151. A Placebo-Controlled Trial of Antibiotics for Smaller Skin Abscesses
- Author
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Daum, Robert S, Miller, Loren G, Immergluck, Lilly, Fritz, Stephanie, Creech, C Buddy, Young, David, Kumar, Neha, Downing, Michele, Pettibone, Stephanie, Hoagland, Rebecca, Eells, Samantha J, Boyle, Mary G, Parker, Trisha Chan, and Chambers, Henry F
- Subjects
Biomedical and Clinical Sciences ,Clinical Sciences ,Infectious Diseases ,Antimicrobial Resistance ,Emerging Infectious Diseases ,Clinical Trials and Supportive Activities ,Clinical Research ,6.1 Pharmaceuticals ,Infection ,Abscess ,Adolescent ,Adult ,Anti-Bacterial Agents ,Child ,Child ,Preschool ,Clindamycin ,Combined Modality Therapy ,Double-Blind Method ,Drainage ,Female ,Humans ,Infant ,Intention to Treat Analysis ,Male ,Methicillin-Resistant Staphylococcus aureus ,Prospective Studies ,Skin Diseases ,Bacterial ,Staphylococcal Skin Infections ,Staphylococcus aureus ,Trimethoprim ,Sulfamethoxazole Drug Combination ,DMID 07-0051 Team ,Medical and Health Sciences ,General & Internal Medicine ,Biomedical and clinical sciences ,Health sciences - Abstract
BackgroundUncomplicated skin abscesses are common, yet the appropriate management of the condition in the era of community-associated methicillin-resistant Staphylococcus aureus (MRSA) is unclear.MethodsWe conducted a multicenter, prospective, double-blind trial involving outpatient adults and children. Patients were stratified according to the presence of a surgically drainable abscess, abscess size, the number of sites of skin infection, and the presence of nonpurulent cellulitis. Participants with a skin abscess 5 cm or smaller in diameter were enrolled. After abscess incision and drainage, participants were randomly assigned to receive clindamycin, trimethoprim-sulfamethoxazole (TMP-SMX), or placebo for 10 days. The primary outcome was clinical cure 7 to 10 days after the end of treatment.ResultsWe enrolled 786 participants: 505 (64.2%) were adults and 281 (35.8%) were children. A total of 448 (57.0%) of the participants were male. S. aureus was isolated from 527 participants (67.0%), and MRSA was isolated from 388 (49.4%). Ten days after therapy in the intention-to-treat population, the cure rate among participants in the clindamycin group was similar to that in the TMP-SMX group (221 of 266 participants [83.1%] and 215 of 263 participants [81.7%], respectively; P=0.73), and the cure rate in each active-treatment group was higher than that in the placebo group (177 of 257 participants [68.9%], P
- Published
- 2017