{ "schema_version": 1, "kind": "condition", "id": "furuncle-boil", "name": "Boil and Furuncle", "category": "infectious", "sources": "IDSA Practice Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections 2014 · Egyptian National Drug Formulary - Antimicrobial 2023 · IDSA Practice Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections, 2014 update · IDSA Clinical Practice Guidelines for the Treatment of MRSA Infections in Adults and Children, 2011 · Egyptian National Drug Formulary - Antimicrobial 2023 (mupirocin monograph)", "review_status": "reviewed", "verified_against": "IDSA Practice Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections, 2014 update · Egyptian National Drug Formulary - Antimicrobial 2023 · IDSA Clinical Practice Guidelines for the Treatment of MRSA Infections in Adults and Children, 2011", "verified_date": "2026-08", "treatments": [ { "id": 762, "generic": "Warm Compresses & Incision & Drainage (Primary Care Strategy)", "line": 1, "is_adjunct": false, "form": null, "strength_mg": null, "adult_dose": "Apply warm moist compresses for 15-20 minutes 3-4 times daily to promote spontaneous drainage for small uncomplicated furuncles (< 2 cm). Perform surgical incision and drainage for fluctuant, painful, or larger abscesses. Systemic antibiotics are NOT required for simple localized drained boils without cellulitis.", "adult_duration": "5-7 days PRN", "dose_source": "IDSA Practice Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections, 2014 update", "rationale": "Incision and drainage is the primary and definitive treatment for fluctuating furuncles; systemic antibiotics provide no added benefit for small, uncomplicated drained lesions without surrounding cellulitis or systemic symptoms.", "cautions": [ "Incision and drainage is the primary definitive treatment for fluctuant boils.", "Indicate systemic antibiotics if surrounding cellulitis (> 2 cm), systemic signs (fever, tachycardia), facial location (risk of cavernous sinus thrombosis), immunosuppression, or severe diabetes are present.", "Never squeeze or compress facial boils in the nasolabial triangle ('danger triangle of the face').", "The compress routine and the 2 cm threshold are ordinary practice, not guideline text - IDSA gives neither. What IDSA does say is that incision and drainage is the treatment for a carbuncle, an abscess or a large furuncle, and that whether to add an antibiotic turns on systemic inflammatory response." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Warm compresses and drainage for small boils in children; assess for surrounding erythema or systemic features.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [], "condition_id": "furuncle-boil" }, { "id": 763, "generic": "Cefadroxil", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": 500.0, "adult_dose": "1 g daily, as a single dose or in 2 divided doses, for 7 days for boils with surrounding cellulitis, systemic symptoms, or high-risk locations", "adult_duration": "7 days", "dose_source": "Egyptian National Drug Formulary - Antimicrobial 2023", "rationale": "First-generation oral cephalosporin with reliable anti-staphylococcal activity, used as first-line systemic therapy when a boil has surrounding cellulitis, systemic symptoms, or is in a high-risk location; cheap and widely stocked in Egypt.", "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.", "First-line oral anti-staphylococcal systemic antibiotic for complicated furuncles/carbuncles in Egyptian primary care.", "Take with or without food; maintain consistent dosing intervals.", "Use with caution in patients with penicillin allergy (1-10% cross-reactivity risk for 1st gen cephalosporins)." ], "peds_mgkg_low": 30.0, "peds_mgkg_high": 30.0, "peds_max_mg": 1000.0, "peds_basis": "day", "peds_unit": "mg", "peds_note": "30 mg/kg/day in 2 divided doses for 7 days.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": [ { "weight_kg": 10, "low_mg": 300, "high_mg": 300, "capped": false }, { "weight_kg": 20, "low_mg": 600, "high_mg": 600, "capped": false }, { "weight_kg": 30, "low_mg": 900, "high_mg": 900, "capped": false }, { "weight_kg": 40, "low_mg": 1000, "high_mg": 1000, "capped": true } ], "brands": [ { "trade_name": "MEGADROXIL 500 MG 8 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SHIFA MEDICAL PRODUCTS > MASH PREMIERE", "price_egp": 4.5, "pack_count": 8, "unit_price": 0.56, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CEFADROXIL 500MG 8 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA", "price_egp": 7.5, "pack_count": 8, "unit_price": 0.94, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DURABIOTIC 500MG 8 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "LOGESTIC PHARMA FOR PHARMACEUTICALS", "price_egp": 9.0, "pack_count": 8, "unit_price": 1.12, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "BIODROXIL 500MG 8 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KAHIRA > NOVARTIS", "price_egp": 10.5, "pack_count": 8, "unit_price": 1.31, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LONGICEF 500 MG 8 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KAHIRA", "price_egp": 15.0, "pack_count": 8, "unit_price": 1.88, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CURISAFE 500MG 8 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO B", "price_egp": 45.0, "pack_count": 8, "unit_price": 5.62, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DURICEF 500MG 12 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SMITHKLINE BEECHAM", "price_egp": 72.0, "pack_count": 12, "unit_price": 6.0, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LONGICEF 125MG/5ML SUSP. 60 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KAHIRA", "price_egp": 4.25, "pack_count": null, "unit_price": null, "strength_mg": 125.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "CEFADROXIL 250MG/5ML PD. FOR ORAL SUSP. 60ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA", "price_egp": 7.5, "pack_count": null, "unit_price": null, "strength_mg": 250.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "furuncle-boil" }, { "id": 764, "generic": "Clindamycin", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": 300.0, "adult_dose": "300 mg to 450 mg orally three times daily for 7 days for penicillin/cephalosporin-allergic patients or suspected MRSA", "adult_duration": "7 days", "dose_source": "IDSA Clinical Practice Guidelines for the Treatment of MRSA Infections in Adults and Children, 2011", "rationale": "Lincosamide antibiotic with anti-staphylococcal and anti-MRSA activity, used as the oral alternative to cefadroxil for boils in patients with penicillin or cephalosporin allergy or when community-acquired MRSA is suspected.", "cautions": [ "Oral option for patients with severe penicillin allergy or suspected community-acquired MRSA.", "Discontinue immediately if severe or persistent diarrhea occurs due to risk of Clostridioides difficile-associated colitis.", "The paediatric band here is the ordinary skin-infection dose. If MRSA is the reason clindamycin was chosen, IDSA gives children 10-13 mg/kg per dose every 6-8 hours - roughly 30-40 mg/kg/day, well above the low end of this band." ], "peds_mgkg_low": 10.0, "peds_mgkg_high": 25.0, "peds_max_mg": 1350.0, "peds_basis": "day", "peds_unit": "mg", "peds_note": "10-25 mg/kg/day in 3-4 divided doses for 7 days.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": [ { "weight_kg": 10, "low_mg": 100, "high_mg": 250, "capped": false }, { "weight_kg": 20, "low_mg": 200, "high_mg": 500, "capped": false }, { "weight_kg": 30, "low_mg": 300, "high_mg": 750, "capped": false }, { "weight_kg": 40, "low_mg": 400, "high_mg": 1000, "capped": false } ], "brands": [ { "trade_name": "ADCOCLINDACE 300 MG 16 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ARAB DRUG COMPANY (ADCO)", "price_egp": 24.0, "pack_count": 16, "unit_price": 1.5, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CLINACYN 300MG 16 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA > EGYPTIAN PHARMACISTS COMPANY", "price_egp": 31.5, "pack_count": 16, "unit_price": 1.97, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CLINDAM 300 MG 16 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA > OCTOBER PHARMA", "price_egp": 75.0, "pack_count": 16, "unit_price": 4.69, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MEPACLIND 300MG 8 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEPACO", "price_egp": 38.0, "pack_count": 8, "unit_price": 4.75, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CLINDACINE ART 300 MG 12 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RAMEDA > ART PHARMA", "price_egp": 76.0, "pack_count": 12, "unit_price": 6.33, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ALFACLINDAMYCIN 300 MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ATCO PHARMA > ROTABIOGEN", "price_egp": 69.0, "pack_count": 10, "unit_price": 6.9, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DALACIN C 300MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PFIZER", "price_egp": 114.0, "pack_count": 10, "unit_price": 11.4, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "KLENDABIOTICAM 1 % TOP. SOLUTION", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PANAX PHARMA", "price_egp": 8.5, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "ADCOCLINDACE 10MG/ML TOP. SOL.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ARAB DRUG COMPANY (ADCO)", "price_egp": 12.0, "pack_count": null, "unit_price": null, "strength_mg": 10.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "furuncle-boil" }, { "id": 765, "generic": "Mupirocin", "line": 1, "is_adjunct": true, "form": "topical", "strength_mg": null, "adult_dose": "Apply the 2% ointment or cream to the affected area 2 to 3 times daily.", "adult_duration": "7 to 14 days, depending on severity and response; reassess if no better after 3 to 5 days", "dose_source": "Egyptian National Drug Formulary - Antimicrobial 2023 (mupirocin monograph) - verbatim: \"Apply to affected area 2 to 3 times daily, typically for 7 to 14 days depending on severity and clinical response; if no response after 3 to 5 days, re-evaluate treatment.\"", "rationale": "Drainage stays the main treatment, but the article lists a topical antibiotic as an add-on. The article also describes mupirocin for clearing nasal staphylococcal carriage in the patient whose boils keep recurring.", "cautions": [ "For external use only - keep it off the eyes and off mucous membranes, because the base can be absorbed and cause drying and irritation.", "Stop it if the skin becomes irritated or sensitised, or if a systemic allergic reaction develops.", "Do not use it for weeks on end: prolonged use encourages fungal or resistant bacterial overgrowth.", "It does not replace incision and drainage - a fluctuant boil still needs draining." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Infants, children and adolescents: apply a small amount three times daily for 5 to 10 days, and review the child if there is no improvement by day 5.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "BACTROFORM 2% TOP. OINT. 15 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "WESTERN PHARMACEUTICALS INDUSTRIES > WESTERN PHARMA", "price_egp": 35.0, "pack_count": null, "unit_price": null, "strength_mg": 15000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MUPIROCIN SAJA 2% TOP. OINT. 15 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "BIOPHARM EGYPT > SAJA PHARMA", "price_egp": 35.0, "pack_count": null, "unit_price": null, "strength_mg": 15000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MUPIRAX 2% OINT. 10 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLOBAL NAPI PHARMACEUTICALS", "price_egp": 48.0, "pack_count": null, "unit_price": null, "strength_mg": 10000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MUPIROCIN SAJA 2% TOP. OINT. 20 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "BIOPHARM EGYPT > SAJA PHARMA", "price_egp": 83.0, "pack_count": null, "unit_price": null, "strength_mg": 20000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MUPIRAX 2% OINT. 30 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLOBAL NAPI PHARMACEUTICALS", "price_egp": 118.0, "pack_count": null, "unit_price": null, "strength_mg": 30000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "furuncle-boil" } ] }