Empirical Selection of Antibiotics for Hand Infections

¹ From the Summer L. Koch Hand Surgical Service, Cook County Hospital, and Northwestern University Medical School, Chicago

Bacterial cultures and antibiotic sensitivity tests in a series of recent infections of the hand and forearm were analyzed. Staphylococci (58.6 per cent), beta hemolytic streptococci (12.1 per cent), and Escherichia coli (8.3 per cent) were the organisms most frequently isolated. Knowledge of the gram stain property of organism aids considerably in the empirical selection of antibiotics while awaiting positive identification and sensitivity reports. The possibility of encountering gram positive and gram negative organisms together in an acute infection is extremely small. More than 98 per cent of all gram positive organisms were sensitive to lincomycin, chloramphenicol, and methicillin. Empirical selections of antibiotics for unidentified gram negative organisms are less certain, but kanamycin showed statistical superiority (85.6 per cent). Penicillin for gram positive organisms and streptomycin for gram negative organisms had the highest rates of resistance.

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