From the FDA Drug Label
Duration of therapy varies with the type and severity of infection as well as the overall condition of the patient, therefore, it should be determined by the clinical and bacteriological response of the patient In severe staphylococcal infections, therapy with penicillinase-resistant penicillins should be continued for at least 14 days. Therapy should be continued for at least 48 hours after the patient has become afebrile, asymptomatic, and cultures are negative.
The recommended length of antibiotics for MSSA skin boils is at least 14 days for severe infections, and should be continued for at least 48 hours after the patient has become afebrile, asymptomatic, and cultures are negative, as determined by the clinical and bacteriological response of the patient 1.
From the Research
The recommended treatment for Methicillin-Sensitive Staphylococcus Aureus (MSSA) skin boils typically involves incision and drainage as the primary intervention, often followed by antibiotic therapy for 7-10 days. For small, uncomplicated boils, incision and drainage alone may be sufficient. The procedure involves making a small incision in the boil to allow the pus to drain, which relieves pressure and promotes healing. For larger or multiple boils, or those associated with surrounding cellulitis, systemic antibiotics are recommended. First-line antibiotic options include dicloxacillin (500 mg orally four times daily), cephalexin (500 mg orally four times daily), or clindamycin (300-450 mg orally three times daily) for penicillin-allergic patients, as supported by studies such as 2 and 3. Warm compresses applied to the area for 15 minutes, 3-4 times daily can help promote drainage and relieve discomfort. Good hygiene practices are essential during treatment, including keeping the area clean, washing hands frequently, and not sharing personal items. MSSA responds well to these beta-lactam antibiotics because, unlike MRSA, it has not developed resistance to methicillin and related antibiotics. Complete drainage of the purulent material is crucial for successful treatment as antibiotics alone may not penetrate well into the abscess cavity, as noted in 4. It's also important to consider the most recent and highest quality evidence, such as the 2021 study 4, which provides a comprehensive review of interventions for bacterial folliculitis and boils, although it does not specifically focus on MSSA, its findings on the general management of skin and soft tissue infections are relevant. In terms of the duration of antibiotic therapy, the evidence suggests that 7-10 days is a common recommendation, but the optimal duration may depend on the specific circumstances of the patient and the infection, as discussed in 2 and 4. Overall, the key to successful treatment of MSSA skin boils is a combination of incision and drainage, appropriate antibiotic therapy, and good hygiene practices.