Paronychia Organism-Specific Therapy 

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Organism-specific therapeutic regimens for paronychia are provided below, including those for methicillin-susceptible Staphylococcus aureus, methicillin-resistant S aureus, Streptococcus pyogenes, Pseudomonas aeruginosa, Eikenella corrodens, and Candida. ^{[1, 2, 3, 4, 5, 6, 7, 8, 9]}

Multiple organisms are common in paronychia ^[10] ; cultures may be obtained to identify the underlying cause.

See the list below:

Dicloxacillin 250 mg PO QID or

Cephalexin 500 mg PO TID/QID

See the list below:

Trimethoprim-sulfamethoxazole (160 mg/800 mg) 1 DS tablet PO BID or

Doxycycline 100 mg PO BID or

Clindamycin 300-450 mg PO TID

See the list below:

Amoxicillin-clavulanate (875 mg/125 mg) 1 tablet PO BID or

Penicillin V 500 mg PO BID/QID

See the list below:

Ciprofloxacin 500 mg PO BID

See the list below:

Amoxicillin-clavulanate (875 mg/125 mg) 1 tablet PO BID or

Trimethoprim-sulfamethoxazole (160 mg/800 mg) 1 DS tablet PO BID

See the list below:

Fluconazole 100 mg PO daily for 7-14d or

Itraconazole 200 mg PO BID for 7d

Murphy-Lavoie H, Haydel MJ. Paronychia in emergency medicine. Medscape Reference. Available at http://emedicine.medscape.com/article/785158-overview. Accessed: Oct 20, 2010.

Rigopoulos D, Larios G, Gregoriou G, Alevizos A. Acute and chronic paronychia. Am Fam Physician. Feb 1 2008. 77(3):339-46.

Tosti A, Piraccini BM, Ghetti E, Colombo MD. Topical steroids versus systemic antifungals in the treatment of chronic paronychia: an open, randomized double-blind and double dummy study. J Am Acad Dermatol. 2002 Jul. 47(1):73-6. [Medline].

Vidimos A, Billingsley EM. Dermatologic manifestations of paronychia. Medscape Reference. Available at http://emedicine.medscape.com/article/1106062-overview. Accessed: Jun 10, 2010.

Chanprapaph K, Vachiramon V, Rattanakaemakorn P. Epidermal growth factor receptor inhibitors: a review of cutaneous adverse events and management. Dermatol Res Pract. 2014. 2014:734249. [Medline]. [Full Text].

Relhan V, Goel K, Bansal S, Garg VK. Management of chronic paronychia. Indian J Dermatol. 2014 Jan. 59(1):15-20. [Medline]. [Full Text].

Shafritz AB, Coppage JM. Acute and chronic paronychia of the hand. J Am Acad Orthop Surg. 2014 Mar. 22(3):165-74. [Medline].

Rabarin F, Jeudy J, Cesari B, Petit A, Bigorre N, Saint-Cast Y, et al. Acute finger-tip infection: Management and treatment. A 103-case series. Orthop Traumatol Surg Res. 2017 Oct. 103 (6):933-936. [Medline].

Gupta AK, Foley KA, Versteeg SG. New Antifungal Agents and New Formulations Against Dermatophytes. Mycopathologia. 2017 Feb. 182 (1-2):127-141. [Medline].

Leggit JC. Acute and Chronic Paronychia. Am Fam Physician. 2017 Jul 1. 96 (1):44-51. [Medline].

Elizabeth M Billingsley, MD Professor of Dermatology, Pennsylvania State University College of Medicine; Director, Mohs Micrographic Surgery, Penn State Hershey Medical Center

Elizabeth M Billingsley, MD is a member of the following medical societies: American Academy of Dermatology, American College of Mohs Surgery, Association of Professors of Dermatology, Council for Nail Disorders, Pennsylvania Academy of Dermatology

Disclosure: Nothing to disclose.

Jasmeet Anand, PharmD, RPh Adjunct Instructor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Thomas E Herchline, MD Professor of Medicine, Wright State University, Boonshoft School of Medicine; Medical Consultant, Public Health, Dayton and Montgomery County (Ohio) Tuberculosis Clinic

Thomas E Herchline, MD is a member of the following medical societies: Alpha Omega Alpha, Infectious Diseases Society of America, Infectious Diseases Society of Ohio

Disclosure: Nothing to disclose.

Paronychia Organism-Specific Therapy 

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