. 2018 Feb 6:360:k243.

doi: 10.1136/bmj.k243.

Antibiotics after incision and drainage for uncomplicated skin abscesses: a clinical practice guideline

Mieke Vermandere¹, Bert Aertgeerts^{1

2}, Thomas Agoritsas^{3

4}, Catherine Liu⁵, Jako Burgers^{6

7}, Arnaud Merglen⁸, Patrick Mbah Okwen⁹, Lyubov Lytvyn^{3

10}, Shunjie Chua¹¹, Per O Vandvik^{12

13}, Gordon H Guyatt³, Claudia Beltran-Arroyave¹⁴, Valéry Lavergne¹⁵, Reinhart Speeckaert¹⁶, Finn E Steen¹⁷, Victoria Arteaga¹⁸, Rachelle Sender¹⁹, Shelley McLeod²⁰, Xin Sun²¹, Wen Wang²¹, Reed A C Siemieniuk^{22

23}

Affiliations

¹ Academic Centre for General Practice, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
² CEBAM, Belgian Centre for Evidence-Based Medicine, Cochrane Belgium, Leuven, Belgium.
³ Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada L8S 4L8.
⁴ Division General Internal Medicine & Division of Clinical Epidemiology, University Hospitals of Geneva, CH-1211, Geneva, Switzerland.
⁵ Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center; Division of Allergy and Infectious Diseases, University of Washington.
⁶ Dutch College of General Practitioners, Utrecht, The Netherlands.
⁷ Care and Public Health Research Institute, Department Family Medicine, Maastricht, The Netherlands.
⁸ Division of General Pediatrics, University Hospitals of Geneva & Faculty of Medicine, University of Geneva, Geneva, Switzerland.
⁹ Bali District Hospital, Bali, and Centre for Development of Best Practices in Health, Yaounde, Cameroon.
¹⁰ Oslo University Hospital, Blindern 0317 Oslo, Norway.
¹¹ MOH Holdings, Singapore, Singapore 099253.
¹² Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
¹³ Norwegian Institute of Public Health, Oslo, Norway.
¹⁴ Department of Paediatrics, Universidad de Antioquia, Medellín, Colombia.
¹⁵ Department of medical microbiology and infectious diseases, Sacré-Coeur Hospital, University of Montreal, Montreal, Quebec, Canada.
¹⁶ Department of Dermatology, Ghent University Hospital, Ghent, Belgium.
¹⁷ BI Norwegian Business School, Oslo, Norway.
¹⁸ Medellín, Colombia.
¹⁹ Department of Family Medicine, McMaster University Medical School, Hamilton, Ontario, Canada.
²⁰ Schwartz/Reisman Emergency Medicine Institute, Sinai Health System; Department of Family & Community Medicine, University of Toronto, Ontario, Canada.
²¹ Chinese Evidence-based Medicine Center and CREAT Group, West China Hospital, Sichuan University, Chengdu 610041, China.
²² Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada L8S 4L8 reed.siemieniuk@medportal.ca.
²³ Department of Medicine, University of Toronto, Toronto, Ontario, Canada.

PMID: 29437651
PMCID: PMC5799894
DOI: 10.1136/bmj.k243

Antibiotics after incision and drainage for uncomplicated skin abscesses: a clinical practice guideline

Mieke Vermandere et al. BMJ. 2018.

. 2018 Feb 6:360:k243.

doi: 10.1136/bmj.k243.

Authors

Affiliations

¹ Academic Centre for General Practice, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
² CEBAM, Belgian Centre for Evidence-Based Medicine, Cochrane Belgium, Leuven, Belgium.
³ Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada L8S 4L8.
⁴ Division General Internal Medicine & Division of Clinical Epidemiology, University Hospitals of Geneva, CH-1211, Geneva, Switzerland.
⁵ Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center; Division of Allergy and Infectious Diseases, University of Washington.
⁶ Dutch College of General Practitioners, Utrecht, The Netherlands.
⁷ Care and Public Health Research Institute, Department Family Medicine, Maastricht, The Netherlands.
⁸ Division of General Pediatrics, University Hospitals of Geneva & Faculty of Medicine, University of Geneva, Geneva, Switzerland.
⁹ Bali District Hospital, Bali, and Centre for Development of Best Practices in Health, Yaounde, Cameroon.
¹⁰ Oslo University Hospital, Blindern 0317 Oslo, Norway.
¹¹ MOH Holdings, Singapore, Singapore 099253.
¹² Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
¹³ Norwegian Institute of Public Health, Oslo, Norway.
¹⁴ Department of Paediatrics, Universidad de Antioquia, Medellín, Colombia.
¹⁵ Department of medical microbiology and infectious diseases, Sacré-Coeur Hospital, University of Montreal, Montreal, Quebec, Canada.
¹⁶ Department of Dermatology, Ghent University Hospital, Ghent, Belgium.
¹⁷ BI Norwegian Business School, Oslo, Norway.
¹⁸ Medellín, Colombia.
¹⁹ Department of Family Medicine, McMaster University Medical School, Hamilton, Ontario, Canada.
²⁰ Schwartz/Reisman Emergency Medicine Institute, Sinai Health System; Department of Family & Community Medicine, University of Toronto, Ontario, Canada.
²¹ Chinese Evidence-based Medicine Center and CREAT Group, West China Hospital, Sichuan University, Chengdu 610041, China.
²² Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada L8S 4L8 reed.siemieniuk@medportal.ca.
²³ Department of Medicine, University of Toronto, Toronto, Ontario, Canada.

PMID: 29437651
PMCID: PMC5799894
DOI: 10.1136/bmj.k243

No abstract available

PubMed Disclaimer

Conflict of interest statement

Competing interests: All authors have completed the BMJ Rapid Recommendations interests disclosure form and a detailed, contextualised description of all disclosures is reported in appendix 2 on bmj.com. As with all BMJ Rapid Recommendations, the executive team and The BMJ judged that no panel member had any financial conflict of interest. Professional and academic interests are minimised as much as possible, while maintaining necessary expertise on the panel to make fully informed decisions.

Figures

**Fig 1**
Characteristics of patients and trials included in systematic review of the effects of antibiotics on uncomplicated skin abscesses. (MRSA = meticillin resistant *Staphylococcus aureus*; MSSA = meticillin susceptible *S aureus*)

**Fig 2**
Practical issues about use of antibiotics after incision and drainage of uncomplicated skin abscesses. (FDA = US Food and Drug Administration)

See this image and copyright information in PMC

Comment in

Guideline: TMP-SMX is recommended after uncomplicated skin abscess incision and drainage.
Aung K. Aung K. Ann Intern Med. 2018 May 15;168(10):JC50. doi: 10.7326/ACPJC-2018-168-10-050. Ann Intern Med. 2018. PMID: 29800426 No abstract available.

References

1. Stevens DL, Bisno AL, Chambers HF, et al. Infectious Diseases Society of America Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis 2014;59:e10-52. 10.1093/cid/ciu296. - DOI - PubMed
1. Liu C, Bayer A, Cosgrove SE, et al. Clinical practice guidelines by the infectious diseases society of america for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children: executive summary. Clin Infect Dis 2011;52:285-92. 10.1093/cid/cir034. - DOI - PubMed
1. Mistry RD. Skin and soft tissue infections. Pediatr Clin North Am 2013;60:1063-82. 10.1016/j.pcl.2013.06.011. - DOI - PubMed
1. Barbic D, Chenkin J, Cho DD, Jelic T, Scheuermeyer FX. In patients presenting to the emergency department with skin and soft tissue infections what is the diagnostic accuracy of point-of-care ultrasonography for the diagnosis of abscess compared to the current standard of care? A systematic review and meta-analysis. BMJ Open 2017;7:e013688. 10.1136/bmjopen-2016-013688. - DOI - PMC - PubMed
1. Daum RS, Miller LG, Immergluck L, et al. DMID 07-0051 Team A placebo-controlled trial of antibiotics for smaller skin abscesses. N Engl J Med 2017;376:2545-55. 10.1056/NEJMoa1607033 - DOI - PMC - PubMed

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Antibiotics after incision and drainage for uncomplicated skin abscesses: a clinical practice guideline

Affiliations

Antibiotics after incision and drainage for uncomplicated skin abscesses: a clinical practice guideline

Authors

Affiliations

Conflict of interest statement

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Medical