What is the treatment for cellulitis of the fingertip?

From the Guidelines

Cellulitis of the fingertip should be treated with oral antibiotics that cover common skin pathogens, typically dicloxacillin 500mg four times daily or cephalexin 500mg four times daily for 5 days, as this duration has been shown to be as effective as a 10-day course if clinical improvement has occurred by 5 days 1. For patients with penicillin allergy, clindamycin 300-450mg three times daily is an appropriate alternative. Alongside antibiotics, the affected finger should be elevated when possible to reduce swelling, and warm compresses applied for 15-20 minutes 3-4 times daily to improve blood circulation and help resolve the infection. Some key points to consider in the treatment of cellulitis include:

• The use of antibiotics that cover streptococci, as these are common causes of cellulitis 1
• The consideration of coverage against MRSA in certain cases, such as those with systemic signs of infection or severe disease 1
• The importance of elevation and warm compresses in reducing swelling and improving circulation 1
• The potential need for surgical drainage if an abscess is present 1
• The recommendation for patients to seek immediate medical attention if they develop fever, red streaking up the arm, rapidly increasing pain or swelling, or if symptoms don't improve within 48 hours of starting antibiotics. Proper hand hygiene and keeping the area clean and dry will help prevent worsening of the infection and recurrence. It's also important to note that the treatment should be individualized based on the patient’s clinical response and that the duration of therapy may need to be extended if the infection has not improved within the initial 5-day period 1.

From the Research

Treatment for Cellulitis of the Fingertip

• The treatment for cellulitis, including cellulitis of the fingertip, typically involves oral antibiotics such as penicillin, amoxicillin, and cephalexin, which target β-hemolytic streptococci or methicillin-sensitive Staphylococcus aureus 2, 3.
• For non-purulent, uncomplicated cases of cellulitis, coverage for methicillin-resistant Staphylococcus aureus is generally not recommended 2.
• However, in areas with a high prevalence of community-associated methicillin-resistant Staphylococcus aureus (MRSA) infections, antibiotics with activity against community-associated MRSA, such as trimethoprim-sulfamethoxazole and clindamycin, may be preferred 4.
• The addition of oral nonsteroidal anti-inflammatory (NSAI) therapy to antibiotic treatment may hasten the resolution of cellulitis-related inflammation 5.
• A short course (5 days) of antibiotic therapy may be as effective as a standard course (10 days) for uncomplicated cellulitis 6.

Antibiotic Options

• Cephalexin: a commonly prescribed antibiotic for cellulitis, but may have lower success rates compared to trimethoprim-sulfamethoxazole 4.
• Trimethoprim-sulfamethoxazole: may be preferred in areas with a high prevalence of community-associated MRSA infections 4.
• Clindamycin: may be effective against community-associated MRSA infections and may have higher success rates compared to cephalexin in certain patient populations 4.
• Levofloxacin: a fluoroquinolone antibiotic that may be effective for uncomplicated cellulitis, with a short course (5 days) being as effective as a standard course (10 days) 6.