dermatologic disorders
Furuncles and Carbuncles
Treatment of Furuncles and Carbuncles
Drainage Often antibiotics effective against MRSA Abscesses are incised and drained. Intermittent hot compresses are used to facilitate drainage. Antibiotics, when used, should be MRSA and purulent or complicated cellulitis , pending culture and sensitivity test results. In afebrile patients, treatment of a single lesion Lesions > 5 mm or<5 mm that do not resolve with drainage Multiple lesions Evidence of expanding cellulitis Immunocompromise Patients at risk of Infective Endocarditis None Fever Treatment choices include sulfamethoxazole/trimethoprim800/160 mg to 1600/320 mg orally 2 times a day,clindamycin300 to 600 mg orally every 6 to 8 hours, anddoxycyclineorminocycline100 mg orally every 12 hours. Inpatients with furunculosis in hospital settings where MRSA is prevalent may require isolation from other inpatients and Treatment based on culture results. Furuncles frequently recur and can be prevented by applying liquid soap containing eitherchlorhexidinegluconate with isopropyl alcohol or 2 to 3% chloroxylenol . Patients with recurrent furunculosis should be treated for predisposing factors such as obesity, diabetes, occupational or industrial exposure to inciting factors, and nasal carriage ofS. aureusor MRSA colonization. If furuncles develop despite the aforementioned measures,rifampinplus another oral antibiotic could be considered. 