Hand infections in Jamaica.
Empirical antibiotic treatment for hand infections is changing to single antibiotic therapy against Staphylococcus aureus in immunocompetent patients. Fifty-one patients treated surgically for hand infections were reviewed to assess the nature of infection in terms of site, organism, mechanism of injury, and antibiotic sensitivity of the organisms. Twenty-three per cent of patients had diabetes mellitus and were noted to be older than non-diabetics. Eighty-four per cent of non-diabetic patients had single organism infections, 59% involving S aureus. Fifty per cent of diabetic patients had multi-organism infection caused by gram positive and gram negative organisms. Patients stuck with a piece of wood also had multi-organism infections. Double antibiotic therapy is therefore advocated for patients with diabetes mellitus and all patients who had hand infections as a result of being stuck with a piece of wood. All others should have single antibiotic therapy with amoxycillin and clavulanic acid.
Mansingh
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Division of Orthopaedics, Department of Surgery, Radiology, Anaesthesia and Intensive Care, University of the West Indies, Kingston 7, Jamaica. amansingh@uhwi.org.jm
Sawh
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DM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000188:drug therapy* / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D048909:Diabetes Complications; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D005260:Female; D006230:Hand Injuries / Q000150:complications / Q000382:microbiology* / Q000601:surgery; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007563:Jamaica; D007709:Klebsiella / Q000302:isolation & purification; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D012189:Retrospective Studies; D013211:Staphylococcus aureus / Q000302:isolation & purification
D000900:Anti-Bacterial Agents