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Empirical Selection of Antibiotics for Hand Infections
NELSON H. STONE; HESTER HURSCH; CHARLES R. HUMPHREY; JOHN A. BOSWICKJR.
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From the Summer L. Koch Hand Surgical Service, Cook County Hospital, and Northwestern University Medical School, Chicago
1969 by The Journal of Bone and Joint Surgery, Incorporated
The Journal of Bone & Joint Surgery.  1969; 51:899-903 
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Abstract

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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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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