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Adding antibiotic to conventional approach beneficial for uncomplicated cutaneous abscesses

The addition of an antibiotic course of therapy to surgically draining uncomplicated cutaneous abscesses resulted in a higher cure rate among patients compared to surgical drainage of skin abscesses alone, University of California, Los Angeles (UCLA) researchers reported in The New England Journal of Medicine (Mar. 3, 2016; 374:823–832).

“Traditional teaching has been that the only treatment needed for most skin abscesses is surgical drainage—and that antibiotics does not provide an extra benefit,” said Dr. Gregory Moran, clinical professor of emergency medicine at the Geffen School, chief of the department of emergency medicine at Olive View–UCLA and one of the study’s authors.

“Our findings will likely result in patients more often being recommended to take antibiotics in addition to having surgical drainage when they get a skin abscess," said Dr. Moran, who was quoted in a UCLA press release.

These findings are particularly important to help in the prevention and spreading of community-acquired methicillin-resistant staphylococcus aureus (MRSA), the UCLA researchers indicated.

“MRSA is not going away, so we need to find better ways to treat and prevent it,” said Dr. David Talan, the study’s lead author and a professor in the department of emergency medicine and department of medicine, division of infectious diseases, at the David Geffen School of Medicine at UCLA and Olive View–

UCLA Medical Center.

Few recurring infections

The researchers conducted a randomized trial at five U.S. emergency departments to determine whether trimethoprim–sulfamethoxazole (at doses of 320 mg and 1600 mg, respectively, twice daily, for seven days) would be superior to placebo in outpatients older than 12 years of age who had an uncomplicated abscess being treated with drainage.

More than 1,200 patients with a median age of 35 years (range, 14 to 73) were included. Data showed that 45.3% of the participants had wound cultures positive for MRSA.

Findings revealed that clinical cure of the cutaneous abscess occurred in 93% of patients who took trimethoprim–sulfamethoxazole, well above the 86% who took the placebo.

“We found that adding in a specific antibiotic to the medical treatment also resulted in fewer recurring infections, fewer infections in other places on the body and fewer people passing on the infection to other members of the household,” said Dr. Talan, who added that this translates into fewer medical visits and reduced health care costs.

Dr. Talan said, “We hope the information will help guide doctors as to the best ways to address skin infections.”

Tips for your patients to prevent the spread of skin infections

MRSA and other types of skin infection can be easily transmitted from one person to another, but Dr. Talan said the following tips can help prevent infection from spreading:

  • People with skin infections should be careful to keep lesions covered with a dressing or bandage and should thoroughly wash their hands after changing the bandage. Used bandages should be placed immediately in the trash.

  • Individuals should avoid sharing personal items such as towels, razors or brushes with anyone who has an active skin infection.

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