Christina Korownyk1, G Michael Allan. 1. Northeast Community Health Centre, Family Medicine Department, 14007-50 St, Edmonton, AB. cpoag@ualberta.ca
Abstract
OBJECTIVE: To provide family physicians with an overview of the evidence for managing superficial cutaneous abscesses. SOURCES OF INFORMATION: PubMed (from 1950), EMBASE (from 1974), The Cochrane Library (from 1966), and Google (from 1998) were searched as were reference lists of identified articles. Summary sites, such as ACP Journal Club and InfoPOEMs, and background resources were also reviewed. MAIN MESSAGE: There are many areas of debate regarding abscess management, including pain control, necessity of culture and sensitivity testing, empiric treatment with antibiotics, and open versus primary closure of wounds. Usefulness of cultures and empiric antibiotic treatment has risen to the forefront with the increasing incidence of community-acquired, methicillin-resistant Staphylococcus aureus. CONCLUSION: In immunocompetent patients with no confounding risk factors, incision and drainage under local anesthetic is generally sufficient for abscess management. There is no compelling evidence for routine cultures or empiric treatment with antibiotics. Further research is required.
OBJECTIVE: To provide family physicians with an overview of the evidence for managing superficial cutaneous abscesses. SOURCES OF INFORMATION: PubMed (from 1950), EMBASE (from 1974), The Cochrane Library (from 1966), and Google (from 1998) were searched as were reference lists of identified articles. Summary sites, such as ACP Journal Club and InfoPOEMs, and background resources were also reviewed. MAIN MESSAGE: There are many areas of debate regarding abscess management, including pain control, necessity of culture and sensitivity testing, empiric treatment with antibiotics, and open versus primary closure of wounds. Usefulness of cultures and empiric antibiotic treatment has risen to the forefront with the increasing incidence of community-acquired, methicillin-resistant Staphylococcus aureus. CONCLUSION: In immunocompetent patients with no confounding risk factors, incision and drainage under local anesthetic is generally sufficient for abscess management. There is no compelling evidence for routine cultures or empiric treatment with antibiotics. Further research is required.
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