From the Guidelines
An abscess in the right axilla requires prompt medical attention, and the standard treatment typically involves incision and drainage of the abscess by a medical professional, which allows the pus to be removed, as recommended by the 2018 WSES/SIS-E consensus conference 1. The goal of treatment is to eliminate the infection, reduce pain, and prevent further complications.
- Incision and drainage is the primary treatment for simple abscesses or boils, and antibiotics are not needed for simple abscesses, as stated in the 2018 WSES/SIS-E consensus conference 1.
- However, antibiotic therapy may be recommended if systemic signs of infection are present, in immunocompromised patients, if source control is incomplete, or in cases of abscess with significant cellulitis, as recommended by the 2018 WSES/SIS-E consensus conference 1.
- Empiric broad-spectrum antibiotic therapy with coverage of Gram-positive, Gram-negative, and anaerobic bacteria may be required, depending on the clinical setting, as stated in the 2018 WSES/SIS-E consensus conference 1.
- While waiting for medical care, applying warm compresses to the area for 15-20 minutes several times daily can help reduce pain and potentially help the abscess come to a head, and over-the-counter pain relievers like acetaminophen or ibuprofen can help manage pain.
- Axillary abscesses are often caused by bacteria, particularly Staphylococcus aureus, which infect hair follicles or sweat glands in the armpit, and poor hygiene, shaving, tight clothing, excessive sweating, or a weakened immune system can increase the risk, as mentioned in the clinical practice guidelines by the Infectious Diseases Society of America 1.
- It is essential not to attempt to drain the abscess yourself, as this can spread the infection and worsen the condition.
- The most recent and highest quality study, the 2018 WSES/SIS-E consensus conference 1, provides the best guidance for the management of skin and soft-tissue infections, including abscesses in the axilla.
From the FDA Drug Label
Adults: Serious infections – 150 to 300 mg every 6 hours. More severe infections – 300 to 450 mg every 6 hours The answer to the question of treating an abscess in the right axilla with pain is that clindamycin can be used to treat serious infections. The dosage for adults with serious infections is 150 to 300 mg every 6 hours, and for more severe infections, the dosage is 300 to 450 mg every 6 hours 2.
- Key points:
- Clindamycin can be used for serious infections
- Dosage depends on the severity of the infection
- Treatment should be guided by a physician However, the FDA label does not provide specific information on treating an abscess in the right axilla with pain, so the decision to use clindamycin should be made by a physician based on clinical judgment 2.
From the Research
Abscess in Right Axilla Pain
- An abscess is a localized collection of purulent material surrounded by inflammation and granulation in response to an infectious source 3
- The most common bacteria causing abscesses are Staphylococcus aureus, Streptococcus pyogenes, and other β-hemolytic streptococci, and methicillin-resistant S. aureus is most common in abscesses 4
Diagnosis and Management
- The history and physical examination are helpful in differentiating cellulitis and abscess in many cases, and point-of-care ultrasound can be a useful tool in unclear cases 4
- Treatment for abscesses typically involves incision and drainage, and loop drainage is preferred over the traditional incision and drainage technique 4
- Adjunctive antibiotics can be considered, but systemic antibiotics do not significantly improve the percentage of patients with complete resolution of their abscesses when given in addition to incision and drainage 5
Antibiotic Treatment
- Trimethoprim-sulfamethoxazole was associated with improved outcomes regardless of lesion size or guideline antibiotic criteria 6
- Treatment effect was greatest with history of MRSA infection, fever, and positive MRSA culture 6
- Cephalexin plus trimethoprim-sulfamethoxazole did not result in higher rates of clinical resolution of cellulitis compared to cephalexin alone in patients with uncomplicated cellulitis 7
Pain Management
- There is no direct evidence in the provided studies regarding pain management for an abscess in the right axilla
- However, incision and drainage of the abscess can help to reduce pain and promote healing 3