gastrointestinal disorders
Anorectal Abscess
Treatment of Anorectal Abscess
Incision and drainage Antibiotics for high-risk patients (See also the American Society of Colon and Rectal Surgeons'2016 clinical practice guidelinefor the management of anorectal abscess, fistula-in-ano, and rectovaginal fistula.) Prompt incision and adequate drainage are required and should not wait until the abscess points. Many abscesses can be drained as an in-office procedure; deeper abscesses may require drainage in the operating room. Patients with fever, immunocompromise, or diabetes and those with marked cellulitis should also receive antibiotics (eg,ciprofloxacin500 mg IV every 12 hours andmetronidazole500 mg IV every 8 hours,ampicillin/sulbactam1.5 g IV every 8 hours). Patients with absolute neutropenia (< 1000/mcL [1 × 109/L]) should be treated with antibiotics alone. Antibiotics are not indicated for healthy patients with superficial abscesses. Anorectal Fistula may develop after drainage. 