Recommendations for Empiric Antibiotic Therapy in Hidradenitis Suppurativa

Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition of the follicular epithelium that impacts 1% to 4% of the general population. It manifests clinically as inflamed nodules that typically are located in intertriginous areas of the body and frequently recur. The nodules can become infected and lead to abscesses, pain, and scarring-all of which can have debilitating consequences for a patient's quality of life. This study aimed to improve HS outcomes by analyzing what pathogens most frequently grow in HS wound cultures. We conducted a retrospective medical chart review of 485 patients with a diagnosis of HS from January 2006 to December 2021 comprising 600 visits at the University of Texas Medical Branch at Galveston. We also provide recommendations for empiric antibiotics based on the anatomic location of HS lesions and culture sensitivity profiles. Utilizing tailored antibiotic therapy following initial clinical evaluation may increase early disease control and improve morbidity and disease outcomes, thereby improving patient quality of life.