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Skin Abscess

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3. Systemic Antibiotics for the Treatment of Skin and Soft Tissue Abscesses: A Systematic Review and Meta-Analysis

Systemic Antibiotics for the Treatment of Skin and Soft Tissue Abscesses: A Systematic Review and Meta-Analysis Systemic Antibiotics for the Treatment of Skin and Soft Tissue Abscesses: A Systematic Review and Meta-Analysis Michael Gottlieb, MD*; Joshua M. DeMott, PharmD, MSc; Marilyn Hallock, MD, MS; Gary D. Peksa, PharmD *Corresponding Author. E-mail: michaelgottliebmd@gmail.com, Twitter: @MGottliebMD. Study objective: The addition of antibiotics to standard incision and drainage (...) /10.1016/j.annemergmed.2018.02.011 INTRODUCTION Background Skinandsofttissueinfectionsareacommonpresentation toboththe emergencydepartment(ED) and outpatient clinics, comprisingmorethan6 millionvisits each year in theUnited States. 1,2 Abscesses represent nearly halfof all cases and theoverall incidence isincreasing annually. 2-5 Although the standard clinical management of skin and soft tissue abscesses includes incision and drainage, the adjunctive use of systemic antibiotics remains controversial. 6

2018 Annals of Emergency Medicine Systematic Review Snapshots

4. Trimethoprim?Sulfamethoxazole for Uncomplicated Skin Abscess

Trimethoprim?Sulfamethoxazole for Uncomplicated Skin Abscess BestBets: Trimethoprim–Sulfamethoxazole for Uncomplicated Skin Abscess Trimethoprim–Sulfamethoxazole for Uncomplicated Skin Abscess Report By: Reece Baker MD and Jason Seamon DO - Emergency Medicine Physicians Institution: Grand Rapids Medical Education Research Partners/Michigan State University Date Submitted: 30th May 2016 Date Completed: 11th February 2017 Last Modified: 11th February 2017 Status: Green (complete) Three Part (...) Question In [patients with uncomplicated skin abscesses who have undergone abscess incision and drainage], does [treatment with oral trimethoprim-sulfamethoxazole compared to placebo] [reduce treatment failure at 7 days]? Clinical Scenario A man aged 21 years presents to the ED with a 3-day history of increasing redness, swelling and pain in his right thigh. On examination there is an area of fluctuance, approximately 3 cm in diameter, with associated tenderness, on the right anterior thigh. Erythema

2017 BestBETS

5. Adjunctive antibiotics for drained skin abscesses improve clinical cure rate

Adjunctive antibiotics for drained skin abscesses improve clinical cure rate Adjunctive antibiotics for drained skin abscesses improve clinical cure rate | BMJ Evidence-Based Medicine We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie settings via your browser at any time. To learn more about how we use cookies, please see our . Log in using your username and password For personal accounts OR managers of institutional accounts (...) Username * Password * your user name or password? Search for this keyword Search for this keyword Main menu Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here Adjunctive antibiotics for drained skin abscesses improve clinical cure rate Article Text Commentary: General medicine Adjunctive antibiotics for drained skin abscesses improve clinical cure rate David A Talan Statistics from

2017 Evidence-Based Medicine (Requires free registration)

6. Antibiotics for uncomplicated skin abscesses: systematic review and network meta-analysis (PubMed)

Antibiotics for uncomplicated skin abscesses: systematic review and network meta-analysis To assess the impact of adjunctive antibiotic therapy on uncomplicated skin abscesses.Systematic review and network meta-analysis.Medline, Embase, the Cochrane Central Register of Controlled Trials and ClinicalTrials.gov.A BMJ Rapid Recommendation panel provided input on design, important outcomes and the interpretation of the results. Eligible randomised controlled trials (RCTs) included a comparison (...) of antibiotics against no antibiotics or a comparison of different antibiotics in patients with uncomplicated skin abscesses, and reported outcomes prespecified by the linked guideline panel.Reviewers independently screened abstracts and full texts for eligibility, assessed risk of bias and extracted data. We performed random-effects meta-analyses that compared antibiotics with no antibiotics, along with a limited number of prespecified subgroup hypotheses. We also performed network meta-analysis

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2018 EvidenceUpdates

7. Systemic Antibiotics for the Treatment of Skin and Soft Tissue Abscesses: A Systematic Review and Meta-Analysis

Systemic Antibiotics for the Treatment of Skin and Soft Tissue Abscesses: A Systematic Review and Meta-Analysis The addition of antibiotics to standard incision and drainage is controversial, with earlier studies demonstrating no significant benefit. However, 2 large, multicenter trials have recently been published that have challenged the previous literature. The goal of this review was to determine whether systemic antibiotics for abscesses after incision and drainage improve cure (...) 0.32, 95% CI 0.23 to 0.44), with a minimally increased risk of minor adverse events (risk difference 4.4%, 95% CI 1.0% to 7.8%; odds ratio 1.29, 95% CI 1.06 to 1.58).The use of systemic antibiotics for skin and soft tissue abscesses after incision and drainage resulted in an increased rate of clinical cure. Providers should consider the use of antibiotics while balancing the risk of adverse events.Copyright © 2018 American College of Emergency Physicians. Published by Elsevier Inc. All rights

2018 EvidenceUpdates

8. Lack of Receptor for Advanced Glycation End products leads to less severe staphylococcal skin infection but more skin abscesses and prolonged wound healing. (PubMed)

Lack of Receptor for Advanced Glycation End products leads to less severe staphylococcal skin infection but more skin abscesses and prolonged wound healing. Lack of receptor for advanced glycation end products (RAGE) ameliorates several infections including Staphylococcus aureus pneumonia. We sought to investigate the role of RAGE in staphylococcal skin infection in mice.Wild-type (WT) and RAGE deficient (RAGE-/-) mice were subcutaneously inoculated with S. aureus SH1000 strain in abscess (...) -forming dose or necrotic dose. Clinical signs of dermatitis, along with histopathological changes, were compared between the groups.The skin lesion size was smaller in RAGE-/- mice. Infected RAGE-/- mice expressed lower proinflammatory cytokines in local skins compared to control mice. Low dose of bacteria caused more abscess formation in RAGE-/- mice compared to skin necrosis that was more often observed in WT mice. As a result of more abscess formation, the wound healing was prolonged in RAGE

2018 Journal of Infectious Diseases

9. Multiple neonatal Staphylococcal cold abscesses in large skin folds: a benign neonatal skin infection. (PubMed)

Multiple neonatal Staphylococcal cold abscesses in large skin folds: a benign neonatal skin infection. 30388319 2019 03 20 1468-3083 33 3 2019 Mar Journal of the European Academy of Dermatology and Venereology : JEADV J Eur Acad Dermatol Venereol Multiple neonatal staphylococcal cold abscesses in large skin folds: a benign neonatal skin infection. e125-e128 10.1111/jdv.15323 Hubiche T T Department of Dermatology and Infectious Diseases, Fréjus Saint Raphaël Hospital, Fréjus, France. Chiaverini (...) and Infectious Diseases, Fréjus Saint Raphaël Hospital, Fréjus, France. Boralevi F F Department of Pediatric Dermatology, National Center for Rare Skin Disorders- INSERM U1035, Bordeaux, France. ‘Groupe de Recherche de la Société Française de Dermatologie Pédiatrique’ eng Letter 2018 11 25 England J Eur Acad Dermatol Venereol 9216037 0926-9959 2018 11 6 6 0 2018 11 6 6 0 2018 11 3 6 0 ppublish 30388319 10.1111/jdv.15323

2018 Journal of the European Academy of Dermatology and Venereology

10. A Placebo-Controlled Trial of Antibiotics for Smaller Skin Abscesses. (PubMed)

A Placebo-Controlled Trial of Antibiotics for Smaller Skin Abscesses. Uncomplicated skin abscesses are common, yet the appropriate management of the condition in the era of community-associated methicillin-resistant Staphylococcus aureus (MRSA) is unclear.We conducted a multicenter, prospective, double-blind trial involving outpatient adults and children. Patients were stratified according to the presence of a surgically drainable abscess, abscess size, the number of sites of skin infection (...) , and the presence of nonpurulent cellulitis. Participants with a skin abscess 5 cm or smaller in diameter were enrolled. After abscess incision and drainage, participants were randomly assigned to receive clindamycin, trimethoprim-sulfamethoxazole (TMP-SMX), or placebo for 10 days. The primary outcome was clinical cure 7 to 10 days after the end of treatment.We enrolled 786 participants: 505 (64.2%) were adults and 281 (35.8%) were children. A total of 448 (57.0%) of the participants were male. S. aureus

2017 NEJM

11. Primary Care Corner with Geoffrey Modest: antibiotics for skin abscesses?

Primary Care Corner with Geoffrey Modest: antibiotics for skin abscesses? Primary Care Corner with Geoffrey Modest: antibiotics for skin abscesses? | BMJ EBM Spotlight by by Dr Geoffrey Modest A recent article found that either clindamycin or trimethoprim/sulfamethoxazole (TMP/SMX) are superior to placebo for uncomplicated skin abscesses (see Daum RS. N Engl J Med 2017;376:2545-55 ). Details: — multicenter, prospective, double-blind trial of 786 outpatient adults and children who had a skin (...) infections Commentary: — Skin abscesses are quite common, affecting 4% of people in the United States annually. Often these are treated as outpatients with clindamycin or TMP/SMX, given the large percent of community MRSA — In this study TMP/SMX was effective at a lower dose than often prescribed, though a 10-day course was given (vs 7 days). It is possible that the cure rates might have been higher with higher doses of TMP/SMX — 13 patients had resistance to clindamycin and did not fare as well (54

2017 Evidence-Based Medicine blog

12. New Clinical Decisions article: Skin Abscess

New Clinical Decisions article: Skin Abscess Rotation Prep | NEJM Resident 360 Social Login Email Login Log in via Email Create Your Account We will not share your email with anyone. Password must be at least 8 characters. Show or Hide the password you are typing. Request to Join has invited you to join this group Your browser does not support video tags Welcome! NEJM Resident 360 helps you prepare for your next rotation quickly and efficiently, provides support for coping with the pressures

2016 Now@NEJM

13. Uncomplicated Skin Abscess

Uncomplicated Skin Abscess Rotation Prep | NEJM Resident 360 Social Login Email Login Log in via Email Create Your Account We will not share your email with anyone. Password must be at least 8 characters. Show or Hide the password you are typing. Request to Join has invited you to join this group Your browser does not support video tags Welcome! NEJM Resident 360 helps you prepare for your next rotation quickly and efficiently, provides support for coping with the pressures of resident life

2016 Now@NEJM

14. Mastitis and breast abscess

-like symptoms, malaise, and myalgia fever breast pain decreased milk outflow breast warmth breast tenderness breast firmness breast swelling breast erythema breast mass fistula nipple discharge nipple inversion/retraction lymphadenopathy extra-mammary skin lesions female sex women aged >30 years poor breastfeeding technique lactation milk stasis nipple injury previous mastitis prolonged mastitis (breast abscess) prior breast abscess (breast abscess) shaving or plucking areola hair anatomical breast (...) defect, mammoplasty, or scar other underlying breast condition nipple piercing foreign body skin infection Staphylococcus aureus carrier immunosuppression hospital admission breast trauma primiparity overabundant milk supply post-maturity (breast abscess) complications of delivery maternal fatigue tight clothing antifungal nipple cream fibrocystic breast disease cigarette smoking vaginal manipulation (breast abscess) poor nutrition antiretroviral therapy Diagnostic investigations breast ultrasound

2019 BMJ Best Practice

15. A Trial of Antibiotics for Smaller Skin Abscesses. (PubMed)

A Trial of Antibiotics for Smaller Skin Abscesses. 29281571 2018 01 01 2018 12 02 1533-4406 377 26 2017 12 28 The New England journal of medicine N. Engl. J. Med. A Trial of Antibiotics for Smaller Skin Abscesses. e36 10.1056/NEJMc1711124 Kramer Tobias S TS Charité Universitätsmedizin Berlin, Berlin, Germany tobias.kramer@charite.de. Gastmeier Petra P Charité Universitätsmedizin Berlin, Berlin, Germany tobias.kramer@charite.de. Leistner Rasmus R Charité Universitätsmedizin Berlin, Berlin (...) , Germany tobias.kramer@charite.de. eng Letter Comment United States N Engl J Med 0255562 0028-4793 0 Anti-Bacterial Agents AIM IM N Engl J Med. 2017 Jun 29;376(26):2545-2555 28657870 N Engl J Med. 2017 Dec 28;377(26):e36 29281570 Abscess Anti-Bacterial Agents Drainage Humans Skin Diseases 2017 12 28 6 0 2017 12 28 6 0 2018 1 2 6 0 ppublish 29281571 10.1056/NEJMc1711124#SA1 10.1056/NEJMc1711124

2018 The New England journal of medicine

16. Skin Abscess. (PubMed)

Skin Abscess. 26962909 2016 03 15 2016 03 11 1533-4406 374 9 2016 Mar 03 The New England journal of medicine N. Engl. J. Med. CLINICAL DECISIONS. Skin Abscess. 882-4 10.1056/NEJMclde1600286 Wilbur MaryAnn B MB Daum Robert S RS Gold Howard S HS eng Journal Article United States N Engl J Med 0255562 0028-4793 0 Anti-Bacterial Agents 0 Drug Combinations 39295-60-8 trimethoprim, sulfadoxine drug combination 88463U4SM5 Sulfadoxine AN164J8Y0X Trimethoprim AIM IM Abscess drug therapy therapy Anti (...) -Bacterial Agents therapeutic use Combined Modality Therapy Drainage Drug Combinations Female Humans Skin Diseases, Bacterial drug therapy therapy Sulfadoxine therapeutic use Trimethoprim therapeutic use Young Adult 2016 3 11 6 0 2016 3 11 6 0 2016 3 16 6 0 ppublish 26962909 10.1056/NEJMclde1600286

2016 NEJM

17. Atypical Behçet disease with endocarditis, pyoderma gangrenosum–like ulcers and methicillin-resistant Staphylococcus aureus–positive skin abscesses (PubMed)

Atypical Behçet disease with endocarditis, pyoderma gangrenosum–like ulcers and methicillin-resistant Staphylococcus aureus–positive skin abscesses 29984279 2019 02 26 2352-5126 4 5 2018 Jun JAAD case reports JAAD Case Rep Atypical Behçet disease with endocarditis, pyoderma gangrenosum-like ulcers and methicillin-resistant Staphylococcus aureus -positive skin abscesses. 449-451 10.1016/j.jdcr.2018.01.003 Sanchez Isabelle M IM Department of Dermatology, University of California San (...) Francisco, San Francisco, California. Shinkai Kanade K Department of Dermatology, University of California San Francisco, San Francisco, California. eng Case Reports 2018 04 30 United States JAAD Case Rep 101665210 2352-5126 BD, Behçet disease Behcet disease IE, infectious endocarditis MRSA, methicillin-resistant Staphylococcus aureus PG, pyoderma gangrenosum cardiac manifestations endocarditis methicillin-resistant Staphylococcus aureus–positive abscesses pyoderma gangrenosum–like ulcers 2018 7 10 6 0

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2018 JAAD Case Reports

18. Photo Quiz: Pneumonia and Pyogenic Skin Abscesses in a 79-Year-Old Man (PubMed)

Photo Quiz: Pneumonia and Pyogenic Skin Abscesses in a 79-Year-Old Man 29367311 2018 12 04 1098-660X 56 2 2018 02 Journal of clinical microbiology J. Clin. Microbiol. Photo Quiz: Pneumonia and Pyogenic Skin Abscesses in a 79-Year-Old Man. e03352-15 10.1128/JCM.03352-15 Held Jürgen J Institute for Microbiology and Hygiene, Medical Center-University of Freiburg, Freiburg, Germany. Schweizer Heiko H Renal Division, Department of Internal Medicine, Medical Center-University of Freiburg, Freiburg (...) United States J Clin Microbiol 7505564 0095-1137 infection skin 2018 1 26 6 0 2018 1 26 6 0 2018 1 26 6 0 epublish 29367311 56/2/e03352-15 10.1128/JCM.03352-15 PMC5786709

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2018 Journal of clinical microbiology

19. Ignavigranum ruoffiae, a rare pathogen that caused a skin abscess (PubMed)

Ignavigranum ruoffiae, a rare pathogen that caused a skin abscess Ignavigranum ruoffiae is an extremely rare cause of human infections.An 83-year-old male with a painless, ten-day-old, erythematous skin abscess on his left flank, which had showed a purulent discharge for 48 h, was admitted to the Emergency service. He was treated with cephalexin, disinfection with Codex water and spray of rifampicin. Five days later, surgical drainage of the abscess was proposed due to the torpid evolution (...) of the patient. Samples were taken for culture, and antibiotic treatment with trimethoprim-sulfamethoxazole was established. The patient returned after 10 days showing healing of the abscess. Microbiological studies showed a few Gram-positive cocci present as single cells and short chains that grew after 72 h of incubation at 35 °C with CO2 on 5 % sheep blood agar. Colonies presented a strong sauerkraut odour. Initial biochemical test results were negative for catalase, aesculin and bile-aesculin

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2018 JMM Case Reports

20. The LOOP Trial in Treatment of Skin Abscesses

The LOOP Trial in Treatment of Skin Abscesses The LOOP Trial in Treatment of Skin Abscesses - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. The LOOP Trial in Treatment of Skin Abscesses The safety (...) to Brief Summary: This prospective, randomized controlled trial enrolled a convenience sample of adults and children presenting to two Level 1 trauma centers over 12-months with subcutaneous skin abscesses necessitating drainage. Two methods of drainage were compared: 1) the LOOP technique or 2) standard packing technique. Condition or disease Intervention/treatment Phase Abscess Procedure: LOOP Technique Procedure: Standard incision and drainage Not Applicable Detailed Description: This prospective

2018 Clinical Trials

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