Impact of Methicillin-Resistant Staphylococcus aureus on Treatment of Hand Infections

Objective: With the increasing incidence of methicillin-resistant Staphylococcus aureus (MRSA) in hand infections in urban centers, multiple studies have recommended using MRSA-effective antibiotics as first-line treatment of hand infections. This study assesses the effect of adopting this recommendation for the treatment of hand infections at the authors' hospital. Methods: Patients with hand infections drained in the authors' hospital were prospectively enrolled in an observational study over a 12-month period. Culture results and response to treatment were recorded. Results: Twenty-two patients met inclusion criteria. Eleven of 14 patients with S aureus infections had MRSA. All of these patients responded to the initial antibiotic selected. Two patients had infections that did not respond to trimethoprim-sulfamethoxazole. One grew group A Streptococcus infection, and the other had lymphangitic streaking that suggested Streptococcus infection. Conclusion: Because of the high prevalence of MRSA among hand infections at the authors' institution, we continue to prescribe MRSA-effective antibiotics as first-line treatment of hand abscesses. Close follow-up is still necessary to confirm that each patient has responded appropriately to treatment or to allow modification of the treatment plan if the patient has not responded to treatment.