From the Research
For pilonidal cyst infections, amoxicillin-clavulanate (Augmentin) 875/125 mg twice daily for 7-10 days is the recommended first-line antibiotic treatment. This recommendation is based on the fact that broad-spectrum antibiotics that cover skin flora, particularly Staphylococcus and anaerobic bacteria, are typically recommended for pilonidal cyst infections 1. The choice of antibiotic should target the mixed bacterial population commonly found in pilonidal infections.
Key Considerations
- Alternatives to amoxicillin-clavulanate include trimethoprim-sulfamethoxazole (Bactrim) DS twice daily, clindamycin 300-450 mg four times daily, or metronidazole 500 mg three times daily plus ciprofloxacin 500 mg twice daily for patients with penicillin allergies.
- Antibiotics alone are usually insufficient for definitive treatment, and most infected pilonidal cysts require drainage (incision and drainage procedure) along with antibiotic therapy 2.
- After drainage, proper wound care with regular cleaning, packing if needed, and keeping the area dry and hair-free is essential to prevent recurrence.
- Definitive treatment may ultimately require surgical excision of the cyst once the acute infection resolves, with minimally invasive techniques being a safe and effective alternative to conventional techniques 2.
Important Factors
- Patients should seek medical attention promptly as these infections can worsen quickly and may require culture-directed antibiotic therapy based on specific bacterial sensitivities.
- The goal of treatment is to reduce morbidity, mortality, and improve quality of life, with a focus on minimizing complications and promoting wound healing 1, 2.