Evidence-based approach to abscess management.
OBJECTIVE
To provide family physicians with an overview of the evidence for managing superficial cutaneous abscesses.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Korownyk
Christina
C
Northeast Community Health Centre, Family Medicine Department, 14007-50 St, Edmonton, AB. cpoag@ualberta.ca
Allan
G Michael
GM
D000038:Abscess / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001431:Bacteriological Techniques; D004322:Drainage / Q000009:adverse effects / Q000379:methods; D019317:Evidence-Based Medicine / Q000379:methods*; D005260:Female; D005542:Forearm; D006801:Humans; D010146:Pain / Q000209:etiology; D059408:Pain Management; D017192:Skin Diseases, Bacterial / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D013536:Suture Techniques; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents