Antibiotics increase cure rate from small skin abscesses compared with drainage alone

Researchers assess the use of antibiotics in combination with incision and drainage for the treatment of skin abscesses in comparison with drainage alone.

Abscess wound after cleaning

The role of antibiotics in treating small skin abscesses, including those infected with methicillin-resistant Staphylococcus aureus (MRSA), is currently unclear, with some clinicians opting to simply drain abscesses without antibiotics.

In a study published in The New England Journal of Medicine
[1]
(online, 29 June 2017), researchers randomly assigned 786 adults and children with a skin abscess 5cm or smaller in diameter to clindamycin, co-trimoxazole or placebo, following abscess incision and drainage. Half of all participants had abscesses owing to MRSA.

After 10 days, the cure rate was similar between the two antibiotic-treated groups (83.1% and 81.7%, respectively). Both of these were significantly higher than the cure rate in the placebo-treated group of 68.9%. The results were similar among patients with MRSA abscesses.

Antibiotic therapy seems to improve short-term outcomes, the study authors say, but the choice of clindamycin or co-trimoxazole should be based on a variety of factors, such as tolerability, cost and local antibiotic susceptibility patterns.

References

[1] Daum R, Miller L, Immergluck L et al. A placebo-controlled trial of antibiotics for smaller skin abscesses. N Engl J Med 2017; 376:2545-2455. doi: 10.1056/NEJMoa1607033

Last updated
Citation
The Pharmaceutical Journal, July 2017;Online:DOI:10.1211/PJ.2017.20203281