From the Guidelines
Doxycycline is typically prescribed for 7-10 days at a dose of 100 mg twice daily for skin abscesses, with the primary treatment being incision and drainage, and antibiotics serving as adjunctive therapy in cases with surrounding cellulitis, systemic symptoms, or risk factors for complications. The treatment of skin abscesses involves a combination of surgical and medical interventions. According to the guidelines by the Infectious Diseases Society of America 1, incision and drainage is the primary treatment for cutaneous abscesses, with antibiotic therapy recommended for abscesses associated with severe or extensive disease, rapid progression, signs of systemic illness, associated comorbidities or immunosuppression, extremes of age, abscess in an area difficult to drain, associated septic phlebitis, or lack of response to incision and drainage alone.
For empirical coverage of CA-MRSA in outpatients with skin and soft tissue infections (SSTIs), oral antibiotic options include clindamycin, trimethoprim-sulfamethoxazole, a tetracycline (doxycycline or minocycline), and linezolid 1. Doxycycline is particularly effective against MRSA, which commonly causes skin abscesses. The duration of doxycycline treatment may be extended to 14 days for larger abscesses, immunocompromised patients, or if there's inadequate clinical improvement.
Key considerations for the use of doxycycline include:
- Taking the medication with a full glass of water and avoiding lying down for 30 minutes after taking it to prevent esophageal irritation
- Avoiding consumption with dairy products, antacids, or iron supplements, as these can reduce absorption
- Being aware of common side effects, such as photosensitivity and gastrointestinal upset
- Completing the full course of antibiotics even if symptoms improve before finishing to prevent antibiotic resistance and recurrence of infection
It's also important to note that more recent guidelines, such as those from 2014 1, provide updated recommendations for the diagnosis and management of skin and soft tissue infections, including the use of doxycycline for specific types of infections. However, the core principles of treatment, including incision and drainage and adjunctive antibiotic therapy, remain consistent across these guidelines.
From the Research
Doxycycline for Skin Abscess Duration
- There is no direct evidence in the provided studies regarding the use of doxycycline for skin abscess duration 2, 3, 4, 5, 6.
- The studies primarily focus on the use of trimethoprim-sulfamethoxazole (TMP-SMX) and clindamycin for the treatment of skin abscesses, particularly those caused by community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) 2, 3, 4, 6.
- One study discusses the treatment of skin abscesses with a review of wound packing and post-procedural antibiotics, but does not mention doxycycline 5.
- Another study compares the use of TMP-SMX and clindamycin for CA-MRSA skin infections, but does not include doxycycline in the comparison 6.
- Overall, there is a lack of research on the use of doxycycline for skin abscess duration in the provided studies.