emDocs - December 06, 2019 - By Bryant R
(Originally published at R.E.B.E.L. EM on May 12, 2018)
"Abscess management has evolved somewhat in the 14 years since my residency graduation. The point at which antibiotics are likely to be more helpful than harmful is not always easy to assess, and evidence based expert opinion has flip flopped impressively.
Based on current evidence, I would like to answer 3 big questions that every clinician may have when confronted with an abscess:
-Who needs antibiotics?
-Which abscesses need to be drained?
-How should abscesses be drained?
Take Home Points:
- There is room for a safe increase in antibiotic use
- There does not need to be reckless over-use of antibiotics
- Use ultrasound with any abscess you are unsure of
- Use a loop vessel rather than packing"