What is the treatment for an abscess (Abscess)

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From the Guidelines

Incision and drainage (I&D) is the primary treatment for abscesses, and antibiotics may be prescribed in certain cases, such as when there are signs of systemic infection or in immunocompromised patients. The treatment of abscesses involves making a small cut in the abscess to allow the pus to drain out, followed by packing the cavity with sterile gauze 1. After I&D, antibiotics may be prescribed, typically to cover Gram-positive bacteria, including MRSA 1.

Key Considerations

  • The need for antibiotic therapy should be assessed on a case-by-case basis, taking into account the presence of systemic signs of infection, immunocompromised status, or incomplete source control 1.
  • Empiric therapy for community-acquired MRSA (CA-MRSA) should be considered for patients at risk for CA-MRSA or who do not respond to first-line therapy 1.
  • Incision and drainage is the primary treatment for simple abscesses or boils, and antibiotics are not needed for uncomplicated cases 1.

Antibiotic Options

  • For MRSA concerns, consider trimethoprim-sulfamethoxazole (Bactrim) 1-2 double-strength tablets twice daily 1.
  • Other antibiotic options include dicloxacillin, cephalexin, doxycycline, and clindamycin, depending on the suspected causative organism and local resistance patterns 1.

Post-Procedure Care

  • Keep the area clean by changing dressings daily and washing with mild soap and water.
  • Warm compresses applied for 15-20 minutes several times daily can help with healing.
  • Pain management with acetaminophen or ibuprofen is recommended.

It is essential to seek immediate medical attention if the abscess is large, recurrent, or accompanied by fever or severe pain, as more extensive treatment may be needed 1.

From the FDA Drug Label

  1. 1 Acute Bacterial Skin and Skin Structure Infections SIVEXTRO is an oxazolidinone-class antibacterial indicated in adult and pediatric patients 12 years of age and older for the treatment of acute bacterial skin and skin structure infections (ABSSSI) caused by susceptible isolates of the following Gram-positive microorganisms: Staphylococcus aureus (including methicillin-resistant [MRSA] and methicillin-susceptible [MSSA] isolates), Streptococcus pyogenes, Streptococcus agalactiae, Streptococcus anginosus Group (including Streptococcus anginosus, Streptococcus intermedius, and Streptococcus constellatus), and Enterococcus faecalis.

The treatment for an abscess is included in the treatment of acute bacterial skin and skin structure infections (ABSSSI).

  • Tedizolid (PO) is indicated for the treatment of ABSSSI, which includes major cutaneous abscess.
  • The recommended dosage of SIVEXTRO is 200 mg administered once daily for six (6) days either orally or as an intravenous infusion in patients 12 years of age or older 2.
  • The types of ABSSSI included in the clinical trials were cellulitis/erysipelas, wound infection, and major cutaneous abscess 2, 2.

From the Research

Abscess Treatment Overview

  • Abscesses are typically treated with incision and drainage, with or without antibiotics 3, 4, 5, 6, 7
  • The decision to use antibiotics depends on various factors, including the size and location of the abscess, the presence of complications, and the patient's overall health 3, 5, 6, 7

Incision and Drainage

  • Incision and drainage is the standard treatment for uncomplicated skin abscesses 4, 5, 7
  • This procedure can be performed in an outpatient setting, and wound culture and antibiotics are not always necessary 4, 5
  • Packing wounds larger than 5 cm may reduce recurrence and complications 4

Antibiotic Use

  • Antibiotics may be prescribed after incision and drainage, but their use is not always necessary 3, 5, 6, 7
  • The choice of antibiotic depends on the suspected causative organism, with clindamycin and trimethoprim-sulfamethoxazole being common options 3
  • Post-operative antibiotics are only indicated in certain cases, such as immunocompromised patients or those with high-risk features 5, 6, 7

Treatment Variations

  • There is variation in clinical practice regarding post-operative antibiotic prescription for cutaneous abscesses 6
  • Research is needed to develop a standardized evidence-based treatment protocol for the management of skin abscesses 6
  • Alternative treatments, such as the minimal invasive Loop Drainage Technique, may be considered in certain cases 7

References

1
Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

3
Research

A Placebo-Controlled Trial of Antibiotics for Smaller Skin Abscesses.

The New England journal of medicine, 2017

4
Research

Abscess Incision and Drainage.

Primary care, 2022

5
Research

Treatment of Skin Abscesses: A Review of Wound Packing and Post-Procedural Antibiotics.

South Dakota medicine : the journal of the South Dakota State Medical Association, 2016

7
Research

[Treatment of Skin Abscesses in the Emergency Department].

Therapeutische Umschau. Revue therapeutique, 2020

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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