Paronychia are one of the most frequent causes of consultation for hand infections [1]. Two stages are described in the absence of complication: the phlegmonous stage (periungual inflammation) and the purulent stage [2] (periungual, subungual collection, or felon). In case of collection (Fig. 1), treatment consists of drainage and excision of infected tissues [[2], [3], [4]]. However, in case of risk factors, delayed management, or inadequate treatment, severe complications can occur, potentially leading to amputation [5].

Despite its frequency, the management of paronychia remains poorly standardized. Most guidelines address abscesses in general, leaving key decisions—such as antibiotic use and sampling—to clinician discretion [6,7]. The rise of antimicrobial resistance has further challenged postoperative antibiotic strategies.

Staphylococcus aureus (S. aureus) is the main pathogen involved [[8], [9], [10], [11], [12], [13]], though sampling practices and resistance profiles remain inconsistently reported.

The primary objective of this study was to observe patient characteristics and management strategies in two separate centres (hereafter referred to as Centre 1 and Centre 2). The secondary objective was to evaluate the impact of bacteriological sampling and perioperative antibiotic therapy to propose a treatment decision tree.