infection can easily be confused with localised allergic reaction but it is better to treat early rather than late because there is a possibility of more serious complications arising from infected stings including cellulitis. Infections from bee sting are not common (unlike with wasp stings) but are certainly possible. One way in which stings are infected is from scratching itchy stings with dirty finger nails.

5. If you start developing chest pains (up to 2 weeks after the sting) seek urgent medical attention and suspect Kounis syndrome. Take an oral antihistamine but do not delay seeking medical attention.

I would advise against using topical antihistamine creams. Chlorpheniramine 4mg tablets (Piriton) are the preferred antihistamine of choice. Do not under any circumstance buy an epipen or similar adrenaline device on the black market. It's a prescription only medicine and for good reason.

 

[Dan Job]

Has anyone experienced more sever reactions from some colonies but not from others? My hive new in May, a Virgin Q now mated have turned nasty since her offspring have been coming through. A sting I received yesterday has caused my hand to swell quite badly to just above my wrist. First time I've reacted this bad. Prob had 10 or so stings before and not reacted much at all likely previous stings from queens sisters that came with her.

 

[Erichalfbee]

Dan Job, I have had the odd sting cause some considerable swelling. I must investigate what you suggest. I have on ONE occasion taken Chlorpheniramine. I fell about and slept for 24 hours!!

 

[midnight sun]

Hello
Saturday I was stung on my foot (exactly the same spot I was stung 14 years ago!)
Anyhow as expected, big swelling but no pain. But unlike the other 2 times I've ever been stung, my palms started to itch like mad and were puffy within minutes.
Sunday the swelling on foot was worse, hard to walk but no pain or itching and the palms got better. Today, Monday, foot worse and crept up my ankle a bit. Itching set in with a vengeance, but no pain. just hard to walk.
So went to GP who said it was an infection and gave me antibiotics. But reading all the posts here on bad stings, most people were given steroids. Only a couple posts mention antibiotics.
If a foot looks like a puffed up Cornish pasty, how can you tell the difference between an infection that requires antibiotics or bee sting that requires steroids? I'm now worried that the GP gave the antibiotics because of inexperience with bee sting reactions.
What do you guys think?
I also asked if, as responsible beekeepers, would it be a good idea to keep an epipen handy in the event if ever a neighbour or guest has an anaphylactic reaction but he was having non of it.

Jen

Antibiotics could be just as a precaution, but who knows what else is lurking on the end of a sting. It could carry anything!

 

[galileo]

Thank you Karol, for a most informative and dare I say definitive post. Having been stung on the neck this morning and reacting in a way that's never happened to me after the innumerable previous encounters with bee venom, I'm printing this information out to digest and disseminate.

Cheers

 

[drstitson]

most doctors are unaware of the natural evolution of a good going sting.

hence why dealing with it as cellulitis.

GP will of course be proved right because after taking the course of Antibiotics the symptoms will have resolved to your satisfaction.

 

[Karol]

Hmmmm! I understand the point that you are making. Serious infections from bee stings are rare so people should not be unduly worried. However, empirical antibiotic treatment for infection is probably responsible for preventing a substantially greater incidence of serious complications arising from genuinely infected bee stings.

http://link.springer.com/article/10.1007/s00238-007-0130-1

http://www.scielo.br/scielo.php?pid=S0103-64402009000300014&script=sci_arttext

http://cid.oxfordjournals.org/content/32/2/e36.full

http://cdnc.ucr.edu/cgi-bin/cdnc?a=d&d=LAH19050713.2.87.18

http://www.merckmanuals.com/home/skin_disorders/bacterial_skin_infections/cellulitis.html