From the Guidelines
To treat a furuncle (boil), incision and drainage is the primary treatment, and antibiotics are not needed for simple cases. The management of furuncles and carbuncles typically involves incision and drainage, with systemic antimicrobials usually unnecessary unless fever or other evidence of systemic infection is present 1. Applying warm compresses to the affected area for 10-15 minutes, 3-4 times daily, can help bring the boil to a head and promote drainage. Keeping the area clean by washing gently with antibacterial soap and water, then covering with a sterile bandage, is also recommended. Over-the-counter pain relievers like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can help manage pain and inflammation.
Some key points to consider in the treatment of furuncles include:
- Incision and drainage is the primary treatment for simple abscesses or boils 1
- Antibiotics are not needed for simple cases, but may be necessary for more complex or severe infections 1
- Empiric therapy for community-acquired MRSA (CA-MRSA) should be recommended for patients at risk for CA-MRSA or who do not respond to first line therapy 1
- Proper hygiene, including regular handwashing and not sharing personal items, can help prevent recurrence
It's worth noting that the most recent and highest quality study, published in 2018, recommends incision and drainage as the primary treatment for simple abscesses or boils, and suggests that antibiotics are not needed for these cases 1. This study also emphasizes the importance of considering the risk of CA-MRSA and the need for empiric therapy in certain cases.
In terms of specific antibiotic treatments, options may include cephalexin (Keflex) 500mg four times daily for 7-10 days or clindamycin 300mg three times daily for those with penicillin allergies, although these should only be used in cases where antibiotics are deemed necessary by a healthcare provider 1. Ultimately, the best course of treatment will depend on the individual case and the severity of the infection.
From the Research
Treatment for Furuncle (Boil)
- The primary treatment for furuncles, also known as boils, is incision and drainage 2, 3.
- In most cases, antimicrobial therapy is not necessary, but it may be considered for patients with severe immunocompromise or systemic signs of infection 2, 3.
- For uncomplicated skin and soft-tissue abscesses caused by meticillin-sensitive Staphylococcus aureus or meticillin-resistant S. aureus (MRSA), incision and drainage is the primary treatment, and oral antibiotic therapy may be limited 4.
- Some studies suggest that oral antibiotics such as minocycline, doxycycline, or trimethoprim-sulfamethoxazole may be effective in treating furuncles, but the evidence is limited and the choice of antibiotic should be based on the specific circumstances of the patient 4, 5.
- A systematic review of randomized controlled trials found that there is uncertainty about the effectiveness of different oral antibiotics in treating bacterial folliculitis and boils, and that incision and drainage is the primary treatment for these conditions 5.