Bartholin Abscess Antibiotics — SCE Infectious Diseases MCQ

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EasySTIsBartholin Abscess AntibioticsSCE Infectious Diseases

A 35-year-old woman with well-controlled HIV (CD4 600, VL <50 on ART) develops a Bartholin abscess. She is systemically well. In addition to incision and drainage with Word catheter insertion, should she receive antibiotic prophylaxis or treatment?

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Correct answer: B — Antibiotics are not routinely indicated for uncomplicated Bartholin abscess after adequate drainage in a systemically well, immunocompetent patient — swab for culture including STI NAAT

Explanation lettering: B = shown as A · A = shown as B · E = shown as C · C = shown as E

Uncomplicated Bartholin abscess management is primarily surgical (I&D with Word catheter or marsupialisation). Antibiotics are not routinely required in systemically well patients after adequate drainage — regardless of HIV status (when well-controlled with good CD4). Antibiotics are indicated only if: surrounding cellulitis, systemic sepsis, or immunocompromise with poor CD4 count. Wound swabs should be sent for culture (aerobic, anaerobic) and STI NAAT (Chlamydia, Gonorrhoea). The well-controlled HIV with CD4 600 does not alter standard surgical management.

Reference: BASHH 2019 – Bartholin abscess; NICE CKS 2024; RCOG 2016