• Adam J Singer and Henry C Thode.
• Department of Emergency Medicine, Stony Brook University, Stony Brook, New York, USA.
• Emerg Med J. 2014 Jul 1; 31 (7): 576-578.

BackgroundOver the last decade, there has been a significant increase in the number of cutaneous abscesses. While there is general agreement that abscesses should be treated with incision and drainage, it is unclear whether systemic antibiotics should be routinely prescribed.ObjectiveTo evaluate whether systemic antibiotics, when compared with a placebo, improve cure rates in patients with simple abscesses after incision and drainage.Methods DesignSystematic review and meta-analysis using RevMan5.Patients And SettingsChildren and adults with simple abscesses treated in outpatient clinics or emergency departments.Data SourcesCochrane Central, Medline, Embase and bibliographies.Outcome MeasuresPercentage of patients with complete resolution of abscess without the need for recurrent incision and drainage, additional antibiotics, or hospital admission within 7-10 days of treatment.ResultsWe included four trials, consisting of 589 patients in total (428 adults and 161 children). Patients were randomised to one of three antibiotics (cephridine (27), cephalexin (82), or trimethoprim sulfamethoxazole (161)) or to placebo (285), with 34 lost to follow-up or having incomplete data. When given in addition to incision and drainage, systemic antibiotics did not significantly improve the percentage of patients with complete resolution of their abscesses 7-10 days after treatment (88.1% vs 86.0%; OR 1.17 (95% CI 0.70 to 1.95)).ConclusionsWhen given in addition to incision and drainage, systemic antibiotics do not significantly improve the percentage of patients with complete resolution of their abscesses.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

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