Choosing Wisely:

Don’t routinely prescribe antibiotics for inflamed epidermal cysts.

Rationale and Comments: The overwhelming majority of red and swollen epidermal cysts are inflamed but not infected. It is important to confirm infection before treating these cysts with antibiotics. Appropriate treatments for inflamed epidermal cysts include incision and drainage or an injection of corticosteroid directly into the cyst.
Sponsoring Organizations:
  • American Academy of Dermatology
  • Sources:
  • IDSA guideline
  • Disciplines:
  • Infectious disease
  • Dermatologic
  • References: • Liu C, Bayer A, Cosgrove SE, Daum RS, Fridkin SK, Gorwitz RJ, Kaplan SL, Karchmer AW, Levine DP, Murray BE, J Rybak M, Talan DA, Chambers HF; Infectious Diseases Society of America. Clinical practice guidelines by the Infectious Diseases Society of America for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children. Clin Infect Dis. 2011 Feb 1;52(3):e18-55.
    • Diven DG, Dozier SE, Meyer DJ, Smith EB. Bacteriology of inflamed and uninflamed epidermal inclusion cysts. Arch Dermatol. 1998 Jan;134(1):49-51.

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