Paronychia Organism-Specific Therapy 

Updated: Jul 30, 2018
Author: Elizabeth M Billingsley, MD; Chief Editor: Thomas E Herchline, MD 

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