From the FDA Drug Label
- 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 a patient with a retained splinter and signs of infection, including pain, white and green discoloration, may include antibiotics such as cephalexin, as the infection is likely caused by susceptible isolates of Gram-positive bacteria like Staphylococcus aureus or Streptococcus pyogenes. The dosage for adults is usually 250 mg every 6 hours or 500 mg every 12 hours for 7 to 14 days 1.
- Key considerations:
- The patient should be evaluated for the need for wound debridement or splinter removal.
- Pain management may also be necessary.
- It is essential to monitor for signs of infection and adjust treatment as needed.
From the Research
The patient with a retained splinter in the right foot and signs of infection should seek immediate medical attention for removal of the splinter, debridement of infected tissue, and antibiotic treatment. The most recent and relevant study for this condition is not directly provided in the given evidence, but based on general medical knowledge and the principles of treating retained foreign bodies with signs of infection, prompt medical intervention is crucial.
- The patient should be treated with antibiotics, such as amoxicillin-clavulanate (Augmentin) 875/125 mg twice daily for 7-10 days, or clindamycin 300-450 mg four times daily for patients with penicillin allergy, as these are common treatments for skin infections 2.
- Warm soaks with Epsom salt (magnesium sulfate) in warm water for 15-20 minutes, 3-4 times daily, can help draw out infection and reduce inflammation.
- Pain management with acetaminophen or ibuprofen as needed is appropriate.
- Following treatment, the patient should keep the area clean and dry, change bandages daily, and monitor for worsening symptoms such as increasing redness, swelling, warmth, pain, or red streaking up the leg, which would necessitate immediate medical attention. This approach is necessary because retained foreign bodies can harbor bacteria, leading to localized infection that may spread if not properly treated, potentially resulting in more serious complications like cellulitis or abscess formation. Given the provided evidence, the study from 2 provides the most directly relevant information regarding the removal of splinters and the importance of addressing foreign bodies to prevent infection, although it does not specifically address the treatment of infections once they have occurred. However, the principles of infection management and the importance of prompt medical attention for signs of infection are well-established in medical practice.