Evidence-based medicine| Volume 35, ISSUE 1, P125-128, January 2010

Empiric Antibiotics for Acute Infections of the Hand

      A 40-year-old right-handed man employed as a laborer presents with a 7-day history of progressive pain, erythema, and swelling over the volar surface of the index finger. On history taking, the patient notes incurring a small superficial laceration over the same area of his finger 10 days previously. He was given a prescription for cephalexin and discharged home. He returned 3 days later with worsening symptoms including swelling, fluctuance, and tenderness with manipulation of the finger. He had incision and drainage, and intraoperative cultures were identified to be methicillin-resistant Staphylococcus aureus (MRSA).
      • List the most common pathogenic organisms in the hand.
      • Describe the risk factors of MRSA infections.
      • State the Center for Disease control recommendations regarding empiric coverage for MRSA.
      • List the antibiotics effective in treating MRSA.
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