From the Guidelines
Treatment for an armpit boil (furuncle) typically involves incision and drainage as the primary treatment, with antibiotics recommended for severe or extensive disease, or when associated with conditions such as cellulitis, systemic illness, or immunosuppression. The use of warm compresses, applied to the area for 10-15 minutes, 3-4 times daily, can help bring the boil to a head and promote drainage 1. It is essential to keep the area clean by washing gently with antibacterial soap and water. Over-the-counter pain relievers like ibuprofen (400-600mg every 6-8 hours) or acetaminophen (500-1000mg every 6 hours) can help manage discomfort. Avoid squeezing or popping the boil yourself as this can spread infection.
For outpatients with purulent cellulitis, empirical therapy for CA-MRSA is recommended pending culture results, with options including clindamycin, trimethoprim-sulfamethoxazole (TMP-SMX), a tetracycline (doxycycline or minocycline), and linezolid 1. If coverage for both b-hemolytic streptococci and CA-MRSA is desired, options include clindamycin alone or TMP-SMX or a tetracycline in combination with a b-lactam (eg, amoxicillin) or linezolid alone.
Some key points to consider in the treatment of armpit boils include:
- Incision and drainage is the primary treatment for cutaneous abscesses, including armpit boils 1
- Antibiotic therapy is recommended for abscesses associated with severe or extensive disease, or when associated with conditions such as cellulitis, systemic illness, or immunosuppression 1
- Empirical therapy for CA-MRSA is recommended for outpatients with purulent cellulitis, pending culture results 1
- The use of rifampin as a single agent or as adjunctive therapy for the treatment of SSTI is not recommended 1
It is crucial to note that the treatment of armpit boils should be individualized based on the patient's clinical response and the severity of the infection. Recurrent boils may require investigation for underlying conditions like diabetes or immune disorders. Boils occur when hair follicles become infected with bacteria, usually Staphylococcus aureus, and the warm, moist environment of the armpit can make this area particularly susceptible to such infections.
From the Research
Treatment for Armpit Boil (Furuncle)
- The treatment for an armpit boil, also known as a furuncle, typically involves incision and drainage 2.
- Oral antibiotics may not be necessary in most cases, but should be prescribed for patients with severe immunocompromise or systemic signs of infection 2.
- For recurrent cases of furuncles, culture of the exudate is recommended to determine the best course of treatment 2.
Comparison of Treatments
- A systematic review of 18 randomized controlled trials (RCTs) found that there may be little to no difference in clinical cure rate between different oral antibiotics, such as cefadroxil, flucloxacillin, azithromycin, cefaclor, cefdinir, and cefalexin 3.
- The review also found that there may be little to no difference in risk of severe adverse events leading to treatment withdrawal between these antibiotics, although the certainty of the evidence was low or very low 3.
- Topical antibiotics, such as mupirocin, and topical antiseptics, such as benzoyl peroxide, may also be effective in treating furuncles, but more research is needed to compare their efficacy and safety with oral antibiotics 2, 3.
Management of Furuncles
- Incision and drainage is a common management strategy for furuncles, and may be performed in conjunction with oral antibiotics in severe cases 2.
- Patients with furuncles should be monitored for signs of infection, such as redness, swelling, and purulence, and treated promptly if these symptoms occur 2.
- Recurrent furuncles may require culture and sensitivity testing to determine the best course of treatment, and patients may need to be treated with oral antibiotics or other therapies to prevent future episodes 2.