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Paper Chase 3 | Antibiotics are Back for Abscesses

Nate Finnerty, MD and Rebekah Richards, MD
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Discuss findings from the recent article by Talan DA, Mower WR, Krishnadasan A, Abrahamian FM, Lovecchio F, Karras DJ, Steele MT, Rothman RE, Hoagland R, Moran GJ. Trimethoprim-Sulfamethoxazole versus Placebo for Uncomplicated Skin Abscess. N Engl J Med. 2016 Mar 3

 

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Danielle K. -

Great info! Love that patients with diabetes were included. Did they mention anything about sulfa allergic patients? Would the next best drug be clindamycin to continue covering for MRSA (depending on local resistance?) Thanks so much!

Mike W., MD -

Good question - the sulfa allergic patient makes it tough as resistant develops quickly to quinolones and PCN and cephalosporins are not adequately effective for MRSA. I think clinda is a good choice for sulfa patients - one additional advantage is that it can be used in pregnant patients too

Ian L., Dr -

The over 65 age group has more sulphur allergy and I would be quite hesitant in that age group for sure .
Like to know the recurrence rate over months -years in healthy non-immunosuppressed after education and printouts to reduce recurrence .
In the healthy immunocompetent I would wait for one or two recurrences .

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Cross-React and HACK Full episode audio for MD edition 209:41 min - 98 MB - M4Ahippo Urgent Care RAP - October 2016 479 KB - PDF