What are the recommended first-line treatments for an ingrown toenail in adults?

Recommended first-line treatments for an ingrown toenail in adults typically include conservative measures such as proper nail care, soaking the affected toe in warm water, and avoiding tight footwear to reduce pressure on the nail. If there is evidence of infection, oral antibiotics may be prescribed, with flucloxacillin as the first-choice antibiotic for mild infections, dosed at 500 mg to 1 g four times daily for 7 days, adjusting duration based on clinical response. Alternative antibiotics include clarithromycin, erythromycin (in pregnancy), or doxycycline if flucloxacillin is unsuitable. For more severe infections, intravenous antibiotics may be required initially, with review at 48 hours to consider switching to oral therapy. Specialist referral should be considered if the infection worsens or does not improve within 1 to 2 days, or if systemic illness develops. Surgical intervention may be necessary if conservative treatment fails or if there is significant nail deformity or chronic infection, but this is beyond first-line management.

Note: The provided guideline context primarily addresses diabetic foot infections and does not specifically detail ingrown toenail management; however, antibiotic recommendations for mild foot infections can be extrapolated to infected ingrown toenails in adults without diabetes or severe complications.