Gram-negative folliculitis should be considered in patients with acne who have a flare-up of pustular or cystic lesions and in patients whose acne is resistant to treatment. Gram-negative folliculitis may also occur in the setting of hot-tub immersion and in people infected with HIV. Note the image below. Gram-negative folliculitis can be treated as for severe acne, with isotretinoin but use of isotretinoin is associated with major side-effects, including birth defects [9]. Fungal infections are usually treated with topical azoles - eg, clotrimazole or oral ketoconazole. Gram negative folliculitis, seen after the use of chronic oral antibiotics, may reveal P. aeruginosa. This is explained in more detail in the gram-negative folliculitis chapter. This is explained in more detail in the gram-negative folliculitis chapter. Gram-negative folliculitis can be treated as for severe acne, with isotretinoin but use of isotretinoin is associated with major side-effects, including birth defects. Fungal infections are usually treated with topical azoles - eg, clotrimazole or oral ketoconazole. What is Gram-negative folliculitis? Gram-negative folliculitis is an acne-like disorder caused by a bacterial infection. Gram-negative bacteria include Escherichia coli, Pseudomonas aeruginosa, Serratia marcescens, Klebsiella and Proteus species. Most cases of folliculitis are diagnosed clinically, but cultures with sensitivities, Gram stain, potassium hydroxide (KOH), or biopsy can be obtained if lesions do not resolve with empiric therapy. Nasal cultures should be performed if S aureus colonization is suspected. Skin and Soft Tissue Infections Cellulitis Note: The most common etiology of cellulitis with purulent drainage is S. aureus , although Group A streptococci and other streptococcal species can also present in this manner. TREATMENT. The following regimens include coverage for MSSA, community-acquired MRSA (CA-MRSA), and streptococci. Coverage for gram negative organisms is not needed except in. Gram-negative folliculitis may be the result of prolonged antibacterial treatments in patients with acne and rosacea. It is caused by It is caused by alteration of facial skin flora and the nasal mucous, a decrease of Gram-positive bacteria and a proliferation of Gram-negative bacteria The infection may occur as …The history and pathophysiology of gram-negative folliculitis in the setting of … Our patient was treated with a two-week course of oral ciprofloxacin , which led to Gram - negative folliculitis. Doctor answers on Symptoms, Diagnosis, Treatment, and More: Dr. Fisher on gram negative folliculitis treatment: You treat the causative bacteria of infection with antibiotics that may be chosen after isolating the particular bacteria and testing to see if it is sensitive to being killed by that antibiotic. for topic: Gram Negative Folliculitis.