They stated: “ A conclusive, multicenter, double-blind, randomized, placebo-controlled clinical trial is lacking and sorely needed.” It identified that there was very little high quality evidence available on the subject. We covered a review by Hankin and Everett from 2007 on SGEM#13. The SGEM bottom line from that review was that irrigation is probably not necessary ( SGEM #156: Working at the Abscess Wash).Īnother issue that has been debated over the years is if antibiotics should be routinely prescribed after I&D.
We recently looked at whether irrigation of a cutaneous abscess after I&D reduces the need for further intervention. One issue was whether or not to pack after I&D? Our bottom line in 2012 was that routine packing of simple cutaneous abscesses might not be necessary ( SGEM#13: Better Out than In). He denies any allergies to antibiotics and has taken Sulfa drugs in the past without complication.īackground: Cutaneous abscesses are a very common complaint in the emergency department and we have discussed the management of these before on the SGEM.
He says that he has heard that antibiotics may not be necessary after his friend had an incision and drainage (I&D) and they did not give her any antibiotics. He cares about providing TOTAL care everywhere and wants us all to be excellent when we see and treat out patients.Ĭase: A 40 year-old male with a history of MRSA presents complaining of an area of redness and swelling consistent with an abscess developing on his arm. He has recently started podcasting and is always looking to expand this new project. He has a new blog called TOTAL EM, which stands for Tools Of the Trade and Academic Learning in Emergency Medicine. He has international experience in critical care and emergency medicine. Guest Skeptic: Chip Lange is an Emergency Medicine Physician Assistant working primarily in rural Missouri in community hospitals.
Trimethoprim–Sulfamethoxazole versus Placebo for Uncomplicated Skin Abscess.