How many days of antibiotic injections are needed to treat a perianal abscess?

Written by Chen Tian Jing
Colorectal Surgery
Updated on April 06, 2025
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During the acute phase of a perianal abscess, the main focus is on the nature of the local abscess. If it is a hard swelling without pus formation, anti-inflammatory injections or antibiotics can be used for symptomatic treatment. Generally, a five to seven-day course of antibiotic and anti-inflammatory treatment can reduce the local swelling, but it cannot guarantee a 100% chance of non-recurrence in the future. If a local pus cavity or swelling has already formed, and there is pus formation, simply using anti-inflammatory injections for symptomatic treatment will not be curative. Surgery is also required, mainly involving opening the local pus cavity, cleaning out the pus thoroughly, and removing local infection foci to promote normal growth of fresh granulation tissue, which could then lead to the healing of the local wound.

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Written by Chen Tian Jing
Colorectal Surgery
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Is the recurrence rate of perianal abscess high?

Perianal abscess is an acute infectious disease localized around the anus. If a perianal abscess acutely erupts, it requires prompt surgical treatment. Without surgery, there is a possibility of recurrent episodes of perianal abscesses or the formation of anal fistulas due to the rupture of the abscess. After surgery for a perianal abscess, it is also important to pay attention to a light diet and regular bowel movements. It is crucial not to allow the stool to become too dry, nor to experience diarrhea. Recurrent diarrhea can lead to infection of the anal crypts, thereby causing perianal abscesses and local infections. Therefore, the care of a perianal abscess is very important; maintaining good dietary and bowel habits is essential to prevent recurrence of the abscess.

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Colorectal Surgery
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Symptoms of perianal abscess

Perianal abscess is a common acute infectious disease in proctology. When a perianal abscess occurs, the patient generally experiences severe pain in the anal area accompanied by local skin redness, increased skin temperature, and even systemic fever and fatigue symptoms due to the local abscess. During an outbreak of a perianal abscess, the abscess cavity or pus encapsulation can generally be clearly seen under perianal color ultrasound, and it is necessary to promptly carry out perianal abscess incision and drainage surgery, as well as further one-time radical surgery for the perianal abscess. If not treated actively, a perianal abscess might rupture and likely form an anal fistula, the treatment of which is also primarily surgical.

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Written by Chen Tian Jing
Colorectal Surgery
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How many days of antibiotic injections are needed to treat a perianal abscess?

During the acute phase of a perianal abscess, the main focus is on the nature of the local abscess. If it is a hard swelling without pus formation, anti-inflammatory injections or antibiotics can be used for symptomatic treatment. Generally, a five to seven-day course of antibiotic and anti-inflammatory treatment can reduce the local swelling, but it cannot guarantee a 100% chance of non-recurrence in the future. If a local pus cavity or swelling has already formed, and there is pus formation, simply using anti-inflammatory injections for symptomatic treatment will not be curative. Surgery is also required, mainly involving opening the local pus cavity, cleaning out the pus thoroughly, and removing local infection foci to promote normal growth of fresh granulation tissue, which could then lead to the healing of the local wound.

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Written by Chen Tian Jing
Colorectal Surgery
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Precautions for Perianal Abscess

The precautions for perianal abscess mainly include those during an acute episode and post-surgical measures. If it is clearly an acute onset of a perianal abscess, it is important to seek treatment promptly. Treatment methods, besides incision and drainage, further include debridement to achieve a complete cure through surgery. Generally, simple incision and drainage only alleviate temporary pain symptoms. If not followed by definitive surgery, there is a high likelihood of developing anal fistulas, necessitating a second surgery. Post-surgical precautions for a perianal abscess primarily involve maintaining cleanliness of the local wound, changing dressings, and ensuring that the drainage from the wound remains unobstructed to prevent false healing.

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Colorectal Surgery
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What should I do if the perianal abscess bursts?

Since a perianal abscess is an acute symptom of a local skin infection around the anus, during the acute phase of a perianal abscess, an abscess cavity and pus formation generally occur within about a week. As the disease worsens and progresses, the perianal abscess will rupture about a week later. If the perianal abscess ruptures, it may have already formed an anal fistula. A perianal abscess and an anal fistula represent two different stages of the disease, and both require surgical treatment. The main surgical treatment for anal fistulas is fistulotomy with seton placement, and care must be taken to drain and disinfect the local wound post-surgery to prevent pseudohealing of the wound.