Randomized Controlled Trial of Trimethoprim-Sulfamethoxazole for Uncomplicated Skin Abscesses in Patients at Risk for Community-Associated Methicillin-Resistant Staphylococcus aureus Infection
| Autor: | Matthew R. Schmitz, Christopher F. Bates, Mihriye Mete, Jeffrey Lightfoot, Timothy Livengood, Brandon Ritz, Justin B. Williams, Cameron K. Olderog, R. Pitotti, Kermit Huebner, Gregory Deye, Gillian Schmitz, David Bruner |
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| Rok vydání: | 2010 |
| Předmět: |
Adult
Male Methicillin-Resistant Staphylococcus aureus medicine.medical_specialty Adolescent medicine.medical_treatment medicine.disease_cause Placebo law.invention Young Adult Anti-Infective Agents Double-Blind Method Randomized controlled trial Risk Factors law Intensive care Trimethoprim Sulfamethoxazole Drug Combination Incision and drainage medicine Humans Abscess Aged Antibacterial agent business.industry Middle Aged medicine.disease Trimethoprim Methicillin-resistant Staphylococcus aureus Surgery Treatment Outcome Emergency Medicine Drainage Female Staphylococcal Skin Infections business medicine.drug |
| Zdroj: | Annals of Emergency Medicine. 56:283-287 |
| ISSN: | 0196-0644 |
| Popis: | 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 trimethoprimsulfamethoxazole 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 trimethoprimsulfamethoxazole does not reduce treatment failure but may decrease the formation of subsequent lesions. [Ann Emerg Med. 2010;56:283-287.] |
| Databáze: | OpenAIRE |
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