From the Research
For a nail bed infection that has persisted for 2 weeks, the most effective treatment would be minocycline, as it has been shown to be reliably effective in treating uncomplicated community-acquired MRSA skin and soft-tissue infections 1. When considering the treatment of nail bed infections, it is essential to target the most common causative organisms, which are Staphylococcus aureus and Streptococcus species.
- The first-line treatment should be an antibiotic that is effective against these organisms, and minocycline has been shown to be a reliable option 1.
- Before starting antibiotics, drainage of any abscess is essential if present, and warm water soaks for 15 minutes 3-4 times daily can help reduce inflammation and promote healing.
- If the infection shows signs of MRSA, minocycline is a suitable alternative to trimethoprim-sulfamethoxazole (TMP-SMX) or doxycycline 1.
- It is crucial to reevaluate the patient if the infection does not improve within 48-72 hours of antibiotic therapy to consider alternative diagnoses or resistant organisms.
- Chronic or recurrent infections may indicate an underlying condition like diabetes or immunosuppression that should be addressed. The use of minocycline is supported by a study published in the International Journal of Antimicrobial Agents, which found that minocycline is often forgotten but preferred to trimethoprim-sulfamethoxazole or doxycycline for the treatment of community-acquired MRSA skin and soft-tissue infections 1.