SA Orthopaedic Journal
Print version ISSN 1681-150X
Infection is one of the most serious and important causes of hand swelling. Neglect or incomplete treatment of hand infections will usually lead to involvement of other parts of the hand resulting in stiffness, loss of hand function, and possibly amputation (Figure 1). Hand infections are common conditions that have significant morbidity. Referral is often delayed and infections present late. Hand infections should be managed by an experienced surgeon. The aims of the investigation were: to identify the spectrum of organisms and appropriate antibiotics for hand infection; and to characterise the patterns and sites of hand infections. This information was collected against the background of a high prevalence of HiV-infected patients and increasing antibiotic resistance. A total of 66 patients treated for hand infections over a period of six months in Pelonomi Hospital, Bloemfontein, South Africa, was prospectively recruited for the study. Staphylococcus aureus was the commonest isolate. Results show that cloxacillin is still an effective first line antibiotic for community-acquired hand infections in the absence of immunosuppression. Alternative empiric therapy would be clindamycin - especially in the beta-lactam intolerant patient. Erythromycin also proved to have a favourable profile. HIV-positive patients were more prone to Gram-negative infections.
Keywords : Hand; infection; bacteriology; epidemiology; antibiotics.