Purulent Skin and Soft-Tissue Infections (Furuncles, Carbuncles, Abscesses)

General Principles

Methicillin-resistant S. aureus (MRSA) and methicillin-sensitive S. aureus (MSSA) account for 25%–50% of cases.


  • Incision and drainage (I&D) alone is usually adequate, especially for abscesses measuring <5 cm.
  • Antibiotic therapy is needed for extensive disease; systemic illness; rapid progression with associated cellulitis; comorbid diseases (diabetes mellitus); immunosuppression, location on face, hand, or genitalia; or lack of response to I&D.
  • Empiric antibiotic therapy should cover community-acquired MRSA. Oral antibiotics include clindamycin 300–450 mg q8h, trimethoprim–sulfamethoxazole (TMP–SMX) 1–2 double-strength tablets q12h, doxycycline 100 mg q12h, and linezolid 600 mg q12h.
  • Duration of antibiotic therapy is usually 5–7 days.1


  1. Stevens DL, Bisno AL, Chambers HF, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis. 2014;59(2):147-159.  [PMID:24947530]


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