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Paronychia Organism-Specific Therapy

Specific Organisms and Therapeutic Regimens

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.

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

Methicillin-susceptible Staphylococcus aureus (MSSA)

See the list below:

Dicloxacillin 250 mg PO QID or

Cephalexin 500 mg PO TID/QID

Methicillin-resistant S aureus (MRSA)

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

Streptococcus pyogenes

See the list below:

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

Penicillin V 500 mg PO BID/QID

Pseudomonas aeruginosa

See the list below:

Ciprofloxacin 500 mg PO BID

Eikenella corrodens

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

Candida (if unresponsive to topical antifungals)

See the list below:

Fluconazole 100 mg PO daily for 7-14d or

Itraconazole 200 mg PO BID for 7d

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