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Can Fam Physician
Vol. 53, No. 10, October 2007, pp.1680 - 1684
Copyright © 2007 by The College of Family Physicians of Canada
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Clinical Review

Evidence-based approach to abscess management

Christina Korownyk, MD CCFP
Assistant Professor at the University of Alberta in Edmonton and practises family medicine at the Northeast Community Health Centre in Edmonton

G. Michael Allan, MD CCFP
Assistant Professor at the University of Alberta and a Research Fellow at the Institute for Health Economics. He practises family medicine at the Northeast Community Health Centre and the Canadian Forces Base in Edmonton

Correspondence to: Dr Christina Korownyk, Northeast Community Health Centre, Family Medicine Department, 14007—50 St, Edmonton, AB T5A 5E4; telephone 780 472-5038; fax 780 472-5192; e-mail cpoag{at}ualberta.ca

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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