FURUNCLES AND ABSCESSES

Localised bacterial skin infection of hair follicles (furuncle/boil) or dermis (abscess), usually with S. aureus.

The surrounding skin becomes:

»       swollen,                                »      red,

»       hot , and                               »     tender to touch.

Note:

Boils in diabetic or immunocompromised patients require careful management.

Check blood glucose levels if the boils are recurrent.

GENERAL MEASURES

Drainage of the abscess is the treatment of choice. Perform surgical incision only after the lesion is fluctuant.

MEDICINE TREATMENT

Antibiotic therapy

Systemic antibiotics are seldom necessary, except if there are:

»     tender draining lymph nodes,

»      fever,

»             extensive surrounding cellulitis, and »            facial abscesses.

• Cloxacillin, IV, 1 g 6 hourly.

When there is clinical improvement, change to:

• Flucloxacillin, oral, 500 mg 6 hourly.

Penicillin allergy:

• Clindamycin, IV, 600 mg 8 hourly.

When there is clinical improvement, change to:

• Clindamycin, oral, 300 mg 8 hourly.