Serrapeptase is a proteolytic enzyme originally derived from the silkworm. Its use in supporting or treating abscesses is primarily justified by scientific rationale, though clinical evidence remains limited and not robust. Serrapeptase is thought to help reduce inflammation, break down non-living tissue, and promote drainage of pus by degrading fibrin and other dead cell components found in abscesses and inflamed tissues. Several in vitro and animal studies have demonstrated that serrapeptase can reduce inflammation and edema, and may enhance antibiotic penetration to sites of infection by disrupting biofilms and breaking down debris.

In the clinical context, a few small studies, mostly from Japan and Europe, have investigated serrapeptase as an adjunctive therapy in ENT (ear, nose, and throat) infections and post-surgical swelling, sometimes including conditions involving abscess formation. These studies report improvements in swelling and pain, but direct evidence specifically for the resolution of abscesses is sparse. Serrapeptase has also been evaluated as an adjunct to antibiotics, with some studies suggesting improved outcomes in infections with abscess components, but larger and more rigorous clinical trials are lacking.

Overall, while there is a plausible scientific rationale and preliminary evidence supporting the use of serrapeptase in conditions involving abscesses, the quality and quantity of clinical evidence is limited. Its use is best described as "scientific" but with weak evidence (rating 2 out of 5).