Management of Bacterial Paronychia

Initial Assessment and Conservative Management

• The American Academy of Dermatology recommends dilute vinegar soaks (50:50 dilution) to the affected nail fold twice daily, as well as topical antiseptics such as 2% povidone-iodine for conservative management of bacterial paronychia 1, 2

Antibiotic Therapy

• For moderate to severe bacterial paronychia, amoxicillin-clavulanate is preferred due to its broader coverage, including beta-lactamase producing organisms 3
• The British Journal of Dermatology notes that fungal infections, such as onychomycosis, present differently and require antifungal therapy rather than antibiotics, typically causing nail plate changes, discoloration, and dystrophy rather than acute inflammation of the nail fold 4, 5, 6