So you thought I&Ding your abscess was enough?  Or your attending told you….no cellulitis so no antibiotics?  WRONG!

A recent double-blinded randomized-controlled trial of outpatient children and adults with abscesses <= 5cm who had I&D performed with either clindamycin or bactrim had higher cure rate at 7-10 days compared to the placebo group that had I&D but no antibiotics (NNT 8).

There was a difference in the Clindamycin and Bactrim group: new infection at one month was lower in the Clindamycin group but this group also had higher rate of diarrhea.

This only worked in patients that had a staph infection; but most >50% patients did have MRSA or MSSA.

This will definitely be changing my practice and I hope it helps all of you! 

 

A Placebo-Controlled Trial of Antibiotics for Smaller Skin Abscesses.  N Engl J Med. 2017 Jun 29;376(26):2545-2555. doi: 10.1056/NEJMoa1607033.