Is antimicrobial therapy needed to manage uncomplicated skin and soft-tissue abscesses?

Abstract

Evaluation of: Rajendran PM, Young D, Maurer T et al. Randomized, double-blind, placebo-controlled trial of cephalexin for treatment of uncomplicated skin abscesses in a population at risk for community-acquired methicillin-resistant Staphylococcus aureus infection. Antimicrob. Agents Chemother. 51, 4044–4048 (2007).Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infections occur across a wide spectrum of epidemiologic groups, which range from medically underserved urban dwellers to professional athletes. CA-MRSA primarily causes skin and soft-tissue infections but it can also cause severe invasive disease, including necrotizing pneumonia and necrotizing fasciitis. In light of CA-MRSA’s proclivity to cause skin and soft-tissue abscesses and its capacity to inflict severe illness, investigators have been prompted to revisit the question of whether adjunctive antimicrobial therapy is necessary in the management of uncomplicated abscesses. This article evaluates the findings of a recently published randomized, double-blind, placebo-controlled trial that aims to determine whether ‘standard-of-care’ antimicrobial therapy is needed after adequate surgical incision and drainage of uncomplicated skin and soft-tissue abscesses.