Treatment of uncomplicated skin abscesses with trimethoprim- sulfamethoxazole

January 01, 0001

Treatment of uncomplicated skin abscesses with trimethoprim- sulfamethoxazole

Community-associated methicillin-resistant Staphylococcus aureus is now the leading cause of uncomplicated skin abscesses in the United States, and the role of antibiotics is controversial. These US authors evaluated whether trimethoprim-sulfamethoxazole reduces the rate of treatment failures during the 7 days after incision and drainage and whether it reduces new lesion formation within 30 days. They conducted a multicenter, double-blind, randomized, placebo-controlled trial, in which adult patients were randomized to oral trimethoprim-sulfamethoxazole or placebo after uncomplicated abscess incision and drainage.

They found: "We randomized 212 patients, and 190 (90%) were available for 7-day follow-up. We observed a statistically similar incidence of treatment failure in patients receiving trimethoprim-sulfamethoxazole (15/88; 17%) versus placebo (27/102; 26%), difference 9%, 95% confidence interval -2% to 21%. On 30-day follow-up (successful in 69% of patients), we observed fewer new lesions in the antibiotic (4/46; 9%) versus placebo (14/50; 28%) groups, difference 19%, 95% confidence interval 4% to 34%."

The authors concluded: "After the incision and drainage of uncomplicated abscesses in adults, treatment with trimethoprim- sulfamethoxazole does not reduce treatment failure but may decrease the formation of subsequent lesions."

Antibiotic treatment of skin abscesses is of marginal benefit.

For the full abstract, click here.

Annals of Emergency Medicine 56(3):283-287, September 2010 © 2010 to Elsevier, Inc.
Randomized Controlled Trial of Trimethoprim-Sulfamethoxazole for Uncomplicated Skin Abscesses in Patients at Risk for Community-Associated Methicillin-Resistant Staphylococcus aureus Infection. Gillian R. Schmitz, David Bruner, Rebecca Pitotti, et al. Correspondence to Dr. Schmitz: [email protected]

Category: S. Skin. Keywords: abscess, incision and drainage, methcillin-resistant Staphylococcus aureus, trimethoprim-sulfamethoxazole, randomized controlled trial, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 7 September 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.