# Bartholin's Cyst and Abscess - Category: infectious - Review status: reviewed (every claim checked against a document named on this page) - Sources: CDC Sexually Transmitted Infections Treatment Guidelines 2021 · Egyptian National Drug Formulary - Antimicrobial 2023 · StatPearls: Bartholin Gland Cyst (NCBI Bookshelf NBK532271) - Verified date: 2026-08 ## Verified against - 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) ## Treatment metadata - Conservative Management & Surgical Drainage (Primary Care Strategy) - Amoxicillin + Clavulanic acid — 1000 mg — oral.solid - Referral & safety-netting (no drug therapy) - Cefadroxil — 500 mg — oral.solid - Metronidazole — 500 mg — oral.solid ## Complete treatment card ```text BARTHOLIN'S CYST AND ABSCESS Sources: CDC Sexually Transmitted Infections Treatment Guidelines 2021 · Egyptian National Drug Formulary - Antimicrobial 2023 · StatPearls: Bartholin Gland Cyst (NCBI Bookshelf NBK532271) Review status: REVIEWED against 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) (2026-08) 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 Source StatPearls "Anatomy, Abdomen and Pelvis: Bartholin Gland" - disease-level clinical article Status traced to the source above 1. CONSERVATIVE MANAGEMENT & SURGICAL DRAINAGE (PRIMARY CARE STRATEGY)[1st line] Adult 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 Peds Asymptomatic cysts require observation. Abscesses require surgical evaluation for drainage under appropriate pediatric anesthesia. 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. Caution 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] Adult 1 g (875/125 mg) orally twice daily (or 625 mg TID) for 7 days following drainage or for expanding cellulitis x 7 days Peds 25-45 mg/kg/day [child max 1750 mg] (25-45 mg/kg/day (amoxicillin component) in 2 divided doses for 7 days.) 3kg -> 75-135 mg/day 4kg -> 100-180 mg/day 5kg -> 125-225 mg/day 6kg -> 150-270 mg/day 7kg -> 175-315 mg/day 8kg -> 200-360 mg/day 9kg -> 225-405 mg/day 10kg -> 250-450 mg/day 11kg -> 275-495 mg/day 12kg -> 300-540 mg/day 13kg -> 325-585 mg/day 14kg -> 350-630 mg/day 15kg -> 375-675 mg/day 16kg -> 400-720 mg/day 17kg -> 425-765 mg/day 18kg -> 450-810 mg/day 19kg -> 475-855 mg/day 20kg -> 500-900 mg/day 21kg -> 525-945 mg/day 22kg -> 550-990 mg/day 23kg -> 575-1035 mg/day 24kg -> 600-1080 mg/day 25kg -> 625-1125 mg/day 26kg -> 650-1170 mg/day 27kg -> 675-1215 mg/day 28kg -> 700-1260 mg/day 29kg -> 725-1305 mg/day 30kg -> 750-1350 mg/day 31kg -> 775-1395 mg/day 32kg -> 800-1440 mg/day 33kg -> 825-1485 mg/day 34kg -> 850-1530 mg/day 35kg -> 875-1575 mg/day 36kg -> 900-1620 mg/day 37kg -> 925-1665 mg/day 38kg -> 950-1710 mg/day 39kg -> 975-1750 mg/day (upper capped) 40kg -> 1000-1750 mg/day (upper capped) 41kg -> 1025-1750 mg/day (upper capped) 42kg -> 1050-1750 mg/day (upper capped) 43kg -> 1075-1750 mg/day (upper capped) 44kg -> 1100-1750 mg/day (upper capped) 45kg -> 1125-1750 mg/day (upper capped) 46kg -> 1150-1750 mg/day (upper capped) 47kg -> 1175-1750 mg/day (upper capped) 48kg -> 1200-1750 mg/day (upper capped) 49kg -> 1225-1750 mg/day (upper capped) 50kg -> 1250-1750 mg/day (upper capped) 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. Caution 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. Egypt E-MOXCLAV 1G 10 F.C. TAB. EIPICO 14.00 EGP (1.40/unit) JULMENTIN 2X 1GM 15 TAB. JULPHAR 57.50 EGP (3.83/unit) DEXICLAVE 1 GM 10 F.C. TABS. RAMEDA > NOVE... 38.50 EGP (3.85/unit) MACLAVEX 1 GM 14 F.C.TABS. MASH PREMIERE 105.00 EGP (7.50/unit) CLAVIMOX 1 GM 12 F.C.TABS. PHARCO 130.00 EGP (10.83/unit) MEGAMOX 1 GM 14 F.C. TABS. AL JAZEERA PH... 178.00 EGP (12.71/unit) CLAVOCILLIN 1 GM 10 DISPERSIBLE TABS. RAMEDA > ORGANOPHARMA 106.00 EGP AUGMENTIN ADULTS 1GM/125MG 12 PWD. ORAL SUSP. SACHETS GLAXO SMITHKLINE 169.00 EGP LARYNCLAVE 125/31 PD. FOR ORAL SUSP. 70ML MISR > AL ROWAD PHARMACEUTICAL... 8.00 EGP -> ? strength differs, ? different route - not oral solid MEGACLAVOX 156MG/5ML PD. FOR SUSP. 60 ML CID 8.00 EGP -> ? strength differs, ? different route - not oral solid 3. REFERRAL & SAFETY-NETTING (NO DRUG THERAPY) [1st line] Adult 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. Caution RED FLAG - Biopsy to rule out malignancy is needed in patients older than 40 or with atypical presentation. 4. CEFADROXIL [2nd line] Adult 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 Peds 30 mg/kg/day [child max 1000 mg] (30 mg/kg/day in 2 divided doses for 7 days.) 3kg -> 90 mg/day 4kg -> 120 mg/day 5kg -> 150 mg/day 6kg -> 180 mg/day 7kg -> 210 mg/day 8kg -> 240 mg/day 9kg -> 270 mg/day 10kg -> 300 mg/day 11kg -> 330 mg/day 12kg -> 360 mg/day 13kg -> 390 mg/day 14kg -> 420 mg/day 15kg -> 450 mg/day 16kg -> 480 mg/day 17kg -> 510 mg/day 18kg -> 540 mg/day 19kg -> 570 mg/day 20kg -> 600 mg/day 21kg -> 630 mg/day 22kg -> 660 mg/day 23kg -> 690 mg/day 24kg -> 720 mg/day 25kg -> 750 mg/day 26kg -> 780 mg/day 27kg -> 810 mg/day 28kg -> 840 mg/day 29kg -> 870 mg/day 30kg -> 900 mg/day 31kg -> 930 mg/day 32kg -> 960 mg/day 33kg -> 990 mg/day 34kg -> 1000 mg/day (capped) 35kg -> 1000 mg/day (capped) 36kg -> 1000 mg/day (capped) 37kg -> 1000 mg/day (capped) 38kg -> 1000 mg/day (capped) 39kg -> 1000 mg/day (capped) 40kg -> 1000 mg/day (capped) 41kg -> 1000 mg/day (capped) 42kg -> 1000 mg/day (capped) 43kg -> 1000 mg/day (capped) 44kg -> 1000 mg/day (capped) 45kg -> 1000 mg/day (capped) 46kg -> 1000 mg/day (capped) 47kg -> 1000 mg/day (capped) 48kg -> 1000 mg/day (capped) 49kg -> 1000 mg/day (capped) 50kg -> 1000 mg/day (capped) 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. Caution 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. Egypt MEGADROXIL 500 MG 8 CAPS. SHIFA MEDICAL... 4.50 EGP (0.56/unit) CEFADROXIL 500MG 8 CAPS. SIGMA 7.50 EGP (0.94/unit) DURABIOTIC 500MG 8 CAPS. LOGESTIC PHAR... 9.00 EGP (1.12/unit) BIODROXIL 500MG 8 CAPS. KAHIRA > NOVA... 10.50 EGP (1.31/unit) LONGICEF 500 MG 8 CAPS. KAHIRA 15.00 EGP (1.88/unit) CURISAFE 500MG 8 CAPS. PHARCO B 45.00 EGP (5.62/unit) DURICEF 500MG 12 CAPS. SMITHKLINE BE... 72.00 EGP (6.00/unit) LONGICEF 125MG/5ML SUSP. 60 ML KAHIRA 4.25 EGP -> ? strength differs, ? different route - not oral solid CEFADROXIL 250MG/5ML PD. FOR ORAL SUSP. 60ML SIGMA 7.50 EGP -> ? strength differs, ? different route - not oral solid 5. METRONIDAZOLE [add-on - not a substitute] Adult 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 Peds 7.5 mg/kg/dose [child max 500 mg] (7.5 mg/kg 3 times daily (max 500 mg/dose) for 7 days.) 3kg -> 22.5 mg/dose 4kg -> 30 mg/dose 5kg -> 37.5 mg/dose 6kg -> 45 mg/dose 7kg -> 52.5 mg/dose 8kg -> 60 mg/dose 9kg -> 67.5 mg/dose 10kg -> 75 mg/dose 11kg -> 82.5 mg/dose 12kg -> 90 mg/dose 13kg -> 97.5 mg/dose 14kg -> 105 mg/dose 15kg -> 112.5 mg/dose 16kg -> 120 mg/dose 17kg -> 127.5 mg/dose 18kg -> 135 mg/dose 19kg -> 142.5 mg/dose 20kg -> 150 mg/dose 21kg -> 157.5 mg/dose 22kg -> 165 mg/dose 23kg -> 172.5 mg/dose 24kg -> 180 mg/dose 25kg -> 187.5 mg/dose 26kg -> 195 mg/dose 27kg -> 202.5 mg/dose 28kg -> 210 mg/dose 29kg -> 217.5 mg/dose 30kg -> 225 mg/dose 31kg -> 232.5 mg/dose 32kg -> 240 mg/dose 33kg -> 247.5 mg/dose 34kg -> 255 mg/dose 35kg -> 262.5 mg/dose 36kg -> 270 mg/dose 37kg -> 277.5 mg/dose 38kg -> 285 mg/dose 39kg -> 292.5 mg/dose 40kg -> 300 mg/dose 41kg -> 307.5 mg/dose 42kg -> 315 mg/dose 43kg -> 322.5 mg/dose 44kg -> 330 mg/dose 45kg -> 337.5 mg/dose 46kg -> 345 mg/dose 47kg -> 352.5 mg/dose 48kg -> 360 mg/dose 49kg -> 367.5 mg/dose 50kg -> 375 mg/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. Caution 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. Egypt DUMOZOL 500MG 20 F.C. TABS. MINA PHARM > ... 7.00 EGP (0.35/unit) ZOLGUARD 500MG 20 TAB. UNIPHARMA CO.... 9.00 EGP (0.45/unit) NITROFECTAZOLE 500 MG 20 F.C. TABS. GYPTO PHARMA 10.50 EGP (0.53/unit) FLAGICURE FORTE 500 MG 20 F.C. TAB KAHIRA 23.00 EGP (1.15/unit) TRICHOGYL 500MG 12 F.C.TAB. EL NASR 15.00 EGP (1.25/unit) FLAGELLAT FORTE 500MG 20 F.C.TABS. MUP 30.00 EGP (1.50/unit) GEDAZOLE 500MG 20 TAB. JEDCO INT. CO... 34.00 EGP (1.70/unit) METROGYPTON 500 MG 20 F.C. TABS. GYPTO PHARMA 34.00 EGP (1.70/unit) DUMOZOL 125MG/5ML SUSP. 125ML MINA PHARM > ... 5.75 EGP -> ? strength differs, ? different route - not oral solid METROZOLE 125MG/5ML SUSP. 120 ML MEMPHIS 19.50 EGP -> ? strength differs, ? different route - not oral solid Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)