From the Guidelines
For both a penile bite and a pilonidal cyst infection, amoxicillin-clavulanate (Augmentin) 875/125 mg twice daily for 7-10 days is the recommended first-line treatment, as it covers both aerobic and anaerobic bacteria commonly found in human bites and skin infections 1.
Key Considerations
- The choice of antibiotic should cover a broad spectrum of bacteria, including skin flora and oral bacteria, as both conditions can be caused by a variety of pathogens.
- Amoxicillin-clavulanate is a good option as it covers both aerobic and anaerobic bacteria, including streptococci, S. aureus, and Eikenella corrodens, as well as multiple anaerobic organisms.
- Alternatives to amoxicillin-clavulanate include trimethoprim-sulfamethoxazole (Bactrim) plus metronidazole, or doxycycline 100 mg twice daily, but these may not provide as broad coverage as amoxicillin-clavulanate.
Important Notes
- Both conditions require prompt treatment to prevent complications, such as abscess formation or severe infection.
- The penile bite needs immediate cleaning and possibly tetanus prophylaxis if not up to date on vaccinations.
- A pilonidal cyst may require drainage if there is an abscess, and antibiotics alone may not be sufficient in this case.
- Both conditions should be evaluated by a healthcare provider to determine the best course of treatment, as the severity of the infection and the presence of any complications will guide the choice of therapy 1.
From the FDA Drug Label
DESCRIPTION Doxycycline is a broad-spectrum antibiotic synthetically derived from oxytetracycline, and is available as doxycycline hyclate (doxycycline hydrochloride hemiethanolate hemihydrate) for oral administration. The FDA drug label does not answer the question.
From the Research
Pilonidal Cyst and Dick Bite Treatment
- There is no direct evidence to suggest a single antibiotic (abx) that can treat both pilonidal cyst and dick bite simultaneously.
- The management of pilonidal disease has been studied extensively, with a trend towards less invasive procedures, such as sinusectomy and endoscopic approaches, which have equivalent or better outcomes compared to classic excision 2, 3.
- Non-operative management strategies, including improved hygiene, depilation, and lifestyle modification, can be used to prevent and minimize disease activity in pilonidal disease 3.
- For recurrent or persistent pilonidal disease, any type of flap repair is acceptable and preferred by patients over healing by secondary intention 2.
- There is a lack of standardization in definitions and reporting of treatment-associated outcomes, making it challenging to develop evidence-based treatment algorithms for pilonidal disease 3.
- No information is available regarding the treatment of "dick bite" in the provided studies.