Recommendations
| Дозування | Ремарки | |
|---|---|---|
|
flucloxacillin PO 500 mg 4 times daily for 7 days
|
Systemic therapy is indicated for malaise and fever, a furuncle above the lower jawline, in immunodeficiency, in the presence of prosthetic material, or if not healing.
|
| Дозування | Ремарки | |
|---|---|---|
|
clindamycin PO 600 mg 3 times daily for 7 days
|
*See protocol Management of antibiotic allergy | Radboud UMC
For nasal furuncle, see the Ear, Nose and Sinuses chapter
Indications for systemic treatment:
• furuncle accompanied by general malaise and fever
• furuncle above the lower jawline
• Increased risk of a complicated course due to impaired immunity: including untreated HIV infection, multiple sclerosis, past transplantation (organ/stem cell/bone marrow), (haematological) malignancy, asplenia, medication (immunosuppressants, (sometimes up to one year after use of) cytostatics) and intravenous drug use.
• Increased risk of endocarditis : history of endocarditis, heart valve prostheses or congenital heart valve abnormalities.
• Increased risk of prosthetic joint infection : a joint prosthesis < 2 years old or a joint prosthesis > 2 years old combined with a history of an infected joint prosthesis, rheumatic joint disease or haemophilia
• For non-healing furuncle
Prevention
For recurrent furunculosis, advise—besides good hygiene—preventive washing two to three times per week with soap or shampoo containing chlorhexidine. Consider, if these measures are insufficient, in cases of three or more recurrences per year and documented staphylococcal carriage, preventive treatment with mupirocin 20 mg/g three times daily for one week, applied to the nasal vestibule. Evaluate the effect of the preventive treatment after three months.