Retreatment of Previously Treated Hand Infections

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Abstract
Presenting patient profiles and bacteriologic culture and sensitivity data from 132 patients representing a 5-yr experience with hand infections were examined. Patients were subdivided into those having no prior treatment and those having previously been treated with antibiotics. Presenting patient profiles showed the majority of patients to be young to middle-aged males. Temperature, pulse and white blood cell counts, while usually mildly elevated, were usually not diagnostic. In comparison with patients not having been previously treated, patients having already received antibiotics with persistant or recurrent infections showed more of a tendency toward mixed infections. Anaerobic, mycobacterial and fungal infections were also increased. Antibiotic susceptibility studies showed the cephalosporins and clindamycin maintain a reasonably good coverage (78% and 72%, respectively). Penicillinase-resistant antibiotics also provided some coverage in 2/3 of patients. Proper antibiotic therapy may depend on several factors including previous treatment. Other measures of surgical drainage when appropriate, elevation, compresses and splinting remain important.

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