Zain Akhtar
Introduction
To assess our unit’s use of antibiotics perioperatively for uncomplicated skin abscesses. Current literature states that Trimethoprim-sulfamethoxazole (TMPSMX) or Clindamycin can be used in addition to incision and drainage, leading to reduced pain and potential reduction in abscess recurrence. However, Incision and drainage remains the primary treatment.
Method
We retrospectively reviewed all incision and drainage of uncomplicated skin abscesses performed under general anaesthesia in our unit, over a combined total of 6 months. For each procedure we identified the location of the uncomplicated skin abscess, whether antibiotics were prescribed postoperatively, the type of antibiotic prescribed if applicable, whether a pus swab was utilised and its culture result. Complicated skin abscesses were identified by factors such as signs of systemic illness, immunosuppression, widespread cellulitis, necrosis and vascular involvement.
Results
Incision and drainage of uncomplicated skin abscesses were performed 70 times between May 2025 and July 2025 in comparison to 63 times between October 2024 and December 2024. In both audit cycles antibiotics were prescribed postoperatively in 55% of cases. Flucloxacillin and Co-amoxiclav were the most commonly used antibiotics overall, but prescribing patterns varied by anatomical site. For instance, Metronidazole was the most common antibiotic prescribed for uncomplicated skin abscesses located in the perianal region.
Conclusion
We will continue to assess the use of antibiotics as an adjunct to incision and drainage of uncomplicated skin abscess, on an individual basis. By working with our microbiology team, we will develop an antimicrobial guideline for uncomplicated skin abscesses based on their anatomical location.
Authors
Zain Akhtar, Hannah Kingston, Alexander Blackmore
Blackpool Victoria Hospital, Blackpool, United Kingdom