Gram-Negative Toe Web Infection Medication

Updated: Apr 07, 2023
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: William D James, MD  more...
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Medication Summary

The best treatment for a gram-negative toe infection is often a combined approach by using both antibacterial agents and antifungal agents; sometimes, astringents are used. [32] Debridement may be of value. Drying of the interdigital spaces is paramount. Sertaconazole nitrate cream 2% or any comparable azole or allylamine is beneficial the treatment of tinea pedis interdigitalis. [33]


Antifungal agents (topical)

Class Summary

The mechanism of action may involve increasing the permeability of the cell membrane, which, in turn, causes intracellular components to leak.

Econazole topical (Ecoza)

Econazole nitrate cream is an antifungal agent that is a water-miscible base consisting of pegoxol 7 stearate, peglicol 5 oleate, mineral oil, benzoic acid, butylated hydroxyanisole, and purified water. The color of the soft cream is white to off white, and it is for topical use only. It exhibits broad-spectrum activity against many gram-negative organisms. Econazole nitrate cream 1% is supplied in tubes of 15 g, 30 g, and 85 g.


Antibiotic agents

Class Summary

Therapy must cover all likely pathogens in the context of the clinical setting.

Cefotaxime (Claforan)

This is a third-generation semisynthetic broad-based antibiotic with a gram-negative spectrum. It has lower efficacy against gram-positive organisms. Specimens for bacteriologic culture should be obtained prior to therapy to test for susceptibilities to cefotaxime.

Ciprofloxacin (Cipro)

Ciprofloxacin is a synthetic broad-spectrum antimicrobial agent that inhibits bacterial DNA synthesis and, consequently, growth. The film-coated tablet is available in 100 mg, 250 mg, 500 mg, and 750 mg. The oral suspension is white to slightly yellow with a strawberry flavor and may contain yellow-orange droplets. Tablets are well absorbed in the gastrointestinal tract after oral administration. Ciprofloxacin has a wide range of activity against gram-negative organisms.

Gentamicin sulfate (G-Myticin, Jenamicin, Garamycin)

Gentamicin sulfate is a wide-spectrum antibiotic that provides highly effective topical treatment in primary and secondary bacterial infections of the skin. Gentamicin sulfate may clear infections that have not responded to other topical antibiotic agents. It treats superinfections caused by fungi or viruses. It treats skin and skin structure infections. The usual duration of treatment is 7-10 days. In more serious infections, a longer course of therapy is needed. Patients should be well hydrated during treatment. Gentamicin sulfate may also be used parenterally as a water-soluble injection against a wide variety of pathogenic bacteria. It may be considered as initial therapy in suggested or confirmed gram-negative infections, and therapy may be instituted before obtaining results of susceptibility testing.