From the Guidelines
For a furuncle (boil), the primary treatment is incision and drainage, and antibiotic therapy is recommended only in certain conditions, such as severe or extensive disease, rapid progression, signs and symptoms 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 1.
Conditions Requiring Antibiotic Therapy
- Severe or extensive disease
- Rapid progression
- Signs and symptoms of systemic illness
- Associated comorbidities or immunosuppression
- Extremes of age
- Abscess in an area difficult to drain
- Associated septic phlebitis
- Lack of response to incision and drainage alone
Recommended Antibiotics
- Clindamycin 300-450 mg orally three times daily for 7-10 days
- Trimethoprim-sulfamethoxazole (TMP-SMX) 1-2 double-strength tablets twice daily for 7-10 days
- Doxycycline 100 mg twice daily for 7-10 days
Additional Recommendations
- Warm compresses applied to the area for 15-20 minutes several times daily can help promote drainage
- Never squeeze or attempt to drain a boil yourself as this can spread the infection
- Complete the full course of antibiotics even if symptoms improve quickly to prevent recurrence and antibiotic resistance
- If the furuncle doesn't improve within 48-72 hours of treatment, worsens, or if you develop fever or spreading redness, seek immediate medical attention as this may indicate a more serious infection requiring different management 1
From the FDA Drug Label
Clindamycin is also indicated in the treatment of serious infections due to susceptible strains of streptococci, pneumococci, and staphylococci Serious skin and soft tissue infections Staphylococci: Serious respiratory tract infections; serious skin and soft tissue infections.
Antibiotic treatment for furuncle: Clindamycin may be used to treat furuncle (a type of skin and soft tissue infection) caused by susceptible strains of staphylococci.
- The dosage for adults with serious infections is 150 to 300 mg every 6 hours, and for more severe infections, it is 300 to 450 mg every 6 hours 2.
- It is essential to perform bacteriologic studies to determine the causative organisms and their susceptibility to clindamycin 2.
From the Research
Antibiotic Treatment for Furuncle
- Furuncle, also known as a boil, is a type of skin and soft tissue infection that can be caused by Staphylococcus aureus, including methicillin-resistant S. aureus (MRSA) 3, 4, 5, 6.
- The choice of antibiotic treatment for furuncle depends on the severity of the infection, local susceptibility patterns, and drug-related safety, tolerability, and cost 5.
- For uncomplicated skin and soft tissue infections, including furuncle, caused by MRSA, oral antibiotic therapy options include clindamycin, doxycycline, trimethoprim-sulfamethoxazole (TMP-SMX), and minocycline 3, 4, 7, 5.
- Minocycline is often preferred over doxycycline or TMP-SMX for the treatment of community-acquired MRSA skin and soft tissue infections, including furuncle, due to its reliability in eradicating the infection 7.
- For severe MRSA infections, including those that are complicated or fail to respond to oral antibiotic therapy, parenteral vancomycin or teicoplanin may be used 3, 4.
- The duration of antibiotic therapy for furuncle is typically 5 to 7 days, although the response to therapy is expected within the first few days 5.
Specific Antibiotic Options
- Clindamycin: effective against MRSA, but may have variable susceptibility patterns 3, 4, 6.
- Doxycycline: often used for the treatment of MRSA skin and soft tissue infections, but may have lower efficacy compared to minocycline 7, 5.
- Minocycline: preferred over doxycycline or TMP-SMX for the treatment of community-acquired MRSA skin and soft tissue infections, including furuncle 7.
- Trimethoprim-sulfamethoxazole (TMP-SMX): may be used for the treatment of MRSA skin and soft tissue infections, but may have lower efficacy compared to minocycline 7, 5.
- Vancomycin: used for severe MRSA infections, including those that are complicated or fail to respond to oral antibiotic therapy 3, 4.