Are Antibiotics Necessary in the Treatment of Locally Infected Ingrown Toenails?
Alexander M. Reyzelman, DPM;
Karla A. Trombello, DPM;
Dean J. Vayser, DPM;
David G. Armstrong, DPM;
Lawrence B. Harkless, DPM
Arch Fam Med. 2000;9:930-932.
Context A wide variety of generalists and specialists treat locally infected ingrown toenails, with perhaps the most common treatment regimen including resection of the nail border coupled with oral antibiotics.
Objective To determine whether oral antibiotic therapy is beneficial as an adjunct to the phenol chemical matrixectomy in the treatment of infected ingrown toenails.
Design We prospectively enrolled healthy patients with infected ingrown toenails. Each patient was randomly assigned to 1 of 3 groups that received either 1 week of antibiotics and a chemical matrixectomy simultaneously (group 1), antibiotics for 1 week and then a matrixectomy (group 2), or a matrixectomy alone (group 3).
Setting Institutional ambulatory outpatient clinic.
Patients Fifty-four healthy patients with infected ingrown toenails were studied. Patients with immunocompromised states, peripheral vascular disease, or cellulitis proximal to the hallux interphalangeal joint were excluded. Groups were age matched for comparison.
Results Mean healing times for groups 1, 2, and 3 were 1.9, 2.3, and 2.0 weeks, respectively. Subjects receiving antibiotics and a simultaneous chemical matrixectomy (group 1) healed significantly sooner than those receiving a 1-week course of antibiotics followed by a matrixectomy (group 2). There was not a significant difference in healing time between those that received a chemical matrixectomy alone (group 3) and those that received a matrixectomy coupled with a course of oral antibiotics (group 1).
Conclusion The use of oral antibiotics as an adjunctive therapy in treating ingrown toenails does not play a role in decreasing the healing time or postprocedure morbidity.
From the Department of Orthopedics, University of Texas Health Science Center at San Antonio.
The Archives of Family Medicine Continuing Medical Education Program
Arch Fam Med. 2000;9(9):887-891.
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J. Am. Podiatr. Med. Assoc. 2002;92:287-295.
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Antibiotics as an adjunct to phenol matrixectomy did not decrease healing time of ingrown toenails
Evid. Based Med. 2001;6:92-92.