From the Guidelines
Keflex (cephalexin) and doxycycline are not typically given together as a standard treatment for skin abscesses. The primary treatment for most skin abscesses is incision and drainage, which is often sufficient without antibiotics, as stated in the guidelines by the Infectious Diseases Society of America 1. When antibiotics are needed, they are usually prescribed individually rather than in combination. For uncomplicated skin abscesses, if methicillin-resistant Staphylococcus aureus (MRSA) is not suspected, cephalexin (500 mg four times daily for 5-10 days) might be used. If MRSA is suspected or confirmed, doxycycline (100 mg twice daily for 5-10 days) could be an appropriate choice, as suggested by the guidelines 1 and a more recent study on infectious diseases associated with organized sports and outbreak control 1. Combination therapy would generally be reserved for severe infections, polymicrobial infections, or cases with specific antibiotic resistance patterns. The decision to use antibiotics and which specific antibiotic to choose depends on factors such as the severity of infection, patient allergies, local resistance patterns, and whether the abscess has been properly drained.
Some key points to consider in the management of skin abscesses include:
- Incision and drainage is the primary treatment for most skin abscesses
- Antibiotic therapy may be recommended for abscesses associated with certain conditions, such as severe or extensive disease, signs and symptoms of systemic illness, or lack of response to incision and drainage alone
- Empirical therapy for CA-MRSA is recommended pending culture results for outpatients with purulent cellulitis
- The use of rifampin as a single agent or as adjunctive therapy for the treatment of SSTI is not recommended
- For hospitalized patients with complicated SSTI, empirical therapy for MRSA should be considered pending culture data
It's also important to note that the use of antibiotics should be guided by knowledge of the local patterns of susceptibility of S. aureus, especially local rates of MRSA, as stated in the study on infectious diseases associated with organized sports and outbreak control 1.
In terms of the choice of antibiotic, cephalexin and doxycycline have different mechanisms of action, with cephalexin disrupting bacterial cell wall synthesis and doxycycline inhibiting protein synthesis. However, using both simultaneously for a simple abscess would typically be unnecessary and could increase the risk of side effects and antibiotic resistance.
Overall, the management of skin abscesses requires a thoughtful approach, taking into account the severity of the infection, the presence of underlying conditions, and the local epidemiology of antibiotic resistance.
From the FDA Drug Label
Skin and skin structure infections caused by Staphylococcus aureus and/or Streptococcus pyogenes The FDA drug label does not answer the question.