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 Bacteriologic studies should be performed to determine the causative organisms and their susceptibility to clindamycin
The best antibiotic for an infected ingrown toenail is not directly stated in the provided drug labels. However, based on the information provided, clindamycin may be considered for the treatment of serious skin and soft tissue infections, including those caused by susceptible strains of staphylococci, which are commonly associated with infected ingrown toenails 1.
- Key considerations:
- Bacteriologic studies should be performed to determine the causative organisms and their susceptibility to clindamycin.
- The use of clindamycin should be reserved for penicillin-allergic patients or other patients for whom, in the judgment of the physician, a penicillin is inappropriate.
- The risk of colitis associated with clindamycin should be considered, and less toxic alternatives should be evaluated before selecting clindamycin.
From the Research
For an infected ingrown toenail, the most effective treatment approach is a combination of oral antibiotics and non-pharmacological interventions, with a focus on preventing the spread of infection and promoting healing. The choice of antibiotic should be guided by the most recent and highest quality evidence, which suggests that antibiotics such as cephalexin or amoxicillin-clavulanate are effective first-line treatments 2. However, it's essential to note that antibiotics alone are not sufficient treatment, and patients should also soak the foot in warm water with Epsom salt for 15-20 minutes several times daily, keep the area clean and dry, wear open-toed shoes or sandals to reduce pressure, and avoid cutting the nail themselves. Some key points to consider when treating an infected ingrown toenail include:
- The use of oral antibiotics such as cephalexin (500mg four times daily for 7-10 days) or amoxicillin-clavulanate (875/125mg twice daily for 7-10 days) as first-line treatments
- Clindamycin (300mg four times daily) as an alternative for those with penicillin allergies
- The importance of non-pharmacological interventions, such as soaking the foot in warm water with Epsom salt and keeping the area clean and dry
- The need to seek medical attention promptly if the infection shows signs of spreading or doesn't improve within 2-3 days of antibiotic treatment
- Prevention strategies, including proper nail trimming straight across, wearing properly fitting shoes, and good foot hygiene, as discussed in 3 and 4. It's also worth noting that the use of antibiotics as an adjunctive therapy in treating ingrown toenails does not play a significant role in decreasing the healing time or postprocedure morbidity, as found in 5. Overall, the treatment of an infected ingrown toenail requires a comprehensive approach that takes into account the most recent and highest quality evidence, as well as the individual patient's needs and circumstances.