Specific Organisms and Therapeutic Regimens
Organism-specific therapeutic regimens for paronychia are provided below, including those for methicillin-susceptible Staphylococcus aureus, methicillin-resistant S aureus, Streptococcus pyogenes, Pseudomonas aeruginosa, Eikenella corrodens, and Candida. [1, 2, 3, 4, 5, 6, 7, 8, 9]
Multiple organisms are common in paronychia [10] ; cultures may be obtained to identify the underlying cause.
Methicillin-susceptible Staphylococcus aureus (MSSA)
See the list below:
-
Dicloxacillin 250 mg PO QID or
-
Cephalexin 500 mg PO TID/QID
Methicillin-resistant S aureus (MRSA)
See the list below:
-
Trimethoprim-sulfamethoxazole (160 mg/800 mg) 1 DS tablet PO BID or
-
Doxycycline 100 mg PO BID or
-
Clindamycin 300-450 mg PO TID
Streptococcus pyogenes
See the list below:
-
Amoxicillin-clavulanate (875 mg/125 mg) 1 tablet PO BID or
-
Penicillin V 500 mg PO BID/QID
Pseudomonas aeruginosa
See the list below:
-
Ciprofloxacin 500 mg PO BID
Eikenella corrodens
See the list below:
-
Amoxicillin-clavulanate (875 mg/125 mg) 1 tablet PO BID or
-
Trimethoprim-sulfamethoxazole (160 mg/800 mg) 1 DS tablet PO BID
Candida (if unresponsive to topical antifungals)
See the list below:
-
Fluconazole 100 mg PO daily for 7-14d or
-
Itraconazole 200 mg PO BID for 7d
