What is the treatment for an infected toe caused by acrylic nails in the emergency room?

From the Guidelines

Emergency room treatment for an infected toe caused by acrylic nails typically involves removing the artificial nail, cleaning the area, and starting antibiotics, as recommended by the most recent guidelines 1. The healthcare provider will first assess the severity of the infection, then carefully remove the acrylic nail to relieve pressure and allow drainage. They will clean the wound with antiseptic solution and may perform a minor procedure to drain any pus if an abscess has formed. Oral antibiotics such as cephalexin (500mg four times daily for 7-10 days) or clindamycin (300mg four times daily for 7-10 days) are commonly prescribed to fight the infection, based on the severity of the infection and the likely etiologic agent(s) 1. For severe infections, intravenous antibiotics might be necessary. Pain management with acetaminophen or ibuprofen is also provided. The provider will likely recommend warm water soaks 3-4 times daily for 15 minutes to improve circulation and healing. These infections occur when bacteria enter through breaks in the skin caused by trauma from artificial nails, with Staphylococcus aureus and Pseudomonas being common culprits. Follow-up with a primary care provider within 2-3 days is important to ensure the infection is resolving properly.

Some key considerations in the treatment of infected toes caused by acrylic nails include:

• The need for prompt removal of the artificial nail to relieve pressure and allow drainage
• The importance of proper wound cleaning and dressing to promote healing
• The selection of appropriate antibiotics based on the severity of the infection and the likely causative organisms
• The potential need for surgical intervention, such as drainage of an abscess or debridement of necrotic tissue
• The importance of follow-up care to ensure the infection is resolving properly and to prevent complications.

Overall, the treatment of infected toes caused by acrylic nails requires a comprehensive approach that takes into account the severity of the infection, the likely causative organisms, and the need for prompt and effective treatment to promote healing and prevent complications.

From the FDA Drug Label

1. 3 Skin and Skin Structure Infections Cephalexin capsules are indicated for the treatment of skin and skin structure infections caused by susceptible isolates of the following Gram-positive bacteria: Staphylococcus aureusand Streptococcus pyogenes.

The treatment for an infected toe caused by acrylic nails in the emergency room may involve antibiotics such as cephalexin, specifically for skin and skin structure infections caused by susceptible Gram-positive bacteria like Staphylococcus aureus and Streptococcus pyogenes. The usual dose of oral cephalexin capsules is 250 mg every 6 hours, but a dose of 500 mg every 12 hours may be administered, with treatment lasting 7 to 14 days 2.

From the Research

Treatment for Infected Toe from Acrylics in Emergency Room

• The treatment for an infected toe caused by acrylic nails in the emergency room may involve several approaches, including:
  • Warm compresses to help bring the infection to the surface and promote drainage 3
  • Topical antibiotics, with or without corticosteroids, to help clear the infection 3
  • Oral antibiotics, which may be prescribed for more severe cases or if the infection is caused by a bacterial pathogen 3, 4, 5
  • Surgical incision and drainage for more severe cases, where an abscess has formed 3, 6
• It's worth noting that the use of antibiotics after surgical treatment is not always necessary, and may even be unnecessary in uncomplicated cases 6
• The choice of treatment will depend on the severity of the infection, the presence of any underlying medical conditions, and the patient's overall health status
• In some cases, a combination of treatments may be used, such as incision and drainage followed by antibiotic therapy 5

Considerations for Treatment

• The treatment of paronychia, a common inflammatory condition of the nail fold, often requires a multifaceted approach, including avoiding exposure to contact irritants and treating underlying inflammation and infection 3
• Topical antifungal agents and corticosteroids may be used to treat chronic paronychia, while oral antibiotics may be prescribed for acute cases 3, 4
• In cases where the infection is caused by a resistant bacterial pathogen, such as methicillin-resistant Staphylococcus aureus, alternative antibiotic therapies may be necessary 4, 5

Important Factors in Treatment

• The completeness of surgical excision is crucial in treating paronychia and preventing recurrence 6
• The use of broad-spectrum antibiotics, such as amoxicillin/clavulanate or clindamycin, may be necessary in cases where the infection is caused by a mixed anaerobic and aerobic infection 5
• Incision and drainage, coupled with antibiotic therapy, can be an effective treatment approach for paronychia in the perinatal setting 5