From the FDA Drug Label
A small amount of mupirocin ointment should be applied to the affected area three times daily. Patients not showing a clinical response within 3 to 5 days should be re-evaluated. Directions adults and children 2 years of age and older: clean the affected area apply a small amount of this product (an amount equal to the surface area of the tip of a finger) on the area 1 to 3 times daily may be covered with a sterile bandage
For purulent drainage from an ingrown toenail, the treatment may involve applying a topical antibiotic such as mupirocin or bacitracin to the affected area.
- Apply a small amount of mupirocin three times daily 1
- Apply a small amount of bacitracin 1 to 3 times daily 2 If there is no clinical response within 3 to 5 days, the patient should be re-evaluated 1.
From the Research
The treatment for purulent drainage from an ingrown toenail should prioritize immediate relief of symptoms and prevention of further infection, with a focus on home care and possibly medical intervention, as suggested by the most recent and highest quality study 3. The condition occurs when the edge of the toenail grows into the surrounding skin, creating an entry point for bacteria, typically Staphylococcus aureus or Streptococcus species, resulting in infection and pus formation. Key steps in management include:
- Soaking the affected foot in warm water with Epsom salt for 15-20 minutes, 3-4 times daily to reduce inflammation and draw out pus.
- Applying an antiseptic solution like povidone-iodine or chlorhexidine to the area, followed by an antibiotic ointment such as bacitracin, neomycin, or mupirocin.
- Covering with a clean bandage and wearing open-toed shoes or sandals to reduce pressure.
- Using over-the-counter pain relievers like ibuprofen (400-600mg every 6-8 hours) or acetaminophen (500-1000mg every 6 hours) to manage pain. If symptoms worsen, show signs of spreading infection, or don't improve within 2-3 days, seeking medical attention is crucial. A healthcare provider may prescribe oral antibiotics like cephalexin (500mg four times daily for 7-10 days) or clindamycin (300mg four times daily for 7-10 days) for more severe infections 4. In some cases, partial nail removal (partial onychectomy) may be necessary to drain the infection and prevent recurrence, as this approach is superior to nonsurgical ones for preventing recurrence 3.