From the Guidelines
For a Bartholin's gland abscess, the recommended first-line antibiotic treatment is typically a broad-spectrum antibiotic that covers common causative organisms including aerobic and anaerobic bacteria, with clindamycin 300-450 mg orally four times daily for 7-10 days being a suitable option, as it provides coverage for both b-hemolytic streptococci and CA-MRSA 1.
Key Considerations
- The primary treatment for a Bartholin's gland abscess is incision and drainage, with antibiotics playing a supportive role in managing the infection.
- Empiric therapy should cover common causative organisms, including aerobic and anaerobic bacteria.
- Clindamycin is a suitable option due to its broad-spectrum activity, including coverage for b-hemolytic streptococci and CA-MRSA.
Alternative Options
- Amoxicillin-clavulanate 875/125 mg orally twice daily for 7-10 days may be considered as an alternative option.
- Cephalexin 500 mg orally four times daily plus metronidazole 500 mg orally twice daily for 7-10 days is another alternative.
- Doxycycline 100 mg orally twice daily for 7-10 days may be used in cases where coverage for CA-MRSA is desired.
Important Notes
- Antibiotics should be adjusted based on culture results if available.
- The choice of antibiotic may need modification if sexually transmitted infections are suspected as causative agents, in which case coverage for gonorrhea and chlamydia should be included.
- Definitive treatment typically requires drainage through incision and drainage, Word catheter placement, marsupialization, or needle aspiration, in addition to antibiotic therapy 1.
From the Research
Treatment of Bartholin's Gland Abscess
The treatment of Bartholin's gland abscess typically involves surgical drainage, and the use of antibiotics may be considered in the early stage of the condition 2. The following are some of the treatment options:
- Surgical drainage using the Word catheter application or marsupialization is the treatment of choice in the management of Bartholin's gland abscess 3, 4
- Placement of a Word catheter or Jacobi ring device to reepithelize the duct may be done under local anesthesia in an outpatient clinic 4
- Destruction of the gland through silver nitrate application or alcohol sclerotherapy is an alternative 4
- Marsupialization is often reserved for recurrent cases, although it can be offered as primary management in some situations 4, 5
- Simple needle aspiration can be offered as first-line treatment for acute Bartholin's gland abscess 6
Antibiotic Use
While the use of antibiotics is mentioned in the early stage of the condition 2, there is no specific information on the appropriate antibiotic for Bartholin's gland abscess in the provided studies.
Recurrence Rates
The recurrence rates for Bartholin's gland abscess vary depending on the treatment method, ranging from 0% to 38% 5. Simple needle aspiration has a success rate of 51% (95% CI: 42-59%) 6, while incision and drainage has a success rate of 60% 6. Marsupialization has been reported to have no recurrence in available studies 5.