Management of High-Pressure Injection Injury of the Hand in the Emergency Department Medication

Updated: Mar 20, 2020
  • Author: Stewart O Sanford, MD; Chief Editor: Trevor John Mills, MD, MPH  more...
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Medication Summary

The goal of therapy is to prevent infections. Prophylactic broad-spectrum antibiotics are indicated.



Class Summary

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

Cefazolin (Ancef, Kefzol, Zolicef)

DOC; first-generation semisynthetic cephalosporin which, by binding to one or more penicillin-binding proteins, arrests bacterial cell wall synthesis and inhibits bacterial growth. Primarily active against skin flora, including Staphylococcus aureus.

Trimethoprim/sulfamethoxazole (Bactrim, Bactrim DS)

Inhibits bacterial synthesis of dihydrofolic acid by competing with para-aminobenzoic acid, inhibiting folic acid synthesis and thus bacterial growth. Antibacterial activity of TMP-SMZ includes common urinary tract pathogens except Pseudomonas aeruginosa.

Clindamycin (Cleocin)

Lincosamide useful as treatment against serious skin and soft-tissue infections caused by most staphylococci strains. Also effective against aerobic and anaerobic streptococci, except enterococci.

Tetracycline (Sumycin)

Treats susceptible bacterial infections of both gram-positive and gram-negative organisms, as well as infections caused by Mycoplasma, Chlamydia, and Rickettsia species. Inhibits bacterial protein synthesis by binding with 30S and possibly 50S ribosomal subunit(s) of susceptible bacteria.

Amoxicillin (Amoxil, Biomox, Trimox)

Interferes with synthesis of cell wall mucopeptide during active multiplication, resulting in bactericidal activity against susceptible bacteria.