Are antibiotics always needed for cutaneous abscesses?—Bonnie Keisler, MSN, CRNP, CWOCN, LDE, Birmingham, Ala.

The development of cutaneous abscesses is viewed as a commonplace complaint that can be found in pediatric and adult emergency department populations. Patients that present with the simple form of this condition can undergo an incision and drainage (I&D), which may or may not require a prescription for an antibiotic. Once this procedure is performed, the patient can be discharged. The performance of an I&D remains the standard course of treatment for addressing cutaneous abscesses.

Antibiotics can be recommended for abscesses that can be associated with a chronic or severe disease, the rapid progression in the presence of an associated cellulitis, signs and symptoms of a systemic illness, and when there is no response to incision and draining. Antibiotics do not always need to be used for cutaneous abscesses, but the condition and presentation must be evaluated on a case-by-case basis to make a final decision regarding the appropriate course of treatment for any individual. For more information, see the following references:

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  1. Liu C, et al. Clinical practice guidelines by the Infectious Diseases Society of America for the treatment of methicillin-resistant staphylococcus aureus infections in adults and children. Clin Infect Dis. 2011;52:e18-e55.
  2. Hankin A, Everett W. Are antibiotics necessary after incision and drainage of a cutaneous abscess? Ann Emerg Med. 2007;50:49-51.
  3. Schmitz G, et al. The treatment of cutaneous abscesses: comparison of emergency medicine providers’ practice patterns. West J Emerg Med. 2013;14:23–28. doi: 10.5811/westjem.2011.9.6856.

—Abimbola Farinde, PhD, PharmD 

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