#MayoIDQ #IDBR
45M CC: tender mass on left thigh that started as an “insect bite” 4 days ago. No F/C. PE: tender fluctuant 2-cm mass with surrounding erythema.
After I&D of abscess in the clinic, what do you recommend?
45M CC: tender mass on left thigh that started as an “insect bite” 4 days ago. No F/C. PE: tender fluctuant 2-cm mass with surrounding erythema.
After I&D of abscess in the clinic, what do you recommend?
2/
2014 IDSA guideline recommends incision and drainage of purulent SSTI (abscess)
Antibiotics vs MRSA / S. aureus as an adjunct to I&D if:
1. SIRS
2. Failed initial Ab Rx
3. Impaired host defense
Any new data since then?
doi.org/10.1093/cid/ci…
2014 IDSA guideline recommends incision and drainage of purulent SSTI (abscess)
Antibiotics vs MRSA / S. aureus as an adjunct to I&D if:
1. SIRS
2. Failed initial Ab Rx
3. Impaired host defense
Any new data since then?
doi.org/10.1093/cid/ci…
3/
After 2014 IDSA guideline, placebo-controlled RCTs were published on use of antibiotics (TMP SMX or clindamycin) for uncomplicated SSTI abscess ... (next)
ncbi.nlm.nih.gov/pmc/articles/P…
After 2014 IDSA guideline, placebo-controlled RCTs were published on use of antibiotics (TMP SMX or clindamycin) for uncomplicated SSTI abscess ... (next)
ncbi.nlm.nih.gov/pmc/articles/P…
4/
RCT compared TMP-SMX vs placebo in uncomplicated skin abscess treated with I&D...
45% had MRSA on culture
Main outcome: clinical cure was 80.5% of TMP-SMX and 73.6% in placebo (P=0.005)
ncbi.nlm.nih.gov/pmc/articles/P…
RCT compared TMP-SMX vs placebo in uncomplicated skin abscess treated with I&D...
45% had MRSA on culture
Main outcome: clinical cure was 80.5% of TMP-SMX and 73.6% in placebo (P=0.005)
ncbi.nlm.nih.gov/pmc/articles/P…
5/
Placebo-controlled RCT
Compared with I&D alone, clindamycin or TMP-SMX in conjunction with I&D improves outcomes in patients with simple abscess
Cure rates similar between clindamycin and TMP-SMX; both significantly higher than placebo
nejm.org/doi/full/10.10…
Placebo-controlled RCT
Compared with I&D alone, clindamycin or TMP-SMX in conjunction with I&D improves outcomes in patients with simple abscess
Cure rates similar between clindamycin and TMP-SMX; both significantly higher than placebo
nejm.org/doi/full/10.10…
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