Empiric Antibiotics for Acute Infections of the Hand

Tosti, Rick; Ilyas, Asif M.

doi:10.1016/j.jhsa.2009.10.024

Cited by 55 publications

(23 citation statements)

References 31 publications

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“…Dosing of vancomycin for the patient with a history of severe penicillin allergy or MRSA should be titrated to achieve a trough of 15 to 20. 22,34 Alternatives to vancomycin include linezolid, daptomycin, or telavancin.…”

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“…Clindamycin is an alternative for both MSSA and MRSA in the patient with a penicillin allergy but should be avoided in patients with S aureus isolates resistant to erythromycin. 22,34 In the event of an infection with a Gram-negative bacterium, a fluoroquinolone such as ciprofloxacin or levofloxacin may be used; alternatives include amoxicillin clavulanic acid, tetracyclines, and trimethoprim sulfamethoxazole, depending on the culture results.…”

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Hand Infections

McDonald

Bavaro

Hofmeister

et al. 2011

The Journal of Hand Surgery

129

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Hand infections are commonly seen by orthopedic surgeons as well as emergency room and primary care physicians. Identifying the cause of the infection and initiating prompt and appropriate medical or surgical treatment can prevent substantial morbidity. The most common bacteria implicated in hand infections remain Staphylococcus aureus and Streptococcus species. Methicillin-resistant S aureus infections have become prevalent and represent a difficult problem best treated with empiric antibiotic therapy until the organism can be confirmed. Other organisms can be involved in specific situations that will be reviewed. Types of infections include cellulitis, superficial abscesses, deep abscesses, septic arthritis, and osteomyelitis. In recent years, treatment of these infections has become challenging owing to increased virulence of some organisms and drug resistance. Treatment involves a combination of proper antimicrobial therapy, immobilization, edema control, and adequate surgical therapy. Best practice management requires use of appropriate diagnostic tools, understanding by the surgeon of the unique and complex anatomy of the hand, and proper antibiotic selection in consultation with infectious disease specialists.

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Hand Infections

McDonald

Bavaro

Hofmeister

et al. 2011

The Journal of Hand Surgery

129

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“…1 Abscesses caused by antibiotic-resistant organisms such as methicillin-resistant Staphylococcus aureus (MRSA) have been correlated with increased costs and morbidity 2e4 ; however, recent reports have indicated that proper selection of an empiric antibiotic can mitigate such complications. 5,6 Several studies have identified a growing epidemic of hand infections caused by MRSA in urban and suburban centers across the United States.…”

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Risk Factors Associated With Clindamycin-Resistant, Methicillin-Resistant Staphylococcus aureus in Hand Abscesses

Tosti

Trionfo

Gaughan

et al. 2015

The Journal of Hand Surgery

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“…given empiric antibiotic if the local resistance is greater than 10% to 15%, and many institutions have now subsequently excluded beta-lactams from empiric treatment 4,13,14 . However, the efficacy of contemporary empiric drug selections is not known, and the possibility of growing multidrug resistance exists, as alternative antibiotics are becoming more commonly selected to cover MRSA.…”

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confidence: 99%

“…RSA has gained attention in the literature and in popular media as a growing concern, especially in urban environments, as several reports have estimated a high proportion in hand abscesses ranging from 34% to 73% 4,[12][13][14][15][16][17][18] . Our results agree with prior studies and indicate that MRSA may be found in approximately half of all hand infections in urban communities in recent years.…”

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confidence: 99%