Flexor tendon sheath infection

Antimicrobial prescribing: NHS Lothian
NHS Lothian

Required Investigations

FBC, U+E, LFT, CRP

  • Blood cultures
  • Wound swabs

 

Antibiotic Recommendations

Continue IV therapy for 24 hours after final washout/clinical improvement  
Total duration: 7 days

Recommended antimicrobials Co-amoxiclav 1.2g every 8 hours IV
Penicillin allergy or known MRSA

Vancomycin IV (use NHS Lothian Calculator located on AMT Intranet page)

AND

Metronidazole 400mg every 8 hours orally

AND

Gentamicin  IV (use NHS Lothian Calculator located on AMT Intranet page), review and revise with microbiology results at 48-72 hours

 

IV to oral switch

Antimicrobial recommendations Co-amoxiclav  625mg every 8 hours orally

Penicillin allergy or known MRSA

Doxycycline  100mg every 12 hours orally

AND

Metronidazole 400mg every 8 hours orally

In people who inject drugs, due to high rates of resistance to doxycycline in Group A Streptococci, check microbiology sensitivity results, and consider discussing with microbiology, an alternative in drug users may be:

Clindamycin 600mg every 8 hours orally