Flexor tendon sheath infection | Right Decisions

Please update your RDS mobile app to version 4.7.1

We are pleased to advise that deep linking capability, enabling users to directly download individual mobile toolkits, has now been released on the RDS mobile app. When you install the update, you will see that each toolkit has a small QR code icon the header area beside the search icon – see screenshot below. Clicking on this icon will open up a window with a full-size QR code and the alternative of a short URL for sharing with users. Instructions are provided.

You may need to actively install the update to install RDS app version 4.7.1 to see this improvement. Installing this update is also strongly recommended to get the full benefits of the new contingency arrangements – specifically, that if the RDS website should fail, you will still be able to download new mobile app toolkits.

To check your current RDS version, click on the three dots bottom right of the RDS app screen. This takes you to a “More” page where you will see the version number. To install latest updates:

On iPhones – go to the Apple store, click on your profile icon top right, scroll down to see the apps waiting to be updated and update the RDS app.

On Android phones – these can vary, but try going to the Google Play store, click on your profile icon top right, click on “Manage apps and device”, select and update the RDS app.

Please get in touch with ann.wales3@nhs.scot with any questions.

Required Investigations

FBC, U+E, LFT, CRP

Blood cultures
Wound swabs

Antibiotic Recommendations

Continue IV therapy for 24 hours after final washout/clinical improvement
Total duration: 7 days

Recommended antimicrobials

Co-amoxiclav 1.2g every 8 hours IV

Penicillin allergy or known MRSA

Vancomycin IV (use NHS Lothian Calculator located on AMT Intranet page)

AND

Metronidazole 400mg every 8 hours orally

AND

Gentamicin IV (use NHS Lothian Calculator located on AMT Intranet page), review and revise with microbiology results at 48-72 hours

IV to oral switch

Antimicrobial recommendations

Co-amoxiclav 625mg every 8 hours orally

Penicillin allergy or known MRSA

Doxycycline 100mg every 12 hours orally

AND

Metronidazole 400mg every 8 hours orally

In people who inject drugs, due to high rates of resistance to doxycycline in Group A Streptococci, check microbiology sensitivity results, and consider discussing with microbiology, an alternative in drug users may be:

Clindamycin 600mg every 8 hours orally