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1. Antibiotics after incision and drainage for uncomplicated skin abscesses

Antibiotics after incision and drainage for uncomplicated skin abscesses Antibiotics after incision and drainage for uncomplicated skin abscesses: a clinical practice guideline | The BMJ Intended for healthcare professionals Username * Password * Edition: Search form Search Search Antibiotics after... Antibiotics after incision and drainage for uncomplicated skin abscesses: a clinical practice guideline CC BY NC Open access (Published 06 February 2018) Cite this as: BMJ 2018;360:k243 Population (...) This recommendation applies to almost all patients with skin abscesses: People with skin abscesses Children and adults Unknown or unconfirmed pathogen(s) Smaller and larger abscesses Emergency and primary care settings However the recommendation is not applicable to patients with: Evidence of systemic illness (sepsis) Pustules and papules Deep tissue infections Immunocompromising conditions Hidradenitis suppurativa Patients who do not undergo incision and drainage Comparison 1 or No antibiotics Antibiotics

2018 BMJ Rapid Recommendations

4. 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

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

6. 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

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

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2018 EvidenceUpdates

8. 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

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. 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

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2018 Journal of Infectious Diseases

11. Point-of-care ultrasound (POCUS) for the diagnosis of skin and soft tissue abscesses

Point-of-care ultrasound (POCUS) for the diagnosis of skin and soft tissue abscesses Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites

2019 PROSPERO

12. 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

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2017 NEJM Controlled trial quality: predicted high

13. The utility of adjunctive antibiotics for the management of skin and soft tissue abscesses after incision and drainage

The utility of adjunctive antibiotics for the management of skin and soft tissue abscesses after incision and drainage Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g. "Dr Smith" or "Joanne") for correspondence

2018 PROSPERO

14. Management of community-associated methicillin-resistant Staphylococcus aureus skin abscesses in children

Management of community-associated methicillin-resistant Staphylococcus aureus skin abscesses in children Uncomplicated skin abscesses in previously well children are typically managed with drainage alone. An increasing percentage of such abscesses are due to methicillin-resistant Staphylococcus aureus infections. Although definitive data are lacking, drainage alone appears to be a reasonable strategy for methicillin-resistant S aureus skin abscesses, with antibiotics reserved for infants (...) younger than three months of age, or for children who are systemically unwell, have underlying medical problems or have significant surrounding cellulitis.  Key Words: Methicillin-resistant; Skin abscess; Staphylococcus aureus  

2011 Canadian Paediatric Society

15. 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

16. 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

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. Macrophage-derived LTB4 promotes abscess formation and clearance of Staphylococcus aureus skin infection in mice (PubMed)

Macrophage-derived LTB4 promotes abscess formation and clearance of Staphylococcus aureus skin infection in mice The early events that shape the innate immune response to restrain pathogens during skin infections remain elusive. Methicillin-resistant Staphylococcus aureus (MRSA) infection engages phagocyte chemotaxis, abscess formation, and microbial clearance. Upon infection, neutrophils and monocytes find a gradient of chemoattractants that influence both phagocyte direction and microbial (...) clearance. The bioactive lipid leukotriene B4 (LTB4) is quickly (seconds to minutes) produced by 5-lipoxygenase (5-LO) and signals through the G protein-coupled receptors LTB4R1 (BLT1) or BLT2 in phagocytes and structural cells. Although it is known that LTB4 enhances antimicrobial effector functions in vitro, whether prompt LTB4 production is required for bacterial clearance and development of an inflammatory milieu necessary for abscess formation to restrain pathogen dissemination is unknown. We found

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2018 PLoS pathogens

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. 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 Controlled trial quality: uncertain

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