The primary management of an abscess is incision and drainage because an abscess is a localized collection of pus that requires mechanical evacuation to resolve. Antibiotics alone are often insufficient as they cannot adequately penetrate the abscess cavity. Incision and drainage allows complete removal of purulent material, reduces pressure, facilitates healing, and prevents the spread of infection. Effective drainage also allows better penetration of antibiotics if needed post-procedure. This approach is essential to prevent complications such as cellulitis or systemic infection.

Reference: Harrison's Principles of Internal Medicine, Kasper et al., 20th Edition.