Trimethoprim-sulfamethoxazole versus placebo for uncomplicated skin abscess

New England Journal of Medicine

Volumn 374, Issue 9, 2016, Pages 823-832

  Talan, David A ^a   Mower, William R ^b   Krishnadasan, Anusha ^a   Abrahamian, Fredrick M ^a   Lovecchio, Frank ^c   Karras, David J ^d   Steele, Mark T ^e   Rothman, Richard E ^f   Hoagland, Rebecca ^g   Moran, Gregory J ^a  

^a OLIVE VIEW UCLA MEDICAL CENTER   (United States)

^b UCLA MEDICAL CENTER   (United States)

^c UNIVERSITY OF ARIZONA   (United States)

^d TEMPLE UNIVERSITY HOSPITAL   (United States)

^e TRUMAN MEDICAL CENTER   (United States)

^f JOHNS HOPKINS UNIVERSITY SCHOOL OF MEDICINE   (United States)

^g NONE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

COTRIMOXAZOLE; PLACEBO; ANTIINFECTIVE AGENT;

ADOLESCENT; ADULT; AGED; ARTICLE; BACTEREMIA; BACTERIAL ARTHRITIS; BACTERIAL ENDOCARDITIS; BACTERIUM CULTURE; CLOSTRIDIUM DIFFICILE INFECTION; CONTROLLED STUDY; DISEASE TRANSMISSION; DOUBLE BLIND PROCEDURE; DRUG EFFICACY; DRUG WITHDRAWAL; EMERGENCY WARD; FEMALE; GASTROINTESTINAL SYMPTOM; HUMAN; MAJOR CLINICAL STUDY; MALE; METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS; MULTICENTER STUDY; NECROTIZING FASCIITIS; OSTEOMYELITIS; PNEUMONIA; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL; SEPSIS; SKIN ABSCESS; SKIN INFECTION; SURGICAL DRAINAGE; ABSCESS; CLINICAL TRIAL; COMPARATIVE STUDY; DRAINAGE; EMERGENCY HEALTH SERVICE; MIDDLE AGED; MULTIMODALITY CANCER THERAPY; SKIN DISEASES, BACTERIAL; TREATMENT OUTCOME; YOUNG ADULT;

ABSCESS; ADOLESCENT; ADULT; AGED; ANTI-BACTERIAL AGENTS; COMBINED MODALITY THERAPY; DRAINAGE; EMERGENCY SERVICE, HOSPITAL; FEMALE; HUMANS; MALE; MIDDLE AGED; SKIN DISEASES, BACTERIAL; TREATMENT OUTCOME; TRIMETHOPRIM, SULFAMETHOXAZOLE DRUG COMBINATION; YOUNG ADULT;

EID: 84959568646     PISSN: 00284793     EISSN: 15334406     Source Type: Journal    
DOI: 10.1056/NEJMoa1507476     Document Type: Article

References (25)

1. Pallin DJ, Egan DJ, Pelletier AJ, Espi-nola JA, Hooper DC, Camargo CA Jr. Increased US emergency department visits for skin and soft tissue infections, and changes in antibiotic choices, during the emergence of community-associated meth-icillin-resistant Staphylococcus aureus. Ann Emerg Med 2008;51:291-8.
2. Qualls ML, Mooney MM, Camargo CA Jr, Zucconi T, Hooper DC, Pallin DJ. Emergency department visit rates for abscess versus other skin infections during the emergence of community-associated meth-icillin-resistant Staphylococcus aureus, 1997-2007. Clin Infect Dis 2012; 55: 103-5.
3. Moran GJ, Krishnadasan A, Gorwitz RJ, et al. Methicillin-resistant S. aureus infections among patients in the emergency department. N Engl J Med 2006; 355: 666-74.
4. Talan DA, Krishnadasan A, Gorwitz RJ, et al. Comparison of Staphylococcus aureus from skin and soft-tissue infections in US emergency department patients, 2004 and 2008. Clin Infect Dis 2011; 53: 144-9.
5. Singer AJ, Talan DA. Management of skin abscesses in the era of methicillin-resistant Staphylococcus aureus. N Engl J Med 2014;370:1039-47.
6. Macfie J, Harvey J. The treatment of acute superficial abscesses: a prospective clinical trial. Br J Surg 1977; 64: 264-6.
7. Meislin HW, Lerner SA, Graves MH, et al. Cutaneous abscesses: anaerobic and aerobic bacteriology and outpatient management. Ann Intern Med 1977; 87: 145-9.
8. Llera JL, Levy RC, Staneck JL. Cutaneous abscesses: natural history and management in an outpatient facility. J Emerg Med 1984;1:489-93.
9. Llera JL, Levy RC. Treatment of cutaneous abscess: a double-blind clinical study. Ann Emerg Med 1985; 14: 15-9.
10. Lee MC, Rios AM, Aten MF, et al. Management and outcome of children with skin and soft tissue abscesses caused by community-acquired methicillin-resis-tant Staphylococcus aureus. Pediatr Infect Dis J 2004;23:123-7.
11. Ruhe JJ, Smith N, Bradsher RW, Menon A. Community-onset methicillin-resistant Staphylococcus aureus skin and soft-tissue infections: impact of antimicrobial therapy on outcome. Clin Infect Dis 2007; 44: 777-84.
12. Szumowski JD, Cohen DE, Kanaya F, Mayer KH. Treatment and outcomes of infections by methicillin-resistant Staphy-lococcus aureus at an ambulator y clinic. Anti-microb Agents Chemother 2007; 51: 423-8.
13. Rajendran PM, Young D, Maurer T, et al. Randomized, double-blind, placebo-controlled trial of cephalexin for treatment of uncomplicated skin abscesses in a population at risk for community-acquired methicillin-resistant Staphylococcus aureus infection. Antimicrob Agents Chemother 2007;51:4044-8.
14. Duong M, Markwell S, Peter J, Baren-kamp S. Randomized, controlled trial of antibiotics in the management of community-acquired skin abscesses in the pediatric patient. Ann Emerg Med 2010; 55: 401-7.
15. Schmitz GR, Bruner D, Pitotti R, et al. Randomized controlled trial of trime-thoprim-sulfamethoxazole for uncomplicated skin abscesses in patients at risk for community-associated methicillin-resis-tant Staphylococcus aureus infection. Ann Emerg Med 2010;56:283-7.
16. Talan DA. Lack of antibiotic efficacy for simple abscesses: have matters come to a head? Ann Emerg Med 2010; 55: 412-4.
17. Fitch MT, Manthey DE, McGinnis HD, Nicks BA, Pariyadath M. Videos in clinical medicine: abscess incision and drainage. N Engl J Med 2007; 357(19): e20.
18. Gilbert DN, Moellering RC, Eliopoulos GM, Sande MA. The Sanford guide to antimicrobial therapy. 38th ed. Sperry-ville, VA: Antimicrobial Therapy, 2008.
19. Guidance for industry: acute bacterial skin and skin structure infections: developing drugs for treatment. Silver Spring, MD: Food and Drug Administration, Center for Drug Evaluation and Research, 2013 (http://www.fda.gov/downloads/drugs/guidancecomplianceregulatoryinformation/guidances/ucm071185.pdf).
20. Spellberg B, Boucher H, Bradley J, Das A, Talbot G. To treat or not to treat: ad-junctive antibiotics for uncomplicated abscesses. Ann Emerg Med 2011; 57: 183-5.
21. Chan HL, Stern RS, Arndt KA, et al. The incidence of erythema multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis: a population-based study with particular reference to reactions caused by drugs among outpatients. Arch Dermatol 1990; 126: 43-7.
22. Liu C, Bayer A, Cosgrove SE, et al. Clinical practice guidelines by the Infectious Diseases Society of America for the treatment of methicillin-resistant Staphy-lococcus aureus infections in adults and children. Clin Infect Dis 2011; 52(3): e18-55.
23. Gorwitz RJ, Jernigan DB, Powers JH, Jernigan JA. Strategies for clinical management of MRSA in the community: summary of an experts' meeting convened by the Centers for Disease Control and Prevention. March 2006 (http://www.cdc.gov/mrsa/pdf/MRSA-Strategies-ExpMtgSummar y-2006.pdf).
24. Stevens DL, Bisno AL, Chambers HF, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis 2014;59(2):e10-52.
25. Bruun JN, Ostby N, Bredesen JE, Kier-ulf P, Lunde PKM. Sulfonamide and tri-methoprim concentrations in human serum and skin blister fluid. Antimicrob Agents Chemother 1981;19:82-5.