Re: “A Whirlwind Year in Review: Trimethoprim-Sulfamethoxazole Versus Placebo for Uncomplicated Skin Abscess” [August 2016]
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ACEP Now: Vol 35 – No 10 – October 2016“This well-designed trial seems to show that patients receiving trimethoprim-sulfamethoxazole following I&D had substantial reduction in both initial treatment failure and abscess recurrence.”
Did anyone ask Dr. Choosing Wisely from ACEP about this one? According to Dr. Wisely, “For patients with uncomplicated skin and soft tissue abscesses successfully treated with incision and drainage, clinicians should provide adequate medical follow-up but avoid antibiotics and wound cultures.”
Have we given CMS another blood-culture-before-antibiotics noose to hang us with?
—Sam Herring, MD
Birmingham, Alabama
One Response to “ACEP Now Reader Takes Issue with Choosing Wisely Trial on Trimethoprim- Sulfamethoxazole for Skin Abscess”
October 30, 2016
Jordan Schooler, MD, PhDThe Choosing Wisely recommendation in question was written prior to the publication of this trial. These recommendations should change as our knowledge advances. And it is only a recommendation, not some sort of federal law. Personally, I will give antibiotics for abscesses from now on. If there is better evidence that supersedes this, I’ll change my practice again.