Antibiotics for simple skin abscesses: the new evidence in perspective

Two studies, both published in New England Journal of Medicine in the last 2 years, go a long way in answering, once and for all, whether antibiotics are beneficial after incision and drainage (I&D) of simple skin abscesses. This is an age-old question in emergency medicine and one that grew more urgent with the emergence of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) in the late 1990s and early 2000s. While CA-MRSA can cause serious invasive infections, it predominantly causes skin and soft tissue abscesses, mostly simple furuncles in young, healthy patients. Between 1997 and 2005, for example, ED visits for skin and soft tissue infections rose more than 50%, with 59% of culturable infections due to MRSA.1 Do all these furuncles we are now seeing really require a prescription for MRSA-active antibiotics?

'A strategy of routinely treating all skin abscesses with adjunctive antibiotics seems perfectly justified'.

There have...

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