Abscesses are walled off collections of pus in soft tissue, with Staphylococcus aureus (both sensitive and resistant to methicillin) being the microbe most frequently involved. Most uncomplicated abscesses should undergo incision in the emergency department using local analgesia or procedural sedation, complete drainage and appropriate follow-up. Evidence suggests that antibiotics are not routinely required after abscess incision and drainage of an uncomplicated abscess. Physicians should not prescribe antibiotics for these patients, unless the patients are immunocompromised, systemically ill, or exhibit extensive surrounding cellulitis or lymphangitis.

Conditions: Skin Abscess, Infection

Procedures: Incision and Drainage (I and D)

Treatments: Antibiotics

Sources

• Duong M, Markwell S, Peter J, Barenkamp S. Randomized, controlled trial of antibiotics in the management of community-acquired skin abscesses in the pediatric patient. Ann Emerg Med. 2010; 55(5):401-7. (PubMed)
• Fridkin SK, Hageman JC, Morrison M, Sanza LT, Como-Sabetti K, Jernigan JA, Harriman K, Harrison LH, Lynfield R, Farley MM; Active Bacterial Core Surveillance Program of the Emerging Infections Program Network. Methicillin-resistant Staphylococcus aureus disease in three communities. N Engl J Med. 2005; 352(14):1436-44. (PubMed)
• Llera JL, Levy RC. Treatment of cutaneous abscess: a double-blind clinical study. Ann Emerg Med. 1985; 14(1):15-9. (PubMed)
• Stevens DL, Bisno AL, Chambers HF, Dellinger EP, Goldstein EJ, Gorbach SL, Hirschmann JV, Kaplan SL, Montoya JG, Wade JC. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the infectious diseases society of America. Clin Infect Dis. 2014; 59(2):147-59. (PubMed)