Established hand infections: a controlled, prospective study

J Hand Surg Am. 1983 Sep;8(5 Pt 1):553-9. doi: 10.1016/s0363-5023(83)80124-5.


A randomized, prospective study of 200 consecutive established hand infections was designed to compare the efficacy of two antibiotics, cefamandole and nafcillin. Bacteriologic data revealed 63.5% of the patients grew multiple organisms (2.3 organisms per culture) and 26% of the patients had anaerobic infections. Complications were noted in 13% of all patients--26% in patients who grew aerobes and anaerobes and 9.8% in patients who grew aerobes alone (p less than 0.05). Despite the fact that 95% of all organisms were sensitive in vitro to cefamandole whereas only 67% of organisms were sensitive to nafcillin (p less than 0.01), complications occurred more frequently in patients treated with cefamandole. We conclude that the empirical selection of a broad-spectrum antibiotic is reasonable based on in vitro sensitivity studies; however, other factors such as treatment delay, initial extent of infection, anatomic location of infection, cause of infection, and extent of surgical debridement are important in the development of complications.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Bacteria, Anaerobic
  • Bacterial Infections / drug therapy*
  • Cefamandole / therapeutic use*
  • Clinical Trials as Topic
  • Female
  • Hand Dermatoses / drug therapy*
  • Humans
  • Male
  • Middle Aged
  • Nafcillin / therapeutic use*
  • Prospective Studies
  • Random Allocation
  • Skin Diseases, Infectious / drug therapy*
  • Staphylococcal Infections / drug therapy
  • Streptococcal Infections / drug therapy


  • Nafcillin
  • Cefamandole