Antibiotics Improve Skin Abscess Outcomes

Adding antibiotics to the treatment of small, uncomplicated skin abscesses can help to improve short-term outcomes, compared with incision and drainage alone, according to the results of a recent study.

The researchers included 786 participants (505 adults and 281 children) in their multicenter, prospective, double-blind trial. The patients were categorized by abscess size, number of sites of skin infection, and the presence of nonpurulent cellulitis. Only participants with skin abscesses 5 cm or smaller were included in the study.
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Following incision and drainage, the participants were randomly selected to receive clindamycin, trimethoprim-sulfamethoxazole (TMP-SMX), or placebo for 10 days. 

Overall, the cure rate was similar among participants in the clindamycin and TMP-SMX groups (83.1% and 81.7%, respectively), which was higher than the cure rate among those who received placebo (68.9%).

New infections at 1 month of follow-up were less common in the clindamycin group than the TMP-SMX group or placebo group, but adverse events were also more common with clindamycin than with TMP-SMX or placebo.

“As compared with incision and drainage alone, clindamycin or TMP-SMX in conjunction with incision and drainage improves short-term outcomes in patients who have a simple abscess. This benefit must be weighed against the known side-effect profile of these antimicrobials,” the researchers concluded.

—Michael Potts

Reference:

Daum RS, Miller LG, Immergluck L, et al. A placebo-controlled trial of antibiotics for smaller skin abscesses [published online June 29, 2017]. doi: 10.1056/NEJMoa1607033.