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Can CLINDAMYCIN treat ECOLI, MRSA infection in thumb?

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I have bad infection under thumbnail (it was caught in truck door in November) and this last wedensday I had to go to the ER and they took of the old nail and there was an absess and they took swabs and cleaned it up and put me on clindamycin. Then on Saturday I had more pus under the new nail growing and so went back to the ER and the dr just told me to soak it in salt water and then drain it myself, which I did successfully. The ER called yesterday morning to say my swabs came back for Ecoli and MRSI Staph infection and to get off clindamycin and on another antibiotic and get thumb checked.

Saw family doctor yesterday and he said that my thumb looks like it is healing- no pus- so shouldn't need to go on any antibiotics now. My thumb also doesn't hurt anymore. He gave me sulfatrim just incase. I took them these past 2 days and having side effects from them, dizzy, fatigue, sore throat, achy and nose bleeds and fever. Should I just stay off the antibiotics if my thumb looks like it is clearing up and not sore?  I am confused as this one doctor said I shouldn't need to go on them now that the pus is gone. Since the pus was drained again on Saturday I haven't felt any pain, swelling, redness or pus so would the infection be gone? Or should I stay on antibiotics? I am getting mixed messages from different doctors. Also can I go in the ocean with my thumb- got mixed messages from doctors about that too some saying yes some saying no? (North pacific ocean).  Thanks so much. 

Category: Family Physician-GP

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Category: HIV- AIDS Specialist
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Hello,
Thank you for posting your query at DoctorSpring.com
I saw the pics.
The infection has subsided.
As the pus has drained, there is no need of Antibiotics.
It's better not to immerse that hand in water.
If redness appears, you can start Antibiotic like Linezolid along with anti inflammatory tablet.
Nothing to worry.
It will come down.
Hope I answered your query. If you have any questions, I will clarify further.
Wish you good health.
Regards


Patient replied :

Hi I am worried my infection came back in under thumb nail it was looking fine but now yellow white pus again under it but I can't get it out. however, it is not painful or red it feels fine. A little pus came out last night when I pushed on it. Should i not be concerned since it doesn't hurt. The only reason I would worry is that the pus that they sampled from my thumb nail came back MRSA Staph and Ecoli. They put me on clindamycin but then off because it is resistant then the infection looked gone so they said no antibtioctics but gave me sulfatrim just incase I took that anyway and had bad adverse reactions to that antibitoic. Thanks


Hello,
Infection might have come back due to inadequate drainage or inadequate dose of antibiotics. I would suggest you to get the pus drained again and start with antibiotics like vancomycin and linezolid at least for 10 days.
Do write back if you have any questions.
Thanks


Patient replied :

Ok thanks. I got a really bad yeast infection from the 4 days I was on clindamycin and it still hasn't gone a way a way so I am skeptical to go back on antibiotics again. Can I drain this myself or can I wait a few days to see if it dissappears? Is there any at home remedies I can do?


Hello,
It is better if the drainage is done under aseptic conditions.
So, your surgeon can drain it for you with some local antibiotic cover.
You can apply Mupirocin ointment locally too, if he feels there is need after the drainage.
Local ointment won't cause any fungal infections.
Hope this was helpful,
Regards.


Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
Experience: 
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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