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Adjunctive antibiotics for drained skin abscesses improve clinical cure rate
  1. David A Talan
  1. Department of Emergency Medicine and Department of Medicine, Division of Infectious Diseases, David Geffen School of Medicine at UCLA, University of California, Los Angeles, California, USA
  1. Correspondence to Dr David A Talan, Department of Emergency Medicine and Department of Medicine, Division of Infectious Diseases, David Geffen School of Medicine at UCLA, University of California, Los Angeles, CA 91342-1495, USA; dtalan{at}ucla.edu

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Commentary on: Daum RS, Miller LG, Immergluck LA, et al. Placebo-controlled trial of antibiotics for smaller skin abscesses. N Engl J Med 2017;376:2545–55.

Context

The primary treatment of a skin abscess is drainage. Past studies of adjunctive antibiotic treatment conducted before and after the emergence of community-associated methicillin-resistant Staphylococcus aureus (MRSA) in the USA and other parts of the world were small and did not clearly demonstrate benefit. In 2016, Talan et al 1 reported a US randomised placebo-controlled trial (RCT) among 1265 mostly adults, including some with co-morbidities, which demonstrated that treatment with an antibiotic possessing in vitro activity against MRSA, trimethoprim–sulfamethoxazole (TMP-SMX), was associated with a significantly higher short-term cure rate among patients with a drained skin abscess ≥2 cm in diameter. TMP-SMX-treated participants also had fewer additional drainage procedures and new site skin infections through 4–6 post-treatment. Overall adverse event rates were similar, with slightly …

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