From the Guidelines
For an 18-year-old with worsening paronychia, the recommended cefalexin dose is 500 mg orally twice daily, as the maximum dose per dose is 500 mg, and the typical dosing frequency for adults is twice daily, as seen in other antibiotic regimens for similar infections 1. When treating paronychia, it's essential to consider the severity of the infection and the potential causative pathogens, which often include Staphylococcus aureus and Streptococcus species.
- Key aspects of treatment include:
- Antibiotic therapy with cefalexin, which works by inhibiting bacterial cell wall synthesis
- Warm soaks 3-4 times daily for 15 minutes to help reduce pain and swelling
- Proper drainage if there is a collection of pus
- Keeping the affected area clean and dry between soaks
- Avoiding manipulation of the nail
- Pain management with acetaminophen or ibuprofen as needed Given the potential for complications, such as spreading infection, it's crucial to monitor the patient's symptoms and seek prompt medical reevaluation if there's no improvement within 48-72 hours of starting antibiotics or if signs of worsening infection appear, such as increasing redness, streaking, or fever. The choice of cefalexin is based on its efficacy against common bacterial causes of paronychia and the patient's age, assuming no penicillin allergy, as the provided evidence does not directly address paronychia treatment but offers guidance on antibiotic dosing for similar infections 1.
From the FDA Drug Label
Adults The adult dosage ranges from 1 to 4 g daily in divided doses. The usual adult dose is 250 mg every 6 hours For the following infections, a dosage of 500 mg may be administered every 12 hours: streptococcal pharyngitis, skin and skin structure infections, and uncomplicated cystitis in patients over 15 years of age.
For an 18-year-old with paronychia worsening, the recommended dose is 500 mg every 12 hours, as paronychia is a type of skin and skin structure infection. 2
From the Research
Cefalexin Dose for Paronychia
- The provided studies do not specify the exact dose of cefalexin for an 18-year-old with paronychia 3, 4, 5, 6, 7.
- According to the studies, oral antibiotics are usually not needed if adequate drainage is achieved unless the patient is immunocompromised or a severe infection is present 3.
- The treatment of paronychia typically involves warm soaks, topical antibiotics, and topical steroids 3, and in some cases, surgical intervention may be necessary 4, 7.
- There is no direct mention of cefalexin dosage in the provided studies, suggesting that the treatment approach may vary depending on the severity and type of paronychia, as well as the presence of any underlying conditions 3, 4, 5, 6, 7.