The Infectious Diseases Society of America (IDSA) recommends systemic antibiotic treatment, in addition to incision and drainage, for patients with severe or extensive disease (e.g., multiple sites of infection) or with rapid disease progression and associated cellulitis, signs and symptoms of systemic illness, associated coexisting conditions or immunosuppression, very young age or advanced age, an abscess in an area difficult to drain (e.g., face, hands, or genitalia), associated septic phlebitis, or an abscess that does not respond to incision and drainage alone.20 In a study involving children with an abscess caused by MRSA, an abscess diameter greater than 5 cm was found to be associated with subsequent hospitalization, although most children were treated with antibiotics that were not active against MRSA, and drainage procedures were not standardized.34In the trial involving adults, discussed above,33 an abscess diameter greater than 5 cm was not associated with an increased rate of treatment failure.35 Notions that patients with larger lesions, surrounding cellulitis, fever, or coexisting conditions particularly benefit from treatment with adjunctive antibiotics have not been systematically investigated or explored within large randomized trials and therefore are speculative.