I chanced upon this article and I find it interesting and worth looking into. We're used of prescribing antibiotics for all bacterial infections, skin abscesses included. Resistance to some antibacterials is already high in the country so any idea to lessen its use will be significant in its reduction.
April 9, 2010 — Antibiotics don't improve outcomes after incision and drainage of uncomplicated skin abscesses, new research indicates. They might prevent new abscesses at one month, however.
"We're seeing so many abscesses now," lead researcher Dr. Gillian R. Schmitz told Reuters Health. Before methicillin-resistant Staphylococcus aureus (MRSA) became so widespread, most abscess patients had diabetes or were immunocompromised, she said, "but now they're popping up all over the place in people with no traditional risk factors."
"But no one has studied best practice for treating abscesses," Dr. Schmitz added.
In the November 2007 issue of Antimicrobial Agents and Chemotherapy, Rajendran and colleagues reported that after incision and drainage for abscess, improvement at 7 days occurred in 84% of patients receiving antibiotics and 91% of patients receiving placebo. In children with skin abscesses, rates of treatment failure were similar for those treated with trimethoprim-sulfamethoxazole vs placebo, as found by Duong and colleagues in the May 5, 2009, online issue of the Annals of Emergency Medicine.
This multicenter, double-blind, randomized, placebo-controlled trial evaluates whether treatment with trimethoprim-sulfamethoxazole for uncomplicated skin abscesses reduces treatment failure in the first 7 days and the rate of new lesion formation in the first 30 days after incision and drainage in adults.
The clinical implications of this study are: (a) In adults with uncomplicated skin abscesses, trimethoprim-sulfamethoxazole does not decrease treatment failure at 7 days after incision and drainage, and (b) In adults with uncomplicated skin abscesses, trimethoprim-sulfamethoxazole might decrease the formation of new lesions at 30 days after incision and drainage.
"Antibiotics are not required for pediatric skin abscess resolution," Dr. Duong's group concludes, adding that further research is needed to see if antibiotics help prevent new lesions in the short term.
Both studies were limited by attrition of patients and by inclusion of subjects who were otherwise healthy, so the results can't be generalized to patients with comorbidities. In Dr. Duong's trial, medication compliance was only 66%.
In an editorial, Dr. David A. Talan of Olive View--UCLA Medical Center in Sylmar, California, states, "Antibiotics for drained simple abscesses are not required to meet the standard of care."
He told Reuters Health, "The rate of resolution of patient groups described in these studies is very high, so doctors can feel that the odds are on their side" if they forego antibiotic treatment, "and they can reassure patients there's a good chance that things will work out fine."
But, he continued, physicians should be aware of the tendency for abscesses to return, and they should advise patients to seek attention if new symptoms appear after first infection resolves.
Ann Emerg Med. Published online March 29, 2010.
Reuters Health Information 2010. © 2010 Reuters Ltd.
Reuters Health Information 2010. © 2010 Reuters Ltd.
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