Which medications are used in the treatment of paronychia?

Updated: Oct 09, 2020
  • Author: Elizabeth M Billingsley, MD; Chief Editor: William D James, MD  more...
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Most paronychia infections can be managed without antibiotics; over-the-counter analgesics are usually sufficient. If cellulitis is present, however, then antibiotics are indicated. Although penicillin covers oral flora, it does not cover methicillin-resistant Staphylococcus aureus (MRSA). Trimethoprim and sulfamethoxazole (TMP/SMZ), doxycycline, or clindamycin may be considered to cover community-acquired MRSA and anaerobic organisms. Cephalexin may also be effective. Combination therapy with an intravenous agent that provides antimicrobial activity against staphylococci is used for inpatient therapy.

Chronic paronychial infections are usually managed with oral antifungals such as ketoconazole, itraconazole, or fluconazole. [43] Many of these agents require a prolonged course with monitoring of laboratory tests to avoid complications.

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