Dawaa Reference

infectious

Bartholin's Cyst and Abscess

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

CDC Sexually Transmitted Infections Treatment Guidelines 2021 · Egyptian National Drug Formulary - Antimicrobial 2023 · StatPearls: Bartholin Gland Cyst (NCBI Bookshelf NBK532271)

Verified against3 documents
  • StatPearls: Bartholin Gland Cyst (NCBI Bookshelf NBK532271)
  • Egyptian National Drug Formulary - Antimicrobial 2023
  • Bartholin Gland Cyst - disease-level clinical article (bartholin-cyst-abscess-clinical.txt)

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (6)

  • An abscess brings pain and swelling bad enough to stop her sitting, walking or having sex [abscess]
  • A cyst is usually painless and is found incidentally at a routine pelvic examination [cyst]
  • Sudden easing of the pain as the swelling bursts and drains by itself
  • A larger cyst may cause discomfort with sex or visibly distort the vulva [cyst]
  • Swelling and pain that come and go with each period suggest endometriosis in the gland
  • Cysts and abscesses form most often in women of reproductive age, and not all of them need any intervention at all [cyst]

Signs — what you find (6)

  • One-sided vulvar swelling, acutely tender, red and oedematous around a fluctuant lump [oedema]
  • Fever is uncommon in an otherwise well woman, so look for another source if she is febrile [fever]
  • Cysts are usually sterile and confined to one side [cyst]
  • A mass tethered to the tissue beneath it is a malignant sign
  • The normal gland is impalpable, and only becomes active after menarche
  • When there are no symptoms the mass may show itself only as asymmetry of the vulva

Tests (6)

  • The diagnosis is normally made clinically; imaging or biopsy is reserved for an atypical mass
  • E coli is the organism in about 44 percent, ahead of Staph aureus, group B strep and enterococcus
  • Swab for chlamydia and gonorrhoea in a woman at risk, even though an STI is rarely the cause
  • A recurrence is more often E coli than a first attack, 57 percent against 37
  • After the menopause the lump needs investigating to exclude cancer
  • Fewer than one in ten are polymicrobial

If not this — what else fits (4)

  • Carcinoma of the gland - rare, 1 to 5 percent of vulvar cancers, commonest in the seventies
  • Any atypical picture, above all a growing painless lump after the menopause, means excluding cancer
  • A benign solid tumour - histology shows nodular hyperplasia or adenoma
  • Endometriosis of the gland, rare and primary

SourceStatPearls "Anatomy, Abdomen and Pelvis: Bartholin Gland" - disease-level clinical article

Presentation findings are traced to the source above.

1

CONSERVATIVE MANAGEMENT & SURGICAL DRAINAGE (PRIMARY CARE STRATEGY)

1st line
Adult dose and duration

Asymptomatic Bartholin cysts require no treatment. Acute fluctuant Bartholin abscesses require surgical incision and drainage (or Word catheter placement); routine systemic antibiotics are NOT required for simple drained abscesses without surrounding cellulitis or systemic infection. - Single procedure / observation

Paediatric dose

Asymptomatic cysts require observation. Abscesses require surgical evaluation for drainage under appropriate pediatric anesthesia.

Dose source

StatPearls: Bartholin Gland Cyst (NCBI Bookshelf NBK532271)

Why

Incision and drainage is the primary and definitive treatment for Bartholin abscesses; systemic antibiotics provide no benefit for uncomplicated drained abscesses without surrounding cellulitis.

Cautions
  • Incision and drainage is the primary treatment for fluctuant Bartholin abscesses; systemic antibiotics are indicated only if surrounding cellulitis, systemic infection, or pregnancy is present.
  • Drainage alone recurs. StatPearls is blunt about it - with incision and drainage only, recurrence rates are unacceptably high - which is the argument for a Word catheter rather than a scalpel and a dressing.
2

AMOXICILLIN + CLAVULANIC ACID

1st line

Strength1000 mg

Formoral.solid

Adult dose and duration

1 g (875/125 mg) orally twice daily (or 625 mg TID) for 7 days following drainage or for expanding cellulitis x 7 days

Paediatric dose

25-45 mg/kg/day [child max 1750 mg]

(25-45 mg/kg/day (amoxicillin component) in 2 divided doses for 7 days.)

Dose by weight
3kg75-135 mg/day
4kg100-180 mg/day
5kg125-225 mg/day
6kg150-270 mg/day
7kg175-315 mg/day
8kg200-360 mg/day
9kg225-405 mg/day
10kg250-450 mg/day
11kg275-495 mg/day
12kg300-540 mg/day
13kg325-585 mg/day
14kg350-630 mg/day
15kg375-675 mg/day
16kg400-720 mg/day
17kg425-765 mg/day
18kg450-810 mg/day
19kg475-855 mg/day
20kg500-900 mg/day
21kg525-945 mg/day
22kg550-990 mg/day
23kg575-1035 mg/day
24kg600-1080 mg/day
25kg625-1125 mg/day
26kg650-1170 mg/day
27kg675-1215 mg/day
28kg700-1260 mg/day
29kg725-1305 mg/day
30kg750-1350 mg/day
31kg775-1395 mg/day
32kg800-1440 mg/day
33kg825-1485 mg/day
34kg850-1530 mg/day
35kg875-1575 mg/day
36kg900-1620 mg/day
37kg925-1665 mg/day
38kg950-1710 mg/day
39kg975-1750 mg/day (upper capped)
40kg1000-1750 mg/day (upper capped)
41kg1025-1750 mg/day (upper capped)
42kg1050-1750 mg/day (upper capped)
43kg1075-1750 mg/day (upper capped)
44kg1100-1750 mg/day (upper capped)
45kg1125-1750 mg/day (upper capped)
46kg1150-1750 mg/day (upper capped)
47kg1175-1750 mg/day (upper capped)
48kg1200-1750 mg/day (upper capped)
49kg1225-1750 mg/day (upper capped)
50kg1250-1750 mg/day (upper capped)
Dose source

Egyptian National Drug Formulary - Antimicrobial 2023

Why

Broad-spectrum penicillin and beta-lactamase inhibitor combination covering the mixed aerobic and anaerobic flora typically responsible for a Bartholin abscess; an adjunct to drainage, not a substitute for it, since surgical drainage remains the definitive treatment.

Cautions
  • First-line empirical antibiotic covering polymicrobial vulvar flora (E. coli, Staph aureus, Streptococci, and anaerobes) following incision and drainage or Word catheter placement.
  • Definitive treatment for a Bartholin abscess is surgical drainage (incision & drainage, Word catheter insertion, or marsupialization); antibiotics alone are insufficient for organized abscesses.
  • Contraindicated in severe penicillin allergy; caution in hepatic impairment.
Egyptian brands
Egyptian brandManufacturerIndicative price
E-MOXCLAV 1G 10 F.C. TAB.EIPICO14.00 EGP (1.40/unit)
JULMENTIN 2X 1GM 15 TAB.JULPHAR57.50 EGP (3.83/unit)
DEXICLAVE 1 GM 10 F.C. TABS.RAMEDA > NOVELL PHARMA38.50 EGP (3.85/unit)
MACLAVEX 1 GM 14 F.C.TABS.MASH PREMIERE105.00 EGP (7.50/unit)
CLAVIMOX 1 GM 12 F.C.TABS.PHARCO130.00 EGP (10.83/unit)
MEGAMOX 1 GM 14 F.C. TABS.AL JAZEERA PHARMACEUTICAL > HIKMA PHARMA178.00 EGP (12.71/unit)
CLAVOCILLIN 1 GM 10 DISPERSIBLE TABS.RAMEDA > ORGANOPHARMA106.00 EGP
AUGMENTIN ADULTS 1GM/125MG 12 PWD. ORAL SUSP. SACHETSGLAXO SMITHKLINE169.00 EGP
LARYNCLAVE 125/31 PD. FOR ORAL SUSP. 70ML? strength differs? different route - not oral solidMISR > AL ROWAD PHARMACEUTICAL INDUSTRIAL CO.8.00 EGP
MEGACLAVOX 156MG/5ML PD. FOR SUSP. 60 ML? strength differs? different route - not oral solidCID8.00 EGP
3

REFERRAL & SAFETY-NETTING (NO DRUG THERAPY)

1st line
Dose source

Bartholin Gland Cyst - disease-level clinical article (bartholin-cyst-abscess-clinical.txt)

Why

Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.

Cautions
  • RED FLAG - Biopsy to rule out malignancy is needed in patients older than 40 or with atypical presentation.
4

CEFADROXIL

2nd line

Strength500 mg

Formoral.solid

Adult dose and duration

1 g daily, as a single dose or in 2 divided doses, for 7 days (combine with Metronidazole if anaerobic involvement suspected) x 7 days

Paediatric dose

30 mg/kg/day [child max 1000 mg]

(30 mg/kg/day in 2 divided doses for 7 days.)

Dose by weight
3kg90 mg/day
4kg120 mg/day
5kg150 mg/day
6kg180 mg/day
7kg210 mg/day
8kg240 mg/day
9kg270 mg/day
10kg300 mg/day
11kg330 mg/day
12kg360 mg/day
13kg390 mg/day
14kg420 mg/day
15kg450 mg/day
16kg480 mg/day
17kg510 mg/day
18kg540 mg/day
19kg570 mg/day
20kg600 mg/day
21kg630 mg/day
22kg660 mg/day
23kg690 mg/day
24kg720 mg/day
25kg750 mg/day
26kg780 mg/day
27kg810 mg/day
28kg840 mg/day
29kg870 mg/day
30kg900 mg/day
31kg930 mg/day
32kg960 mg/day
33kg990 mg/day
34kg1000 mg/day (capped)
35kg1000 mg/day (capped)
36kg1000 mg/day (capped)
37kg1000 mg/day (capped)
38kg1000 mg/day (capped)
39kg1000 mg/day (capped)
40kg1000 mg/day (capped)
41kg1000 mg/day (capped)
42kg1000 mg/day (capped)
43kg1000 mg/day (capped)
44kg1000 mg/day (capped)
45kg1000 mg/day (capped)
46kg1000 mg/day (capped)
47kg1000 mg/day (capped)
48kg1000 mg/day (capped)
49kg1000 mg/day (capped)
50kg1000 mg/day (capped)
Dose source

Egyptian National Drug Formulary - Antimicrobial 2023

Why

First-generation oral cephalosporin used as an alternative antibiotic for Bartholin abscess in patients with mild, non-anaphylactic penicillin allergy; combined with metronidazole when anaerobic involvement is suspected.

Cautions
  • 1 g a day is the whole skin dose. 500 mg twice daily reaches it; 1 g twice daily is double it and is the urinary-tract figure, not the skin one.
  • Alternative oral cephalosporin for patients with mild non-anaphylactic penicillin allergy.
  • Use with caution in renal impairment; dosage adjustment may be required.
Egyptian brands
Egyptian brandManufacturerIndicative price
MEGADROXIL 500 MG 8 CAPS.SHIFA MEDICAL PRODUCTS > MASH PREMIERE4.50 EGP (0.56/unit)
CEFADROXIL 500MG 8 CAPS.SIGMA7.50 EGP (0.94/unit)
DURABIOTIC 500MG 8 CAPS.LOGESTIC PHARMA FOR PHARMACEUTICALS9.00 EGP (1.12/unit)
BIODROXIL 500MG 8 CAPS.KAHIRA > NOVARTIS10.50 EGP (1.31/unit)
LONGICEF 500 MG 8 CAPS.KAHIRA15.00 EGP (1.88/unit)
CURISAFE 500MG 8 CAPS.PHARCO B45.00 EGP (5.62/unit)
DURICEF 500MG 12 CAPS.SMITHKLINE BEECHAM72.00 EGP (6.00/unit)
LONGICEF 125MG/5ML SUSP. 60 ML? strength differs? different route - not oral solidKAHIRA4.25 EGP
CEFADROXIL 250MG/5ML PD. FOR ORAL SUSP. 60ML? strength differs? different route - not oral solidSIGMA7.50 EGP
5

METRONIDAZOLE

add-on - not a substitute

Strength500 mg

Formoral.solid

Adult dose and duration

500 mg orally twice to three times daily for 7 days in combination with a second-line aerobic agent (e.g., Cefadroxil) x 7 days

Paediatric dose

7.5 mg/kg/dose [child max 500 mg]

(7.5 mg/kg 3 times daily (max 500 mg/dose) for 7 days.)

Dose by weight
3kg22.5 mg/dose
4kg30 mg/dose
5kg37.5 mg/dose
6kg45 mg/dose
7kg52.5 mg/dose
8kg60 mg/dose
9kg67.5 mg/dose
10kg75 mg/dose
11kg82.5 mg/dose
12kg90 mg/dose
13kg97.5 mg/dose
14kg105 mg/dose
15kg112.5 mg/dose
16kg120 mg/dose
17kg127.5 mg/dose
18kg135 mg/dose
19kg142.5 mg/dose
20kg150 mg/dose
21kg157.5 mg/dose
22kg165 mg/dose
23kg172.5 mg/dose
24kg180 mg/dose
25kg187.5 mg/dose
26kg195 mg/dose
27kg202.5 mg/dose
28kg210 mg/dose
29kg217.5 mg/dose
30kg225 mg/dose
31kg232.5 mg/dose
32kg240 mg/dose
33kg247.5 mg/dose
34kg255 mg/dose
35kg262.5 mg/dose
36kg270 mg/dose
37kg277.5 mg/dose
38kg285 mg/dose
39kg292.5 mg/dose
40kg300 mg/dose
41kg307.5 mg/dose
42kg315 mg/dose
43kg322.5 mg/dose
44kg330 mg/dose
45kg337.5 mg/dose
46kg345 mg/dose
47kg352.5 mg/dose
48kg360 mg/dose
49kg367.5 mg/dose
50kg375 mg/dose
Dose source

Egyptian National Drug Formulary - Antimicrobial 2023

Why

Anti-anaerobic agent added alongside an aerobic-spectrum antibiotic such as cefadroxil to cover the anaerobic component of a Bartholin abscess; not used alone, since it leaves the aerobic organisms also implicated in these infections uncovered.

Cautions
  • Provides targeted coverage for anaerobic pathogens involved in Bartholin abscesses.
  • Send wound swab for culture and sensitivity, including tests for Neisseria gonorrhoeae and Chlamydia trachomatis.
  • Strictly avoid alcohol and propylene glycol-containing products during treatment and for 3 days (72 hours) after the last dose - Egyptian National Drug Formulary, Antimicrobial 2023.
Egyptian brands
Egyptian brandManufacturerIndicative price
DUMOZOL 500MG 20 F.C. TABS.MINA PHARM > ALPHARMA-DENMARK7.00 EGP (0.35/unit)
ZOLGUARD 500MG 20 TAB.UNIPHARMA CO. > UNIPHARMA9.00 EGP (0.45/unit)
NITROFECTAZOLE 500 MG 20 F.C. TABS.GYPTO PHARMA10.50 EGP (0.53/unit)
FLAGICURE FORTE 500 MG 20 F.C. TABKAHIRA23.00 EGP (1.15/unit)
TRICHOGYL 500MG 12 F.C.TAB.EL NASR15.00 EGP (1.25/unit)
FLAGELLAT FORTE 500MG 20 F.C.TABS.MUP30.00 EGP (1.50/unit)
GEDAZOLE 500MG 20 TAB.JEDCO INT. CO. FOR PHARMACEUTICALS34.00 EGP (1.70/unit)
METROGYPTON 500 MG 20 F.C. TABS.GYPTO PHARMA34.00 EGP (1.70/unit)
DUMOZOL 125MG/5ML SUSP. 125ML? strength differs? different route - not oral solidMINA PHARM > ALPHARMA-DENMARK5.75 EGP
METROZOLE 125MG/5ML SUSP. 120 ML? strength differs? different route - not oral solidMEMPHIS19.50 EGP

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.