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Bartholin Gland Diseases Medication

  • Author: Antonia Quinn, DO; Chief Editor: Erik D Schraga, MD  more...
 
Updated: Jul 22, 2016
 

Medication Summary

Medications used in the treatment of Bartholin abscesses include topical and local anesthetics. Antibiotics for empiric treatment of STDs are advisable in the doses usually used to treat gonococcal and chlamydial infections. Ideally, antibiotics should be started immediately prior to incision and drainage.

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Anesthetics

Class Summary

These agents may be used topically or as injectables. Topical anesthetic may be used on vaginal mucosa prior to submucosal injection.

Lidocaine anesthetic

 

Decreases permeability to sodium ions in neuronal membranes. Inhibits depolarization, blocking the transmission of nerve impulses, which reduces pain.

Topical preparations are available in spray and ointment form.

Injectable lidocaine is available as 1% or 2% concentration, with or without epinephrine.

Bupivacaine (Marcaine, Sensorcaine)

 

By increasing electrical excitation threshold, slowing nerve impulse propagation, and reducing the action potential, bupivacaine prevents the generation and conduction of nerve impulses to reduce pain.

Concentrations of 0.25% and 0.5% are commonly used for local infiltration. Duration of action is significantly longer than lidocaine. Bupivacaine is available with or without epinephrine.

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Antibiotics

Class Summary

Most Bartholin abscesses are caused by opportunistic pathogens. Uncomplicated abscesses in otherwise healthy women may not require antibiotic therapy after successful drainage. Treatment of N gonorrhoeae and C trachomatis should be initiated only in patients with confirmed disease.

Ceftriaxone (Rocephin)

 

An effective monotherapy against N gonorrhoeae, ceftriaxone is a third-generation cephalosporin with broad-spectrum efficiency against gram-negative organisms, lower efficacy against gram-positive organisms, and higher efficacy against resistant organisms. By binding to 1 or more of penicillin-binding proteins, arrests bacterial cell wall synthesis and inhibits bacterial growth.

Ciprofloxacin (Cipro)

 

An alternative monotherapy to ceftriaxone. Bactericidal antibiotic that inhibits bacterial DNA synthesis and, consequently, growth by inhibiting DNA-gyrase in susceptible organisms.

Doxycycline (Bio-Tab, Doryx, Vibramycin)

 

Inhibits protein synthesis and bacterial replication by binding with 30S and, possibly, 50S ribosomal subunits of susceptible bacteria. Indicated for C trachomatis.

Azithromycin (Zithromax)

 

Used to treat mild-to-moderate infections caused by susceptible strains of microorganisms. Alternative monotherapy for C trachomatis.

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Contributor Information and Disclosures
Author

Antonia Quinn, DO Assistant Professor, Department of Emergency Medicine, State University of New York Downstate Medical Center; Assistant Residency Director, Attending Physician, Department of Emergency Medicine, Kings County Hospital Center, SUNY Downstate Medical Center

Antonia Quinn, DO is a member of the following medical societies: American College of Emergency Physicians, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Richard H Sinert, DO Professor of Emergency Medicine, Clinical Assistant Professor of Medicine, Research Director, State University of New York College of Medicine; Consulting Staff, Vice-Chair in Charge of Research, Department of Emergency Medicine, Kings County Hospital Center

Richard H Sinert, DO is a member of the following medical societies: American College of Physicians, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Erik D Schraga, MD Staff Physician, Department of Emergency Medicine, Mills-Peninsula Emergency Medical Associates

Disclosure: Nothing to disclose.

Additional Contributors

Joseph J Sachter, MD, FACEP Consulting Staff, Department of Emergency Medicine, Muhlenberg Regional Medical Center

Joseph J Sachter, MD, FACEP is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American Association for Physician Leadership, American Medical Association, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Acknowledgements

Howard A Blumstein, MD, FAAEM Assistant Professor of Surgery, Medical Director, Department of Emergency Medicine, Wake Forest University School of Medicine

Howard A Blumstein, MD, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, Emergency Medicine Residents Association, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

M Tyson Pillow, MD Assistant Director of Medical Education, Ben Taub General Hospital Emergency Center; Assistant Professor, Baylor College of Medicine

M Tyson Pillow, MD is a member of the following medical societies: Air Medical Physician Association, American College of Emergency Physicians, American Medical Association, American Medical Student Association/Foundation, Emergency Medicine Residents Association, Society for Academic Emergency Medicine, and Student National Medical Association

Disclosure: Nothing to disclose.

Jennifer Coles Schecter, MD Staff Physician, Department of Emergency Medicine, Lahey Clinic, Burlington, MA

Disclosure: Nothing to disclose.

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Word catheter. (Image courtesy of Dr. Gil Shlamovitz.)
Word catheter with inflated balloon. (Image courtesy of Dr. Gil Shlamovitz.)
Bartholin abscess. (Image courtesy of Dr. Gil Shlamovitz.)
 
 
 
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