Hand Infections Treated With Penicillin

A systematic review of the management of acute pyogenic flexor tenosynovitis

“…Of these seven studies, one study used a calcium-antibiotic paste as a dressing for wound care, and two studies used antibiotics in the irrigation fluid only. (Florey, 1944; Marsden, 1946; Unonius, 1947) Six studies that used systemic antibiotics also used antibiotics in the irrigation fluid. For each of these treatment modalities, follow-up timing for outcomes reported varied substantially.…”

“…(Bauman et al, 2005; Carter et al, 1966; Dailiana et al, 2008; Florey, 1944; Gaston and Greenberg, 2009; Gordon, 1951; Juliano and Eglseder, 1991; Lille et al, 2000; Marsden, 1946; Monstrey et al, 1985; Murray, 1951; Neviaser, 1978; Pang et al, 2007; Pillukat et al, 2011; Pollen, 1974; Schnall et al, 1996; Sokolow et al, 1987; Unonius, 1947; Volinger and Partecke, 2003) Patients had excellent range of motion outcomes in 25 of 177 cases (15%) after surgical treatment without accompanying systemic antibiotics, significantly worse than those with antibiotics (p<0.001). (Delsignore et al, 1986; Florey, 1944; Grinnel, 1937; Harris and Nanchahal, 1999) Whether antibiotics were administered preoperatively or post-operatively varied between the studies and often was not clearly delineated.…”

“…Earlier studies in our review stratified based on disease severity, without any defined classification system, and also described worse outcomes with more severe PFT. (Florey, 1944; Gordon, 1951; Grinnel, 1937) Number of Kanaval signs in study participants was described in 3 studies but outcomes were not presented accordingly. (Dailiana et al, 2008; Gutowski et al, 2002; Nikkah et al, 2012)…”

“…This is supported by reports that patients with an average treatment delay of 3.5 days had excellent outcomes as compared to delays of 7.5 days – 24.5 days resulting in fair and poor outcomes. (Carter et al, 1966; Florey, 1944) Cases treated within 48 hours had over 80% excellent range of motion outcomes. (Bauman et al, 2005; Gordon, 1951; Monstrey et al, 1985; Nikkah et al, 2012)…”

“…(Dailiana et al, 2008; Delsignore et a;., 1986; Florey, 1944; Gordon, 1951; Grinnell, 1937; Juliano and Eglseder, 1991; Pang et al, 2007) Four studies described use of systemic antibiotics in 18 patients that required amputations;(Dailiana et al, 2008; Gordon, 1951; Juliano and Eglseder, 1991; Pang et al, 2007) however, at least 15 of these cases occurred in patients that had treatment delay (no antibiotics or surgery) greater than three days. (Dailiana et al, 2008 and Pang et al, 2007) Other collective analyses were limited as there was no standardization of results reported across the studies.…”