The treatment of perianal fistula typically includes antibiotics, drainage, and/or surgery. The antibiotic of choice for perianal fistula will depend on the type of infection and the overall health of the patient.
Antibiotic Selection
The most common antibiotic used for perianal fistula is cefazolin. This is an intravenous antibiotic that is effective against most bacteria that can cause perianal fistula. Other antibiotics, such as amoxicillin-clavulanate, may also be used. The choice of antibiotic should be based on the results of a culture and sensitivity test, which will reveal which antibiotics are effective against the specific type of bacteria causing the infection.
Drainage
In some cases, drainage of the perianal fistula may be necessary. This is done through a procedure called fistulotomy. During a fistulotomy, a surgeon will make a small incision in the fistula and insert a tube to allow the fluid to drain. This can help reduce the swelling and pain caused by the infection.
Surgery
In some cases, surgery may be necessary to treat a perianal fistula. This is typically done if the infection does not respond to antibiotics or drainage. During the procedure, the surgeon will remove any infected tissue and close the fistula. Surgery can help reduce the risk of recurrence or infection of the fistula.
The antibiotic of choice for perianal fistula will depend on the type of infection, the overall health of the patient, and the results of a culture and sensitivity test. In some cases, drainage and/or surgery may be necessary to treat the infection. It is important to follow the advice of a healthcare professional when deciding on the best treatment for perianal fistula.