Furunculosis, Recurrent

- Consider mycobacterial infection.

- If > 6 recurrences/year, some experts recommend suppressive therapy with susceptible oral antibiotic x 3 months, then re-assess. Culture and susceptibility recommended. Benefits of this strategy must be weighed against risks of resistance/adverse effects.

 
Usual Pathogens

S. aureus

Consider decolonization:

Empiric Therapy Dose Duration
Mupirocin 2% bid intranasally 5 days. Repeat monthly for 1st 5 days/mo x 6-12 mos.
+/-    
[Chlorhexidine full body wash daily 5 days. Repeat monthly for 1st 5 days/mo x 6-12 mos.
or    
Dilute bleach bath] 15 minutes daily 5 days. Repeat monthly for 1st 5 days/mo x 6-12 mos.

Alternative

Empiric Therapy Dose Duration
Rifampin 600mg PO daily 10 days
+    
TMP/SMX 1 DS tab PO bid