A 25-year-old man comes to the office due to right hand pain and swelling. He injured the skin over his right knuckles when he punched a man in the teeth during a bar fight 3 days ago. The patient ignored the wound initially, but his hand became more painful and swollen yesterday. He has no medical history and takes no medications. The patient received a tetanus toxoid vaccination at age 18. Temperature is 37.3 C (99.1 F), blood pressure is 120/70 mm Hg, and pulse is 78/min. There are small lacerations over the right third and fourth metacarpophalangeal joints with surrounding erythema, swelling, and tenderness. No discharge or crepitus is present. Hand radiographs reveal no foreign body or bone/joint changes. Cultures are obtained. Which of the following empiric antibiotics is most appropriate for this patient?
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This scenario is highly suggestive of a "fight bite," which is a type of injury that occurs when the skin over the knuckles is broken from hitting another person's teeth. These injuries are at high risk for infection due to the introduction of oral flora into the Show moreā¦
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