Perianal Abscess, Antibiotic Treatment

Glands near the anus can become blocked. This can lead to infection. If the infection can't drain, a collection of pus called an abscess may form. Symptoms of an abscess include anal or rectal pain, itching, swelling, and fever. Frequently the abscess results in a fistula, which is an abnormal connection between the abscess and the skin where pus drains. A fistula may sometimes be seen on exam and may require other testing and treatments.

Your healthcare provider will likely drain the abscess. In some cases, he or she will also prescribe antibiotics. People with artificial valves, diabetes, weak immune systems, and certain other conditions always need antibiotics.

Home care

  • Abscesses are almost always drained. Follow any instructions from your provider about care of the incision site.

  • If you are prescribed antibiotics, take them exactly as prescribed. Take all of the antibiotic medicine as prescribed. Continue it even if you start feeling better. Finish all of the medicine unless your healthcare provider tells you to stop.

  • Try sitz baths. Sit in a tub filled with about 6 inches of hot water for 15 to 30 minutes. Test the water temperature before sitting down to ensure it will not burn you. Repeat this twice a day until pain is relieved.

  • Unless a pain medicine has been prescribed, you may take an over-the-counter medicine, such as ibuprofen, for pain. 

  • Passing stools may be painful. If so, ask your healthcare provider about using a stool-softener for a short time. Gradually adding fiber to your diet, or taking a fiber supplement, is also helpful.

Follow-up care

Follow up with your doctor, or as advised.

When to seek medical advice

Call your healthcare provider right away if any of the following occur:

  • Increasing pain, swelling, or redness

  • Pus draining from the abscess

  • Fever of 100.4ºF (38ºC) or higher that continues for a day after starting antibiotics, or as directed by your healthcare provider

  • Other symptoms such as rectal bleeding, abdominal pain, or chronic diarrhea. Your provider will evaluate whether the abscess may indicate other medical conditions.

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