Antibiotics for a paronychia infection

A prescriber chooses treatment after checking the extent of redness, the presence of an abscess, possible injury and health factors that affect healing. Antibiotics should not be started from an old supply because the drug and dose may be unsuitable.

The cuticle normally seals the space between nail and skin. Picking, biting, trimming, manicure trauma, an ingrown nail or a small splinter can break that seal and allow bacteria into the fold.

Early infection can cause focused tenderness, redness and swelling. As pus gathers, pain may become more pronounced and the area can look pale or yellow. Infection extending beyond the fold may present with expanding warmth and redness in the finger or toe.

Keep the affected digit raised when practical, use warm soaks if advised, and dry around the nail carefully. Avoid tight shoes for an affected toe and pause manicures, artificial nails and cuticle work until the fold has recovered.

If drainage is performed, follow the dressing and cleaning instructions given. Complete prescribed treatment as directed unless the prescriber tells you to stop, and seek advice if vomiting prevents doses or troublesome side effects develop. Do not press a sharp object into the fold.

Arrange urgent assessment if swelling becomes tense, pain escalates, pus re-forms, redness spreads, red lines track up the limb, or you develop fever or chills. Numbness, a dusky colour, inability to bend the digit or severe pain after an injury also require rapid examination.

Do not delay an examination when immune defences, circulation or blood glucose control are impaired. For hives with throat tightness, wheezing or collapse after an antibiotic, contact emergency services immediately.

Discuss whether pus needs releasing, whether a wound or ingrown nail changes management, how dressings should be handled, what medicine reactions to watch for, and when the digit should be checked again.