TMP/SMX Improves Cure Rate After Incision and Drainage of Abscesses in High-MRSA Areas

Trim-sulfa improves cure rate for cutaneous skin abscess after incision and drainage

Clinical Question:
Does adding trimethoprim-sulfamethoxazole after incision and drainage of a superficial skin abscess improve cure rates?

Bottom Line:
For patients with a superficial skin abscess for which the likelihood of community-acquired methicillin-resistant Staphylococcus aureus (MRSA) is high, trimethoprim-sulfamethoxazole for 7 days increases cure rates (number needed to treat [NNT] = 14), reduces the likelihood of requiring additional drainage (NNT = 20), and reduces the
likelihood of skin infections in household members (NNT = 42). Harms were
limited to nonserious gastrointestinal symptoms. (LOE = 1b)

Talan DA, Mower WR, Krishnadasan A, et al. Trimethoprim-sulfamethoxazole
versus placebo for uncomplicated skin abscess. N Engl J Med 2016;374(9):823-832.


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