What Is the Treatment of Skin Abscess? A Structured Evidence-Based Approach
Clinical Scenario
Skin abscess is a localised collection of pus requiring prompt management. Treatment decisions hinge on whether systemic signs of infection are present and on the likely causative organism, particularly S. aureus and its susceptibility profile.
Key Consideration
The presence of systemic inflammatory response — such as fever, tachycardia, tachypnoea, or an abnormal white blood cell count — directly shapes the decision to add systemic antibiotic therapy alongside procedural management.
Treatment Approach
Management combines a procedural intervention with systemic antibiotic therapy targeting S. aureus. The antibiotic choice differs depending on whether methicillin-susceptible or methicillin-resistant organisms are suspected or confirmed.
Full regimen details, drug selection, and clinical decision algorithm available in the complete protocol ↓
References
- The decision to administer antibiotics directed against S. aureus as an adjunct to incision and drainage should be made based on the presence or absence of systemic inflammatory response syndrome (SIRS) such as temperature >38°C or <36°C, tachypnea >24 breaths per minute, tachycardia >90 beats per minute, or white blood cell count >12 000 or <400 cells/µL (moderate; Figure 1) (strong, low).
- Moderate infection: patients with purulent infection with systemic signs of infection.
DOI: 10.1093/cid/ciu296
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