From the Guidelines
Antibiotic Treatment for Pilonidal Cysts
For the management of infected pilonidal cysts, antibiotics such as cephalexin (500mg orally every 6 hours for 7-10 days) or clindamycin (300mg orally every 6 hours for 7-10 days) may be considered 1. In cases of suspected methicillin-resistant Staphylococcus aureus (MRSA) infection, doxycycline (100mg orally every 12 hours for 7-10 days) or trimethoprim-sulfamethoxazole (160/800mg orally every 12 hours for 7-10 days) may be used.
- The selection of antibiotic therapy should be guided by wound culture and sensitivity results, when available 2, 1.
- Incision and drainage should be performed for recurrent abscesses, and the benefits of adjunctive antimicrobial therapy in preventing recurrences are unknown 3.
- A 5-day decolonization regimen with twice-daily intranasal mupirocin and daily bathing with chlorhexidine may be considered, but data about efficacy are sparse 3. Key considerations include:
- Local causes such as foreign material, hidradenitis suppurativa, or pilonidal cyst should be addressed 2, 3.
- Neutrophil disorders should be evaluated in adult patients with recurrent abscesses that began in early childhood 2.
From the Research
Treatment Options for Pilonidal Cysts
- The management of pilonidal disease involves various treatment modalities, including conservative nonoperative management strategies, epilation techniques, and operative management strategies 4.
- Conservative nonoperative management strategies include improved hygiene, depilation, and lifestyle modification, which focus on disease prevention and minimization of disease activity 4.
- Epilation techniques using laser and intense pulse light therapy are also used as primary and adjunct treatment modalities 4, 5.
- Operative management strategies include excision of affected tissue paired with various closure types, such as primary midline closure, primary off-midline closure techniques, and healing by secondary intention 4, 6.
Use of Antibiotics
- There is no direct mention of antibiotics used to treat pilonidal cysts in the provided studies.
- However, the studies mention the use of antimicrobial solutions for wound care and rinsing after surgical intervention 6.
- It can be inferred that antibiotics may be used to prevent or treat infections associated with pilonidal cysts, but the specific antibiotics used are not mentioned in the studies.
Post-Surgical Wound Management
- Post-surgical wound management of pilonidal cysts involves rinsing the wound with clean water, dressing with a sterile compress, and using antimicrobial solutions 6.
- The use of haemoglobin spray has also been reported as a treatment option for post-surgical wound management 6.
- Adequate wound care, including debridement, rinsing, and dressing, is recommended to avoid healing disturbances and promote wound closure 6.