Big painful boils. There is a histologic difference between a carbuncle and a furuncle and I do not care.
Scratching when colonized with S. aureus.
I&D, plus oral antibiotics. Given that most are MRSA trimethoprim/sulfamethoxazole 2-3 ds po tid or doxycycline are the only reliable and affordable oral agents; let local susceptibilities by your guide.
I&D may be all you need. Antibiotics probably do more to prevent recurrence than hasten resolution.
And do not just suck out the pus with a needle, compared to an I&D, 74% of needle aspiration FAILED vrs 20% of open I&D (PubMed).
For recurrent disease: 2 weeks of po antibiotics PLUS
2 weeks of mupirocin to nose and open lesions PLUS
2 weeks of Hibiclens baths PLUS
hot water/bleach all reused clothes and sheets (wet cottons that you reuse can be a source for recurrent re-inoculation of S. aureus, AND
no scratching after picking your nose usually aborts recurrent disease. For women (and some men) new make-up. New razor blades. Flip the mattress and new pillows. It is usually not necessary to treat family members or pets, although who could argue with tossing the cat in the washer/dryer?
One bid of tmp/sulfa is the dose for a UTI, for a cutaneous S. aureus infection it is probably homeopathic.
Last Update: 05/27/18.