Nystatin and triamcinolone cream (Mytrex brand no longer available in the United States) Prolonged therapy over large body surface areas may suppress adrenal function if infection develops, discontinue use until infection is controlledĬombination antifungal agent and corticosteroid If infection develops and is not responsive to antibiotic treatment, discontinue use until infection is controlledīetamethasone valerate 0.1% solution or lotion (Beta-Val) Nausea, vomiting, rash, deposition in renal tubules, and central nervous system symptoms may occurĭosage adjustment recommended in patients with renal impairmentĪssociated with onset of hemolytic uremic syndrome Once or twice daily until clinical resolution (one month maximum)Ģ00 mg orally five times daily for 10 days Ketoconazole cream (Nizoral brand no longer available in the United States) Three or four times daily until clinical resolution (one month maximum) Three times daily until clinical resolution (one month maximum)Īvoid contact with eyes if irritation or sensitivity develops, discontinue use and begin appropriate therapy Twice daily until clinical resolution (one month maximum)Īvoid contact with eyes and mucous membranes One or two pastilles four times daily for seven to 14 daysĪdverse effects include nausea, vomiting, and diarrheaĬiclopirox topical suspension (Loprox TS) Nystatin (Mycostatin) 200,000-unit pastilles Hepatotoxicity and QT prolongation may occurĪntacids may reduce absorption edema may occur with coadministration of calcium channel blockers rhabdomyolysis may occur with coadministration of statins inhibition of cytochrome P450 hepatic enzymes may cause increased levels of many drugs Two to four times daily for five to 10 daysĪvoid contact with eyes may irritate mucous membranes resistance may result with prolonged useġ00 mg orally once daily for seven to 14 days Three or four times daily for five to 10 days Overgrowth of nonsusceptible organisms with prolonged use High doses may cause bone marrow depression discontinue therapy if significant hematologic changes occur caution in folate or glucose-6-phosphate dehydrogenase deficiencyīacitracin/neomycin/polymyxin B ointment (Neosporin) Trimethoprim/sulfamethoxazole (TMP/SMX Bactrim, Septra) *ġ60 mg/800 mg orally twice daily for seven days Alternatively, an eponychial marsupialization, with or without nail removal, may be performed.ĥ00 mg/125 mg orally three times daily for seven daysĭosage adjustment may be necessary in patients with renal impairment cross-sensitivity documented with cephalosporins diarrhea may occurĨ75 mg/125 mg orally twice daily for seven daysġ50 to 450 mg orally three or four times daily (not to exceed 1.8 g daily) for seven daysĪdjust dosage in patients with severe hepatic dysfunction associated with severe and possibly fatal colitis inform patient to report severe diarrhea immediately In recalcitrant chronic paronychia, en bloc excision of the proximal nail fold is an option. Topical steroid creams are more effective than systemic antifungals in the treatment of chronic paronychia. Application of emollient lotions may be beneficial. The patient should avoid exposure to contact irritants treatment of underlying inflammation and infection is recommended, using a combination of a broad-spectrum topical antifungal agent and a corticosteroid. Chronic paronychia is a multifactorial inflammatory reaction of the proximal nail fold to irritants and allergens. Treatment options for acute paronychia include warm compresses topical antibiotics, with or without corticosteroids oral antibiotics or surgical incision and drainage for more severe cases. This enables pathogens to inoculate the nail, resulting in infection. The main factor associated with the development of acute paronychia is direct or indirect trauma to the cuticle or nail fold. Paronychia may be classified as either acute or chronic. Paronychia is an inflammation of the folds of tissue surrounding the nail of a toe or finger.
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