A 12-year-old child with nasal vestibulitis and penicillin allergy. Which treatment is most appropriate?

• A. Chlorhexidine and Neomycin Naseptin nasal cream
• B. Oral penicillin
• C. Amoxicillin nasal spray
• D. Topical corticosteroid spray

Answer: (A)

Treating nasal vestibulitis, a localized infection of the nasal vestibule often caused by Staphylococcus aureus, focuses on delivering antimicrobial therapy directly where the infection is while avoiding systemic antibiotics in a penicillin-allergic patient. A nasal cream that combines chlorhexidine, an effective antiseptic, with neomycin, an aminoglycoside antibiotic, provides targeted antimicrobial action at the site of infection without involving penicillin. This local approach helps clear the infection while minimizing systemic exposure and the risk of allergic reactions. In contrast, systemic antibiotics like oral penicillin or amoxicillin would not be ideal due to the allergy, and a topical corticosteroid spray alone would not address the bacterial infection.