From the Guidelines
For a hand infection, empiric antibiotic treatment typically includes cephalexin 500mg orally four times daily for 7-10 days, as recommended by the most recent guidelines 1. This antibiotic targets Staphylococcus aureus and Streptococcus species, the most common causes of hand infections.
- The choice of antibiotic may vary depending on the severity of the infection and the presence of specific pathogens, such as MRSA.
- If MRSA is suspected, consider clindamycin 300-450mg orally four times daily or trimethoprim-sulfamethoxazole (TMP-SMX) DS tablet twice daily, as suggested by the Infectious Diseases Society of America guidelines 1.
- Hand infections often require more than just antibiotics - incision and drainage may be necessary for abscesses, and elevation of the hand above heart level helps reduce swelling.
- Warm compresses applied 3-4 times daily for 20 minutes can improve blood flow to the area.
- It is essential to seek immediate medical attention if you notice red streaking up the arm, increasing pain, fever, or if symptoms don't improve within 48 hours of starting antibiotics, as these may indicate a worsening infection that could lead to serious complications like tendon damage or sepsis.
- The most recent guidelines from the WHO Expert Committee recommend amoxicillin-clavulanic acid, cloxacillin, and cefalexin as first-choice antibiotics for mild skin and soft tissue infections, including hand infections 1.
From the FDA Drug Label
Clindamycin is indicated in the treatment of serious infections caused by susceptible anaerobic bacteria. Clindamycin is also indicated in the treatment of serious infections due to susceptible strains of streptococci, pneumococci, and staphylococci Anaerobes: Serious skin and soft tissue infections
Antibiotics used to treat hand infections:
- Clindamycin may be used to treat serious skin and soft tissue infections, which can include hand infections, as it is effective against susceptible anaerobic bacteria, streptococci, pneumococci, and staphylococci 2.
- Cephalexin may also be considered for the treatment of bacterial infections, but the label does not specifically mention hand infections 3.