Randomized Controlled Trial of Trimethoprim-Sulfamethoxazole for Uncomplicated Skin Abscesses in Patients at Risk for Community-Associated Methicillin-Resistant Staphylococcus aureus Infection

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.annemergmed.2010.03.002 Byline: Gillian R. Schmitz (a), David Bruner (b), Rebecca Pitotti (c), Cameron Olderog (e), Timothy Livengood (e), Justin Williams (e), Kermit Huebner (f), Jeffrey Lightfoot (b), Brandon Ritz (f), Christopher Bates (c), Matthew Schmitz (d), Mihriye Mete (g), Gregory Deye (h) Abstract: Community-associated methicillin-resistant Staphylococcus aureus is now the leading cause of uncomplicated skin abscesses in the United States, and the role of antibiotics is controversial. We evaluate whether trimethoprim-sulfamethoxazole reduces the rate of treatment failures during the 7 days after incision and drainage and whether it reduces new lesion formation within 30 days. Author Affiliation: (a) Department of Emergency Medicine, Washington Hospital Center, Washington, DC (b) Department of Emergency Medicine, Naval Medical Center, Portsmouth, VA (c) Department of Emergency Medicine, Wilford Hall Medical Center, Lackland Air Force Base, TX (d) Department of Orthopaedic Surgery, Wilford Hall Medical Center, Lackland Air Force Base, TX (e) Department of Emergency Medicine, Brooke Army Medical Center, Ft. Sam Houston, TX (f) Department of Emergency Medicine, Darnall Army Medical Center, Ft. Hood, TX (g) Departments of Epidemiology and Statistics, Medstar Research Institute, Hyattsville, MD (h) Department of Clinical Pharmacology, Walter Reed Army Institute of Research, Silver Spring, MD Article History: Received 20 January 2010; Revised 11 February 2010; Accepted 1 March 2010 Article Note: (footnote) The opinions expressed in this document are solely those of the authors and do not represent an endorsement by or the views of the United States Air Force, the Department of Defense, or the United States Government. , Provide feedback on this article at the journal's Web site, www.annemergmed.com., Supervising editor: Steven M. Green, MD, Author contributions: GRS and DB conceived the study, designed the trial, and performed the majority of data collection. GRS obtained research funding and drafted the article. GRS, DB, JW, and KH were the primary investigators at each of the 4 study sites and oversaw the conduct of the trial. RP enrolled many of the patients and updated and maintained the databases. RP, CO, TL, JL, BR, and CB made follow-up telephone calls. CO, TL, JL, BR, and CB helped collect data and maintain the study at each site. MS assisted with editing, background research, and writing the article. MM performed the statistical analysis. GD provided feedback for the grant and assisted with editing and writing the article. All authors contributed to revision of the article. GRS takes responsibility for the paper as a whole., Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article that might create any potential conflict of interest. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement. This research was funded by EMF EMBRS grant 2007-2008) and the Surgeon General's Office., Publication date: Available online March 26, 2010., Please see page 284 for the Editor's Capsule Summary of this article.