From the Research
Intravenous (IV) antibiotics and hospital admission are not typically recommended for severe paronychia as a first-line treatment, but rather for cases with signs of systemic infection, extensive involvement, or failure of outpatient management, as suggested by the most recent and highest quality study available 1.
Key Considerations
- The primary treatment for acute paronychia involves warm soaks, topical antibiotics, and, if necessary, drainage of any abscess that may have formed, as outlined in the study by 1.
- Oral antibiotics may be considered if there is a severe infection or if the patient is immunocompromised, but IV antibiotics are usually reserved for more severe cases or those that have not responded to initial treatment.
- The decision to admit a patient to the hospital should be based on the severity of the infection, the presence of systemic symptoms, and the patient's overall health status, including any underlying conditions that may affect their ability to recover from the infection.
Treatment Approach
- For severe paronychia, treatment may involve:
- Surgical drainage of any abscess
- Use of oral or IV antibiotics, depending on the severity of the infection and the patient's health status
- Elevation of the affected area and performance of warm soaks to promote healing
- Follow-up care to ensure proper healing and to address any potential complications
Patient Factors
- Immunocompromised patients, diabetics, and those with peripheral vascular disease may require closer monitoring and potentially longer courses of treatment due to their increased risk of complications from paronychia, as noted in the study by 1.
- Patient education on proper wound care and follow-up is crucial to prevent recurrence and ensure optimal outcomes.