What is the best way to treat furuncles?

Nonsuppurative solitary lesions are best treated with local heat until they become fluctuant. Fluctuant furuncles should be opened and drained. Smaller lesions may be punctured with a no. 11 blade and the contents drained, while large abscesses may require a larger incision, drainage, and a wick. Patients with many lesions, evidence of surrounding cellulitis or with systemic symptoms should be considered for oral antibiotics.

As always, the diagnosis should be confirmed with a culture and antibiotic sensitivities performed at the initial visit, since not all follicular-based abscesses are due to staphylococci. The initial antibiotic choice before the culture and antibiogram results is usually oral dicloxacillin, oral cephalexin, or oral amoxicillin/clavulanate. Oral erythromycin, azithromycin, or clarithromycin can be used if the patient is allergic to penicillin. However, if MRSA infection is clinically suspected then the initial antibiotic choice is different (see question What is MRSA?).