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Clindamycin, TMP-SMX Linked to Better Outcomes for Abscesses

Clindamycin or trimethoprim-sulfamethoxazole ups short-term outcomes vs incision, drainage alone


FRIDAY, June 30, 2017 (HealthDay News) -- For small skin abscesses, treatment with clindamycin or trimethoprim-sulfamethoxazole (TMP-SMX) is associated with improved short-term outcomes versus incision and drainage alone, according to a study published online June 28 in the New England Journal of Medicine.

Robert S. Daum, M.D., from the University of Chicago Hospitals, and colleagues conducted a multicenter trial involving adult and children outpatients. The authors enrolled 786 patients (64.2 percent adults, 35.8 percent children) with a skin abscess of 5 cm or smaller in diameter. Participants were randomized to receive clindamycin, TMP-SMX, or placebo for 10 days after abscess incision and drainage.

The researchers found that in the intention-to-treat population, the cure rate was similar for patients in the clindamycin and TMP-SMX groups at 10 days after therapy (83.1 and 81.7 percent, respectively; P = 0.73); the cure rate in each active treatment group was higher than that seen in the placebo group (68.9 percent; both P < 0.001). The beneficial effect was limited to those with Staphylococcus aureus infection. Among those who were initially cured, at one-month follow-up, new infections were less common in the clindamycin group versus the TMP-SMX or placebo groups (6.8 versus 13.5 percent [P = 0.03] and 12.4 percent [P = 0.06], respectively). Adverse events were more frequent with clindamycin versus TMP-SMX or placebo (21.9 versus 11.1 and 12.5 percent; respectively).

"This benefit must be weighed against the known side-effect profile of these antimicrobials," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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