Established hand infections: a controlled, prospective study.
A randomized, prospective study of 200 consecutive established hand infections was designed to compare the efficacy of two antibiotics, cefamandole and nafcillin. Bacteriologic data revealed 63.5% of the patients grew multiple organisms (2.3 organisms per culture) and 26% of the patients had anaerobic infections. Complications were noted in 13% of all patients--26% in patients who grew aerobes and anaerobes and 9.8% in patients who grew aerobes alone (p less than 0.05). Despite the fact that 95% of all organisms were sensitive in vitro to cefamandole whereas only 67% of organisms were sensitive to nafcillin (p less than 0.01), complications occurred more frequently in patients treated with cefamandole. We conclude that the empirical selection of a broad-spectrum antibiotic is reasonable based on in vitro sensitivity studies; however, other factors such as treatment delay, initial extent of infection, anatomic location of infection, cause of infection, and extent of surgical debridement are important in the development of complications.
D000293:Adolescent; D000328:Adult; D000368:Aged; D001421:Bacteria, Anaerobic; D001424:Bacterial Infections / Q000188:drug therapy*; D002435:Cefamandole / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D005260:Female; D006229:Hand Dermatoses / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009254:Nafcillin / Q000627:therapeutic use*; D011446:Prospective Studies; D011897:Random Allocation; D012874:Skin Diseases, Infectious / Q000188:drug therapy*; D013203:Staphylococcal Infections / Q000188:drug therapy; D013290:Streptococcal Infections / Q000188:drug therapy
D009254:Nafcillin; D002435:Cefamandole