Survey of Antibiotic Prescription Use for Inflamed Epidermal Inclusion Cysts

Abstract

This study shows that despite the differences between general practitioners and dermatologists in diagnosis, the majority of physicians use antibiotics for the treatment of inflamed EICs.

Dermatologists and Antibiotics—Reflecting on Our Habits, the Evidence, and Next Steps

“…7 However, if inflammation is the concern, then anti-inflammatory agents such as intralesional triamcinolone could be considered. 7 While noninflamed EICs harbor bacteria, at least 1 study has found that there was no significant difference in the kinds of bacteria present in inflamed vs noninflamed EICs, which calls into question the rationale for antibiotic use. 8 We were not able to identify any studies evaluating the efficacy of antibiotics or intralesional triamcinolone (or a comparison of the 2) for in-flamed EIC management, and these data, when available, might help clinicians feel more confident in their decision to avoid prescribing an antibiotic.…”

“…Barbieri et al also describe increased use of short-term antibiotics for the treatment of cysts. Dermatologists often use the terms inflamed or ruptured for inflamed EICs, yet 94% of dermatologists treat inflamed EICs with cephalosporins, implying a concern for gram-positive infections . However, if inflammation is the concern, then anti-inflammatory agents such as intralesional triamcinolone could be considered .…”

“…Dermatologists often use the terms inflamed or ruptured for inflamed EICs, yet 94% of dermatologists treat inflamed EICs with cephalosporins, implying a concern for gram-positive infections . However, if inflammation is the concern, then anti-inflammatory agents such as intralesional triamcinolone could be considered . While noninflamed EICs harbor bacteria, at least 1 study has found that there was no significant difference in the kinds of bacteria present in inflamed vs noninflamed EICs, which calls into question the rationale for antibiotic use .…”

Intraosseous epidermal cyst of the great toe that was difficult to distinguish from chronic osteomyelitis: A case report and literature review

“…Earlier, infection was considered as the underlying cause of inflammation. Since there were no apparent differences in the microbiological milieu of inflamed and uninflamed EpCs, inflammation was speculated to be caused by the immune response rather than the infection, 1 and intralesional steroids were recommended for the treatment 2 . However, there is a need to develop alternatives to antibiotics for this kind of noninfectious condition to reduce the complications associated with antibiotic use 3 …”