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Antibiotic Therapy Adds Benefit for Treating Simple Abscesses

Uncomplicated, small abscesses are very common. They make up many of the skin infections that bring patients in for treatment, and also present low risk for serious complications. Despite the fact that Staphylococcus aureus, including methicillin-resistant S. aureus (MRSA) strains are the culprit in many of these infections, a single treatment regimen has not been identified.

A recent study described the results of a double-blind, placebo-controlled trial where participants were randomly assigned to receive clindamycin, trimethoprim–sulfamethoxazole (TMP-SMX), or placebo after incision and drainage of a single, small abscess. The study included 786 children and adults who presented with a single abscess (defined as a circumscribed, drainable collection of pus) with a diameter no larger than 5.0 cm (≤3 cm for participants6 to 11 months of age and ≤4 cm for participants 1 to 8 years of age). In addition, they had two or more of the following signs or symptoms for at least 24 hours: erythema, swelling or induration, local warmth, purulent drainage, and tenderness to pain or palpation.

The results showed that while the cure rate was significantly higher in the clindamycin group than the placebo group (14% higher), the cure rates between the groups that received TMP-SMX or clindamycin were not significantly different. The findings demonstrate a clinical benefit of antibiotic therapy in addition to incision and drainage in patients with S. aureus infection. Clindamycin was as effective as TMP-SMX for most patients, but clindamycin may be slightly more effective for children.

The authors conclude that despite perception to the contrary, short-term outcomes among patients with uncomplicated cutaneous abscesses, particularly those caused by S. aureus, are improved by antibiotic treatment in addition to abscess incision and drainage.


Byline: Martha L. Sikes, MS, RPh, PA-C

Posted: July 31, 2017

Source: The New England Journal of Medicine
Adapted from the original article.

[Image: Shutterstock]

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