How is furuncle treated? Drugs internally and topically, antibiotics, ointments

Treatment of furuncle is divided into internal and external (local).

Internal treatment

In most cases (except for mild involvement), systemic treatment is recommended. For severe forms (especially on the face), intravenous treatment should be preferred.

What is the recommended treatment?

The antibiotics of first choice include amoxicillin/clavulanate, cefazolin and cefuroxime. Clindamycin can be used as an alternative antibiotic.

• Amoxicillin/clavulanate

The drug combination of amoxicillin and clavulanic acid has been used since 1981. Although antibiotic resistance is a major problem today, this combination is still effective.

Amoxicillin belongs to the betalactam group of antibiotics. The mechanism of action is inhibition of peptidoglycan synthesis. This mechanism leads to weakening of the cell wall, after which lysis and cell death usually occur.

Clavulanic acid is a betalactam that is structurally related to penicillins. It inactivates certain betalactamase enzymes. This mechanism prevents inactivation of amoxicillin.

• Cefazolin

Cefazolin belongs to the cephalosporin group of semi-synthetic bactericidal antibiotics. It has a broad spectrum of action. Cefazolin blocks the cell wall synthesis of susceptible bacteria.

• Cefuroxime

The mechanism of action of cefuroxime is inhibition of bacterial cell wall synthesis after binding to penicillin-binding proteins. As a result, cell wall biosynthesis is impaired, leading to lysis and death of the bacterial cell.

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Topical treatment

In local treatment, it is recommended that the patient should leave the affected part of the body at rest and in an elevated position. If the furuncle is localized on the face, the patient should not talk. He should also prefer a soft diet.

Any pressure on the furuncle is harmful. Under no circumstances should the patient squeeze. This could cause dangerous developments.

At the beginning of treatment, moist compresses containing antimicrobial ingredients are recommended. Patients should follow the following regimen:

1. Patients should use antibacterial soaps for daily hygiene.
2. This will reduce the possibility of re-infection.

An ointment containing a combination of antibiotics (bacitracin, neomycin) is used for topical treatment of furuncle.

Bacitracin is a bactericidal antibiotic. Its spectrum of antibacterial activity is similar to that of penicillin. It acts mainly on gram-positive microbes, including staphylococci, and on gram-negative cocci.

Neomycin is a bactericidal aminoglycoside antibiotic. It acts mainly on gram-negative but also on some gram-positive microbes (staphylococci).

An ointment containing 4 substances is also used for topical treatment:

• ichtamol
• sodium perborate
• calcium oxide
• potassium aluminium sulphate

Dosage and method of application:

The dosage is individual. Usually the ointment is applied 2-3 times a day to the affected area. The ointment can be applied either in a thin layer (e.g. for eczema) or in a thicker layer (for deep pyoderma).

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What are the preventive measures?

Preventive measures can be summarised as follows:

1. Wash your hands often.
2. Follow your doctor's instructions for wound care, which may include gentle cleaning of wounds and covering wounds with dressings.
3. Avoid sharing personal items such as sheets, towels, clothing or razors.
4. Avoid contact with other persons infected with staph or MRSA infection.