What is the treatment for an axillary abscess?

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Last updated: March 11, 2025View editorial policy

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From the Guidelines

Incision and drainage is the primary treatment for an axillary abscess, and antibiotic therapy should be considered in cases of severe or extensive disease, rapid progression, or signs of systemic illness, as recommended by the Infectious Diseases Society of America 1. The procedure for incision and drainage should be performed by making an adequate incision along skin lines to allow complete drainage of purulent material. After drainage, the cavity should be explored to break up loculations, followed by loose packing with gauze that should be changed daily until the wound begins to heal. Some key points to consider in the treatment of an axillary abscess include:

  • The use of antibiotic therapy, which should target Staphylococcus aureus, including MRSA, with options such as trimethoprim-sulfamethoxazole (TMP-SMX), clindamycin, or doxycycline for 5-10 days 1.
  • The consideration of decolonization with intranasal mupirocin and chlorhexidine body washes for recurrent abscesses.
  • The application of warm compresses to the area to help with pain relief and promote drainage. It is essential to note that the treatment of an axillary abscess should be individualized based on the patient's clinical response and the severity of the infection, as outlined in the guidelines by the Infectious Diseases Society of America 1.

From the FDA Drug Label

SKIN AND SKIN STRUCTURE INFECTIONS Caused by Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pyogenes, Viridans group streptococci, Escherichia coli, Enterobacter cloacae, Klebsiella oxytoca, Klebsiella pneumoniae, Proteus mirabilis, Morganella morganii,1Pseudomonas aeruginosa, Serratia marcescens, Acinetobacter calcoaceticus, Bacteroides fragilis1or Peptostreptococcus species

The treatment for an axillary abscess, which is a type of skin and skin structure infection, may include ceftriaxone (IV), as it is effective against several bacteria that can cause skin infections, including Staphylococcus aureus and Streptococcus pyogenes 2.

  • Key points:
    • Ceftriaxone is effective against a range of bacteria that can cause skin infections.
    • Axillary abscess is a type of skin and skin structure infection.
    • Ceftriaxone may be used to treat axillary abscess caused by susceptible organisms.

From the Research

Treatment for Axillary Abscess

  • The primary treatment for an axillary abscess is incision and drainage, as seen in the study 3 where the abscess was incised, drained, and cultured.
  • Antibiotic therapy may be necessary, especially if the abscess is caused by a bacterial infection such as methicillin-resistant Staphylococcus aureus (MRSA) 3, 4.
  • The choice of antibiotic depends on the susceptibility of the bacterial isolate, with options including clindamycin, trimethoprim/sulfamethoxazole, and minocycline 3, 4.
  • Topical care, such as lesional and intranasal application of mupirocin 2% ointment and daily cleaning of the area with 10% povidone-iodine liquid soap, may also be beneficial 3.
  • For uncomplicated skin and soft-tissue abscesses, incision and drainage alone may be sufficient, and wound culture and antibiotics may not improve healing 5.
  • Pain management is also an important aspect of treatment, and techniques such as ultrasound-guided axillary nerve block may be used to provide effective pain relief during incision and drainage 6.
  • The duration of antibiotic therapy may vary, but studies suggest that a shorter course of 2-3 days may be sufficient in some cases, provided that drainage has been established 7.

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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