Boil medical therapy: Difference between revisions

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Revision as of 13:29, 12 August 2015

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Medical Therapy

Furuncle

Furuncle^[1]

Mild

Preferred regimen: Incision and Drainage

Moderate

Empiric treatment :TMP-SMX OR Doxycycline
Culture directed treatment

MSSA (methicilin susceptible staphylococcus aureus): TMP-SMX
MRSA (methicilin resistant staphylococcus aureus): dicloxacillin OR cephalexin

Severe

Empiric treatment :Vancomycin OR daptomycin OR linezolid OR televancin OR ceftaroline
Culture directed treatment

MSSA (methicilin susceptible staphylococcus aureus): Nafcillin OR cefazolin OR clindamycin
MRSA (methicilin resistant staphylococcus aureus): Vancomycin OR daptomycin OR linezolid OR televancin OR ceftaroline

↑ Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.

[1] Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.

[1]

@@ Line 4: / Line 4: @@
 ==Medical Therapy==
-Most boils run their course within 4 to 10 days. For most people, self-care by applying a warm compress or soaking the boil in warm water can help alleviate the pain and hasten draining of the pus (colloquially referred to as "bringing the boil to a head"). Once the boil drains, the area should be washed with antibacterial soap and bandaged well.
+===Furuncle===
+* Furuncle<ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
-For recurring cases, sufferers may benefit from diet supplements of [[Vitamin A]] and [[Vitamin E|E]].
+:* '''Mild'''
+::* Preferred regimen: Incision and Drainage
-In serious cases, prescription oral [[antibiotic]]s such as [[dicloxacillin]] (Dynapen) or [[cephalexin]] (Keflex), or topical antibiotics, are commonly used. For patients allergic to penicillin-based drugs, [[erythromycin]] (E-base, Erycin) may also be used.
+:* '''Moderate'''
+::* Empiric treatment :[[TMP-SMX]] {{or}} [[Doxycycline]]
-However, some boils are caused by a [[Antibiotic resistance|super bug]] known as Community-Associated Methicillin-Resistant Staphylococcus Aureus, or [[MRSA|CA-MRSA]]. [[Bactrim]] or other [[sulfa]] drugs must be prescribed relatively soon after boil has started to form. [[MRSA]] tends to increase the speed of growth of the infection.
+::* '''Culture directed treatment'''
+:::* MSSA (methicilin susceptible staphylococcus aureus): [[TMP-SMX]]
-[[Magnesium sulfate]] paste applied to the affected area can prevent the growth of bacteria and reduce boils by absorbing pus and drying up the lesion.
+:::* MRSA (methicilin resistant staphylococcus aureus): [[dicloxacillin]] {{or}} [[cephalexin]]
+:* '''Severe'''
-*If [[fever]], [[carbuncle]]s, recurrences -> systemic abx vs. [[S. aureus]]
+::* Empiric treatment :[[Vancomycin]] {{or}} [[daptomycin]] {{or}} [[linezolid]] {{or}} [[televancin]] {{or}} [[ceftaroline]]
-:*[[Dicloxacillin]] 500 mg po q6h x 10-14 days
+::* Culture directed treatment
-:*Alternatives:
+:::* MSSA (methicilin susceptible staphylococcus aureus): [[Nafcillin]] {{or}} [[cefazolin]] {{or}} [[clindamycin]]
-::*[[Cephalexin]] 250 mg qid
+:::* MRSA (methicilin resistant staphylococcus aureus): [[Vancomycin]] {{or}} [[daptomycin]] {{or}} [[linezolid]] {{or}} [[televancin]] {{or}} [[ceftaroline]]
-::*[[Clindamycin]] 150 mg qid
+ [[Category: Infectious Disease Project]]
-::*[[Bactrim]]
-:*Abx
-::*[[Mupirocin]] 2% ointment to anterior nares bid x 5 days
-:::*Eliminates [[S. aureus]] nasal carriage for up to 90 days
-:::*Also effective against [[MRSA]], but 40% recur on maintenance Rx
-::*[[Rifampin]] 600 mg po qd x 10 days
-:::*Eliminates nasal carriage for up to 3 months
-:::*Consider in patients who have failed other preventive measures
-:::*Rx acute recurrence simultaneously with [[dicloxacillin]] or alternative x 10d
-::*[[Clindamycin]] 150 mg po qd x 3 months (suppressive regimen)
-:::*Shown in one study to decrease frequency of recurrence
-==References==
-{{Reflist|2}}
-[[Category:Dermatology]]
-[[Category:Infectious disease]]
-[[Category:primary care]]
-[[Category:Needs overview]]
-{{WikiDoc Help Menu}}
-{{WikiDoc Sources}}

Boil medical therapy: Difference between revisions

Revision as of 13:29, 12 August 2015

Medical Therapy

Furuncle

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