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Incision and drainage (I&D) is the primary treatment for a cutaneous abscess.
Lesions that appear superficial can often have associated abscess formation that is not clearly appreciated without debridement of the wound or, on occasion, additional imaging.
At the time of I&D, a sample should be obtained for culture and sensitivity testing. Superficial wound swabs of the purulent drainage prior to I&D is of limited utility and NOT recommended.
Antibiotics are an adjunct to I&D in the management of uncomplicated skin abscesses caused by CA-MRSA.
Antibiotic therapy should be given BEFORE I&D in patients with prosthetic heart valves or other conditions placing them at high risk for endocarditis.
Indications for antimicrobial therapy in patients with cutaneous abscesses: