Centre of Evidence of Dermatology Best practice guidelines

Guidelines hidradenitis suppurativa Updated on august 2019


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Hurley stage Ⅲ

Back to decision-making tree Print last updated on 01/04/2020

Specialised multidisciplinary care [B]

Initial treatment

  • Ceftriaxone (IV, IM or SC)
    1 g/d (if < 60 kg) to 2 g/d (if ≥ 60 kg)
    + metronidazole oral dose (500 mg 3×/d)


  • Levofloxacine (500 mg, 1-2x/d)
    + clindamycin (600 mg, 3x/d)

→ for 15 to 21 days

read antibiotherapy


After initial treatment, the following options should be discussed according to the Medical and surgical concertation meeting opinion:

In cases of treatment failure, intolerance or contraindication for cyclins antibiotics (risk of serious toxidermia)
Medical and surgical concertation meeting specifically on HS
Double dose if weight > 80 kg
MA, but not reimbursed
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