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

Schmitz, Gillian R., MD ; Bruner, David, MD ; Pitotti, Rebecca, RN, BSN ; Olderog, Cameron, MD ; Livengood, Timothy, MD ; Williams, Justin, MD ; Huebner, Kermit, MD ; Lightfoot, Jeffrey, MD ; Ritz, Brandon, MD ; Bates, Christopher, MD ; Schmitz, Matthew, MD ; Mete, Mihriye, PhD ; Deye, Gregory, MD

Annals of emergency medicine, 2010-09, Vol.56 (3), p.283-287 [Periódico revisado por pares]

New York, NY: Mosby, Inc

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Título:
Randomized Controlled Trial of Trimethoprim-Sulfamethoxazole for Uncomplicated Skin Abscesses in Patients at Risk for Community-Associated Methicillin-Resistant Staphylococcus aureus Infection
Autor: Schmitz, Gillian R., MD ; Bruner, David, MD ; Pitotti, Rebecca, RN, BSN ; Olderog, Cameron, MD ; Livengood, Timothy, MD ; Williams, Justin, MD ; Huebner, Kermit, MD ; Lightfoot, Jeffrey, MD ; Ritz, Brandon, MD ; Bates, Christopher, MD ; Schmitz, Matthew, MD ; Mete, Mihriye, PhD ; Deye, Gregory, MD
Assuntos: Abscess - drug therapy ; Abscess - microbiology ; Abscesses ; Adolescent ; Adult ; Aged ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Anti-Infective Agents - therapeutic use ; Biological and medical sciences ; Clinical death. Palliative care. Organ gift and preservation ; Double-Blind Method ; Drainage ; Emergency ; Female ; Humans ; Intensive care medicine ; Male ; Medical sciences ; Methicillin-Resistant Staphylococcus aureus ; Middle Aged ; Risk Factors ; Staphylococcal Skin Infections - drug therapy ; Staphylococcal Skin Infections - microbiology ; Staphylococcus aureus ; Treatment Outcome ; Trimethoprim, Sulfamethoxazole Drug Combination - therapeutic use ; Young Adult
É parte de: Annals of emergency medicine, 2010-09, Vol.56 (3), p.283-287
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Descrição: Study objective 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. Methods In this multicenter, double-blind, randomized, placebo-controlled trial, we randomized adults to oral trimethoprim-sulfamethoxazole or placebo after uncomplicated abscess incision and drainage. Using emergency department rechecks at 2 and 7 days and telephone follow-up, we assessed treatment failure within 7 days, and using clinical follow-up, telephone follow-up, and medical record review, we recorded the development of new lesions within 30 days. Results We randomized 212 patients, and 190 (90%) were available for 7-day follow-up. We observed a statistically similar incidence of treatment failure in patients receiving trimethoprim-sulfamethoxazole (15/88; 17%) versus placebo (27/102; 26%), difference 9%, 95% confidence interval –2% to 21%; P =.12. On 30-day follow-up (successful in 69% of patients), we observed fewer new lesions in the antibiotic (4/46; 9%) versus placebo (14/50; 28%) groups, difference 19%, 95% confidence interval 4% to 34%, P =.02. Conclusion After the incision and drainage of uncomplicated abscesses in adults, treatment with trimethoprim-sulfamethoxazole does not reduce treatment failure but may decrease the formation of subsequent lesions.
Editor: New York, NY: Mosby, Inc
Idioma: Inglês

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

Schmitz, Gillian R., MD ; Bruner, David, MD ; Pitotti, Rebecca, RN, BSN ; Olderog, Cameron, MD ; Livengood, Timothy, MD ; Williams, Justin, MD ; Huebner, Kermit, MD ; Lightfoot, Jeffrey, MD ; Ritz, Brandon, MD ; Bates, Christopher, MD ; Schmitz, Matthew, MD ; Mete, Mihriye, PhD ; Deye, Gregory, MD

New York, NY: Mosby, Inc

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