Emergent hand surgery consult in ED
Antibiotics for most common skin pathogens Strep and Staph (start immediately if suspected but consider obtaining wound culture if any spontaneous drainage is present)
Vancomycin 1gm IV q12hr AND
Ampicillin/Sulbactam 1.5gm IV q6h OR cefoxitin 2gm IV q8h OR Piperacillin/Tazobactam 3.375gm IV q6h
Vancomycin 1gm IV q12hr AND
Ampicillin/Sulbactam 1.5gm IV q6h OR cefoxitin 2gm IV q8h OR Piperacillin/Tazobactam 3.375gm IV q6h
Special Antibiotic Considerations
Diabetic Patients ensure you have Pseudomonal Coverage by using Piperacillin/Tazobactam rather than Ampicillin/Sulbactam or cefoxitin
Marine Exposure consider adding a Fluroquinolone, Sulfamethoxazole/Trimethoprim or Doxycycline to cover common marine organisms
Diabetic Patients ensure you have Pseudomonal Coverage by using Piperacillin/Tazobactam rather than Ampicillin/Sulbactam or cefoxitin
Marine Exposure consider adding a Fluroquinolone, Sulfamethoxazole/Trimethoprim or Doxycycline to cover common marine organisms
Flexor tenosynovitis
Bed bugs
Medial epicondylitis
Closed fist infection 
Lateral epicondylitis
Digital Mixoid Cyst 
Olecranon bursitis 
Hand cellulitis