Pilonidal Abscess Management: Microbiological Findings and Clinical Outcomes Following Empirical Cefuroxime–Ciprofloxacin Therapy

Abstract

Objective: This study aimed to evaluate the microbiological profile and antibiotic susceptibility patterns in patients undergoing drainage for pilonidal sinus abscess and to assess the efficacy of an empirical cefuroxime-ciprofloxacin regimen. Methods: Between November 2021 and February 2024, 88 patients who underwent drainage for pilonidal abscess at Balıklıgöl State Hospital and Harran University Faculty of Medicine Hospital were included. Pus cultures were obtained under sterile conditions. Patients received cefuroxime 500 mg (twice daily) and ciprofloxacin 500 mg (twice daily) postoperatively. Treatment success was defined as resolution of erythema and pain by day 7. Culture results and antibiograms were analyzed descriptively. Results: İn the study included 63.6% of the patients were male (n=56), and 36.4% (n=32) were female. Staphylococcus (41.2%) and Streptococcus (31.4%) were the predominant isolates. Resistance to the empirical regimen occurred in 3 cases (3.4%), requiring escalation. The overall success rate was 96.6%. Culture negativity (42%) was noted but did not impact outcomes. Conclusion: Pilonidal abscess microbiologically resembles skin/soft tissue infections. The cefuroxime-ciprofloxacin combination demonstrated high efficacy, though regional resistance patterns and anaerobic coverage merit further study.

Keywords

• Pilonidal abscess
• culture
• antibiogram
• antibiotic resistance

Pilonidal Apse Tedavisi: Ampirik Sefuroksim-Siprofloksasin Tedavisi Sonrası Mikrobiyolojik Bulgular ve Klinik Sonuçlar

Abstract

Amaç: Bu çalışmada pilonidal sinüs apsesi nedeniyle drenaj uygulanan hastalarda mikrobiyolojik profil ve antibiyotik duyarlılık paternlerinin değerlendirilmesi ve ampirik sefuroksim-siprofloksasin rejiminin etkinliğinin değerlendirilmesi amaçlanmıştır. Yöntemler: Kasım 2021 ile Şubat 2024 tarihleri arasında Balıklıgöl Devlet Hastanesi ve Harran Üniversitesi Tıp Fakültesi Hastanesi'nde pilonidal apse nedeniyle drenaj uygulanan 88 hasta çalışmaya dahil edildi. Apse kültürleri steril koşullar altında elde edildi. Hastalar postoperatif olarak sefuroksim 500 mg (günde iki kez) ve siprofloksasin 500 mg (günde iki kez) aldı. Tedavi başarısı eritem ve ağrının 7. güne kadar gerilemesi olarak tanımlandı. Kültür sonuçları ve antibiyogramlar tanımlayıcı olarak analiz edildi. Sonuçlar: Çalışmaya dahil edilen hastaların %63,6'sı erkek (n=56), %36,4'ü (n=32) kadındı. Staphylococcus (41.2%) ve Streptococcus (31.4%) baskın izolatlardı. Ampirik rejime direnç 3 olguda (%3,4) görüldü ve yatış gerektirdi. Genel başarı oranı %96,6'dır. Kültür negatifliği (42%) kaydedilmiş ancak sonuçları etkilememiştir. Sonuç: Pilonidal apse mikrobiyolojik olarak deri/yumuşak doku enfeksiyonlarına benzemektedir. Sefuroksim-siprofloksasin kombinasyonu yüksek etkinlik göstermiştir, ancak bölgesel direnç paternleri ve anaerobik kapsama daha fazla çalışmayı hak etmektedir.

Keywords

• Pilonidal apse
• Kültür
• Antibiogram
• Antibiyotik direnci.

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