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β-Lactams May Be Best Choice for Soft Tissue Infection

Fewer adverse effects and same efficacy compared to fluoroquinolones

TUESDAY, Dec. 12 (HealthDay News) -- It may be best to treat skin and soft tissue infections with β-lactams rather than fluoroquinolones, according to a study published in the December issue of the Mayo Clinic Proceedings.

Matthew E. Falagas, M.D., M.Sc., of the Alfa Institute of Biomedical Sciences in Athens, Greece, and colleagues conducted a meta-analysis of 20 randomized controlled trials comprising 4,817 patients.

Overall, fluoroquinolones were moderately more effective, with a 90.4 percent success rate compared to 88.2 percent for β-lactams. However, they were associated with more side effects, in 19.2 percent of cases versus 15.2 percent for the β-lactams.

In patients with moderate-to-severe infections the efficacy of both drugs was the same, and there was also no difference between the two drugs in patients who were not prescribed third-generation cephalosporins, or for those patients who were microbiologically evaluable.

"These facts, in association with the increasing incidence of methicillin-resistant Stapholococcus aureus strains resistant to fluoroquinolones, suggest that fluoroquinolone use is not associated with substantial advantages when compared with β-lactams for empirical treatment of skin and soft tissue infections," the authors conclude.

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