{ "schema_version": 1, "kind": "condition", "id": "paronychia", "name": "Acute Paronychia", "category": "infectious", "sources": "NICE Clinical Knowledge Summaries: Paronychia - acute 2021 · Egyptian National Drug Formulary - Antimicrobial 2023 (fusidic acid monograph) · Egyptian National Drug Formulary - Antimicrobial 2023 (amoxicillin and clavulanate monograph) · No labelled dose - a procedure, not a medicine · Paronychia - StatPearls - NCBI Bookshelf (NBK544307); duration and paediatric dose from Cephalexin US label, SetID 0a24b6e5-6f13-44b4-93f4-47c86945cad2, section 2", "review_status": "reviewed", "verified_against": "Egyptian National Drug Formulary - Antimicrobial 2023 (fusidic acid monograph) · Egyptian National Drug Formulary - Antimicrobial 2023 (amoxicillin and clavulanate monograph) · No labelled dose - a procedure, not a medicine · Acute Paronychia - disease-level clinical article (paronychia-full.txt) · Acute Paronychia - disease-level clinical article (paronychia-clinical.txt)", "verified_date": "2026-08", "treatments": [ { "id": 1385, "generic": "Warm water soak and local care", "line": 1, "is_adjunct": false, "form": null, "strength_mg": null, "adult_dose": "Soak affected digit in warm water for 15-20 minutes three to four times daily", "adult_duration": "7 days or until resolved", "dose_source": "No labelled dose - a procedure, not a medicine", "rationale": "Warm water soaks are a non-drug measure that softens the skin and encourages the paronychia to drain spontaneously, and form the mainstay of care for early, non-fluctuant infection.", "cautions": [ "Do not attempt home drainage with non-sterile instruments.", "Seek urgent evaluation if red streaks extend up finger/toe (lymphangitis) or fever develops." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Soak affected digit in warm water 3-4 times daily under adult supervision", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [], "condition_id": "paronychia" }, { "id": 1386, "generic": "Referral & safety-netting (no drug therapy)", "line": 1, "is_adjunct": false, "form": null, "strength_mg": null, "adult_dose": null, "adult_duration": null, "dose_source": "Paronychia - disease-level clinical article (paronychia-full.txt)", "rationale": "Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.", "cautions": [ "RED FLAG - Refer to a hand surgeon when infection spreads to underlying tendons or is severe (debridement/washout/amputation may be needed).", "RED FLAG - Follow-up requirement within 24-48 hours after drainage to check for worsening infection is not mentioned" ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": null, "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [], "condition_id": "paronychia" }, { "id": 1384, "generic": "Amoxicillin + Clavulanic acid", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": 625.0, "adult_dose": "625 mg (500/125) three times daily or 1000 mg (875/125) twice daily", "adult_duration": "7 days", "dose_source": "Egyptian National Drug Formulary - Antimicrobial 2023 (amoxicillin and clavulanate monograph)", "rationale": "Amoxicillin-clavulanate is an oral antibiotic covering staphylococci and anaerobes, used when paronychia is more extensive or fails topical therapy; incision and drainage of any fluctuant abscess remains essential alongside it.", "cautions": [ "Contraindicated in history of penicillin anaphylaxis or amoxicillin/clavulanate-associated jaundice.", "Incision and drainage of fluctuant abscess remains essential alongside antibiotics.", "Reduce dose in severe renal impairment." ], "peds_mgkg_low": 25.0, "peds_mgkg_high": 45.0, "peds_max_mg": 1750.0, "peds_basis": "day", "peds_unit": "mg", "peds_note": "25-45 mg/kg/day (based on amoxicillin component) divided twice daily for 7 days", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": [ { "weight_kg": 10, "low_mg": 250, "high_mg": 450, "capped": false }, { "weight_kg": 20, "low_mg": 500, "high_mg": 900, "capped": false }, { "weight_kg": 30, "low_mg": 750, "high_mg": 1350, "capped": false }, { "weight_kg": 40, "low_mg": 1000, "high_mg": 1750, "capped": true } ], "brands": [ { "trade_name": "AUJED 625 MG 12 F.C. TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA TEC > JEDCO INT. CO. FOR PHARMACEUTICALS", "price_egp": 19.2, "pack_count": 12, "unit_price": 1.6, "strength_mg": 625.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "E-MOXCLAV 625MG 10 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 30.0, "pack_count": 10, "unit_price": 3.0, "strength_mg": 625.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DEXICLAVE 625 MG 12 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RAMEDA > NOVELL PHARMA", "price_egp": 37.5, "pack_count": 12, "unit_price": 3.12, "strength_mg": 625.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MAGNABIOTIC 625MG 8 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SEDICO", "price_egp": 37.0, "pack_count": 8, "unit_price": 4.62, "strength_mg": 625.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CLAVIMOX 625 MG 12 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO", "price_egp": 107.0, "pack_count": 12, "unit_price": 8.92, "strength_mg": 625.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CURAM 625MG 12 F.C.TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SANDOZ > NOVARTIS", "price_egp": 108.0, "pack_count": 12, "unit_price": 9.0, "strength_mg": 625.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AUGMENTIN 625 MG 10 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MUP > SMITHKLINE BEECHAM", "price_egp": 117.0, "pack_count": 10, "unit_price": 11.7, "strength_mg": 625.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CLAVOCILLIN 625 MG 10 DISPERSIBLE TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RAMEDA > ORGANOPHARMA", "price_egp": 31.5, "pack_count": null, "unit_price": null, "strength_mg": 625.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LARYNCLAVE 125/31 PD. FOR ORAL SUSP. 70ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MISR > AL ROWAD PHARMACEUTICAL INDUSTRIAL CO.", "price_egp": 8.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "MEGACLAVOX 156MG/5ML PD. FOR SUSP. 60 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CID", "price_egp": 8.0, "pack_count": null, "unit_price": null, "strength_mg": 156.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "paronychia" }, { "id": 1387, "generic": "Clindamycin", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": 300.0, "adult_dose": "Oral: 300–450 mg every 6 hours.", "adult_duration": "7 days", "dose_source": "Egyptian National Drug Formulary - Antimicrobial 2023", "rationale": "Oral lincosamide antibiotic providing anti-staphylococcal coverage for acute paronychia.", "cautions": [ "Hypersensitivity to clindamycin, lincomycin, or any component of the formulation.", "High risk of Clostridioides difficile-associated diarrhea (CDAD); discontinue if significant diarrhea occurs." ], "peds_mgkg_low": 20.0, "peds_mgkg_high": 40.0, "peds_max_mg": 1800.0, "peds_basis": "day", "peds_unit": "mg", "peds_note": "Oral: Infants, Children, and Adolescents: 8 to 20 mg/kg/day divided every 6 to 8 hours (or 20 to 40 mg/kg/day for severe infections, max 1800 mg daily).", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": [ { "weight_kg": 10, "low_mg": 200, "high_mg": 400, "capped": false }, { "weight_kg": 20, "low_mg": 400, "high_mg": 800, "capped": false }, { "weight_kg": 30, "low_mg": 600, "high_mg": 1200, "capped": false }, { "weight_kg": 40, "low_mg": 800, "high_mg": 1600, "capped": false } ], "brands": [ { "trade_name": "ADCOCLINDACE 300 MG 16 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ARAB DRUG COMPANY (ADCO)", "price_egp": 24.0, "pack_count": 16, "unit_price": 1.5, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CLINACYN 300MG 16 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA > EGYPTIAN PHARMACISTS COMPANY", "price_egp": 31.5, "pack_count": 16, "unit_price": 1.97, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CLINDAM 300 MG 16 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA > OCTOBER PHARMA", "price_egp": 75.0, "pack_count": 16, "unit_price": 4.69, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MEPACLIND 300MG 8 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEPACO", "price_egp": 38.0, "pack_count": 8, "unit_price": 4.75, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CLINDACINE ART 300 MG 12 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RAMEDA > ART PHARMA", "price_egp": 76.0, "pack_count": 12, "unit_price": 6.33, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ALFACLINDAMYCIN 300 MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ATCO PHARMA > ROTABIOGEN", "price_egp": 69.0, "pack_count": 10, "unit_price": 6.9, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DALACIN C 300MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PFIZER", "price_egp": 114.0, "pack_count": 10, "unit_price": 11.4, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "KLENDABIOTICAM 1 % TOP. SOLUTION", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PANAX PHARMA", "price_egp": 8.5, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "ADCOCLINDACE 10MG/ML TOP. SOL.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ARAB DRUG COMPANY (ADCO)", "price_egp": 12.0, "pack_count": null, "unit_price": null, "strength_mg": 10.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "paronychia" }, { "id": 1388, "generic": "Cefalexin", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": 500.0, "adult_dose": "500 mg three to four times a day", "adult_duration": "7 to 14 days", "dose_source": "Paronychia - StatPearls - NCBI Bookshelf (NBK544307); duration and paediatric dose from Cephalexin US label, SetID 0a24b6e5-6f13-44b4-93f4-47c86945cad2, section 2; paediatric ceiling from Egyptian National Drug Formulary - Antimicrobial 2023 (cephalexin monograph)", "rationale": "Acute paronychia is a staphylococcal infection, so the article's oral choice after failed topical treatment is a plain anti-staphylococcal agent. The card jumps straight to co-amoxiclav and clindamycin, which are the choices for suspected oral inoculation or anaerobic cover, not for the ordinary case.", "cautions": [ "Do not use it in anyone with known hypersensitivity to cephalexin or any other cephalosporin.", "It has no anaerobic cover - if the paronychia may have been seeded from the mouth, or the patient has MRSA risk factors, this is the wrong row." ], "peds_mgkg_low": 25.0, "peds_mgkg_high": 50.0, "peds_max_mg": 2000.0, "peds_basis": "day", "peds_unit": "mg", "peds_note": "Children: a total of 25 to 50 mg/kg a day in divided doses for 7 to 14 days. Maximum 2,000 mg a day (Egyptian National Drug Formulary - Antimicrobial 2023, cephalexin monograph).", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": [ { "weight_kg": 10, "low_mg": 250, "high_mg": 500, "capped": false }, { "weight_kg": 20, "low_mg": 500, "high_mg": 1000, "capped": false }, { "weight_kg": 30, "low_mg": 750, "high_mg": 1500, "capped": false }, { "weight_kg": 40, "low_mg": 1000, "high_mg": 2000, "capped": false } ], "brands": [ { "trade_name": "CEFLODIX 500 MG 12 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ARAB CAPS > PHAROPHARMA", "price_egp": 9.0, "pack_count": 12, "unit_price": 0.75, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CEPHALEXCID 500 MG 12 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CID", "price_egp": 10.3, "pack_count": 12, "unit_price": 0.86, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CEPHOXIN 500MG 12 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO B", "price_egp": 10.5, "pack_count": 12, "unit_price": 0.88, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CEPHALEXIN 500MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ARAB DRUG COMPANY (ADCO)", "price_egp": 10.1, "pack_count": 10, "unit_price": 1.01, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MEDICEFLEXIN 500 MG 20 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "T3A PHARMA > RIVA PHARMA S.A.E.", "price_egp": 25.25, "pack_count": 20, "unit_price": 1.26, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CEPHALEXIN 500MG 12 CAPS B.P.2007", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SHIFA MEDICAL PRODUCTS > OCTOBER PHARMA", "price_egp": 27.0, "pack_count": 12, "unit_price": 2.25, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "KEFLEX 500 MG 12 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "HIKMA PHARMA", "price_egp": 58.0, "pack_count": 12, "unit_price": 4.83, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CEPOREX 500MG 12 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLAXO SMITHKLINE", "price_egp": 69.0, "pack_count": 12, "unit_price": 5.75, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AMTHROST 125MG/5ML SUSP. 60ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA > SABAA", "price_egp": 4.0, "pack_count": null, "unit_price": null, "strength_mg": 125.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "AMTHROST 250MG/5ML SUSP. 60ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA > SABAA", "price_egp": 4.5, "pack_count": null, "unit_price": null, "strength_mg": 250.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "paronychia" }, { "id": 1383, "generic": "Fusidic acid", "line": 1, "is_adjunct": true, "form": "topical", "strength_mg": null, "adult_dose": "Apply 2% ointment or cream to affected nail fold two to three times daily after warm water soak", "adult_duration": "7 days", "dose_source": "Egyptian National Drug Formulary - Antimicrobial 2023 (fusidic acid monograph)", "rationale": "Fusidic acid is a topical antibiotic active against the Staphylococcus aureus that usually causes acute paronychia; it is used alongside warm soaks and drainage of any abscess, not as a substitute for drainage.", "cautions": [ "Perform incision and drainage if a fluctuant abscess is present.", "Avoid biting nails or picking cuticles.", "If infection spreads or fails to resolve within 7 days, initiate oral antibiotics." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Apply 2% cream or ointment 2 to 3 times daily for 7 to 14 days.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "FOSTINO 2% TOPICAL GEL 15 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ZAD", "price_egp": 8.0, "pack_count": null, "unit_price": null, "strength_mg": 15000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ANESTY 2% TOPICAL GEL 15GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MARCYRL PHARMACEUTICAL INDUSTRIES (MPI)", "price_egp": 8.5, "pack_count": null, "unit_price": null, "strength_mg": 15000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FUSIDIC ACID 2% GEL 15 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA", "price_egp": 8.5, "pack_count": null, "unit_price": null, "strength_mg": 15000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FUSIDICTAM 2 % TOP. CREAM 30 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEDIZEN PHARMACEUTICAL INDUSTRIES > MAGIC PHARMA-EGYPT", "price_egp": 26.5, "pack_count": null, "unit_price": null, "strength_mg": 30000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FUCI-TOP 2% CREAM 15 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "HIKMA PHARMA", "price_egp": 44.0, "pack_count": null, "unit_price": null, "strength_mg": 15000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FUCIDIN 2% CREAM 15 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MINA PHARM > LEO PHARMACEUTICAL PRODUCTS", "price_egp": 56.0, "pack_count": null, "unit_price": null, "strength_mg": 15000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FUCIDIN 2% CREAM 30 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MINA PHARM > LEO PHARMACEUTICAL PRODUCTS", "price_egp": 96.0, "pack_count": null, "unit_price": null, "strength_mg": 30000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FUCIDIN 2% OINTMENT 30 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MINA PHARM > LEO PHARMACEUTICAL PRODUCTS", "price_egp": 96.0, "pack_count": null, "unit_price": null, "strength_mg": 30000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "paronychia" } ] }