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Randomised controlled trial
Compared with placebo, trimethoprim–sulfamethoxazole does not reduce rates of treatment failure after drainage of uncomplicated skin abscesses, but reduces the occurrence of new lesions in the following 30 days
  1. Daniel J Elliott1,
  2. Marci L Drees2
  1. 1Division of General Internal Medicine, Christiana Care Health System
  2. 2Division of Infectious Diseases, Christiana Care Health System
  1. Correspondence to Daniel J. Elliott
    Christiana Hospital Office 4B01, 4755 Ogletown-Stanton Road Newark, DE 19718, USA; delliott{at}christianacare.org

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Context

Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) is now the most commonly identified cause of uncomplicated skin abscesses. Incision and drainage of abscesses is critical to resolution, but the role of adjunctive antibiotic therapy remains controversial.1 This study examines whether trimethoprim/sulfamethoxazole (TMP-SMX) following incision and drainage of uncomplicated skin abscesses decreases treatment failure compared to incision and drainage alone.

Methods

Schmitz and colleagues performed a randomised, double-blinded, placebo-controlled trial to compare the benefit of TMP-SMX in healthy patients older than 16 years who were treated for uncomplicated abscesses in the emergency department. The study enrolled 212 patients during 2007–2009 at four emergency departments that treat civilian and military patients. They excluded patients who were immunocompromised, pregnant or breast-feeding, systemically ill, sulfa-allergic, hospitalised in the previous month or who had taken antibiotics within the previous week. Patients were …

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