Bacterial nail infections are treated with topical or systemic antibiotic drugs, and/or incision and drainage of an abscess (pus pocket).
For bacterial nail infections without abscesses, your clinician may prescribe:
- warm water or antiseptic soaks (eg, chlorhexidine, povidone-iodine) x 10-15 minutes multiple times per day
- over the counter triple antibiotic ointment or mupirocin OR
- Prescription-only topical fusidic acid plus betamethasone valerate with topical gentamycin
For bacterial nail infections not responding to topical therapy, your clinician may prescribe one of the following oral antibiotics:
- dicloxacillin (250 mg four times daily)
- cephalexin (500 mg three to four times daily)
- trimethoprim/sulfamethoxazole (one to two double-strength tablets twice daily)
- clindamycin (300 to 450 mg four times per day
- doxycycline (100 mg twice daily)
For an abscess associated with a bacterial nail infection, your clinician will recommend an in-person office visit for incision and drainage of the abscess. You may or may not need antibiotic therapy after this procedure.
Infected ingrown nails may require a more extensive procedure involving partial or complete nail plate removal.