From the Research
An abscess can sometimes resolve with conservative management, though this depends on the size, location, and severity of the infection, and recent evidence suggests that incision and drainage alone may be sufficient for uncomplicated abscesses, without the need for routine antibiotics or wound packing 1, 2.
Key Considerations
- Conservative management typically includes warm compresses, adequate rest, and over-the-counter pain medications like acetaminophen or ibuprofen to manage discomfort.
- For small, superficial abscesses, conservative management may be sufficient, but antibiotics alone are generally not effective for treating abscesses because the medication cannot penetrate the walled-off infection.
- Most moderate to large abscesses require incision and drainage (I&D) by a healthcare provider to remove the collection of pus.
- After drainage, antibiotics such as trimethoprim-sulfamethoxazole or clindamycin may be prescribed, especially if there is surrounding cellulitis or if the patient has risk factors for complications, as supported by a recent study 3.
Management Approach
- The approach to managing an abscess should be individualized based on the size, location, and severity of the infection, as well as the patient's overall health status and risk factors for complications.
- Recent evidence suggests that ultrasound-guided I&D and loop drainage may be suitable alternatives to traditional I&D for certain types of abscesses 2.
- The use of antibiotics should be weighed against potential risks, and oral antibiotics may improve outcomes after I&D, especially for patients with high-risk features or surrounding cellulitis 3, 4.
Important Notes
- Patients should seek medical attention if the abscess is large, extremely painful, accompanied by fever, or shows signs of spreading infection.
- The management of specific types of abscesses, such as Bartholin, breast, dental, hidradenitis suppurativa, peritonsillar, and pilonidal abscesses, may require specialized approaches and consideration of individual patient factors 2.